Im in the same boat. My out of pocket for some tests my wife had done was over $2,000 and I supposedly have decent coverage.
My employer switched to high deductible plans as our only option. I went from having a $0 deductible to a $6,000 deductible and my premiums only fell $16/mo. On top of that, I am on the hook for 25% of anything I have done, even when I meet my deductible. Basically Im laying out over $1k/mo to self insure. To say I am bitter about it is an understatement. I can actually buy the same coverage through Obamacare, for a little less money.
But insurance isn't the only thing pissing me off. It's the ridiculous "code sheet" that the medical provider community will not disclose and hides behind ("we don't set the code pricing"). It is price fixing, plain and simple, but they put the accountability off on a 3rd party that you cannot contact. Pretty effing convenient, huh?
And it's not even the doctors that are ripping you off, it's the medical facilities and ancillary services/products providers. Case in point - I want to have a minor outpatient surgery that will take about an hour in a generic outpatient office that is basically just another doctor's office that they keep clean. It's a surgery that will improve functionality after an injury I sustained a long time ago (no not my man-bits, or the back door you sickos). Call it a minor knee operation - it's a good example.
Doctor's charge - $4k, but my insurance knocks it down to like $2,800 and I would have to pay $1250 or so.
Facility cost? $23,000. Yes $23,000 for about 1 hr in a suburban strip office center. I think there's a freaking Remax agent in the next office. It's ridiculous. When I asked why the facility is charging almost 6 times what the GD surgeon is charging (you know the guy with the freaking KNIFE cutting me open), they gave me the "codes" BS. I worked my way up to the highest level administrator and point blank asked her to itemize that charge and she flat out refused to do so. So, to use their facility for 45-60 minutes (and they have no special equipment) I am going to have to pay $6,000 + $4,250 ($23k-$6k * 25%) = $10,250, and I won't even have paid the doctor yet. It's insane. Keep in mind I am already shelling out about $13.5k/yr for insurance.
Prior to getting that quote, I had watched a couple of youtube videos about people who had the procedure done, to see if it was worth the hassle of going under the knife. I contacted a couple of those people after I got the quote and asked them how much they paid out of pocket, and the ranges were from $100-$1200, all in. And none of them got a bill for more than $3k (before discounts and insurance) from the facility. They were horrified by my numbers. I'd gladly pay $1K or so for this procedure, but the facility cost is a non-starter.
Problem is - we have two huge health companies who control all medical pricing and procedures in my city - so when I tried to say screw you coke and called pepsi, I got pretty much the same quote.
So I am walking around with diminished physical well being/capacity, despite laying out so much money for insurance, not to mention the huge tax bills I pay.
The fact that I pay in so much money to the system and cannot afford a very minor outpatient procedure shows that this thing is utterly broken. And in my opinion - the biggest problem is on the provider side, not insurance. It's time to scrap the whole system and start over.
Cliffs:
- Insurance deductible way too high ($6k), price barely came down from $0 deductibe plan
- Doctor kinda pricey, but reasonable.
- outpatient surgery center: "bite the pillow, we're going in dry. HAHAHA"