trying to figure out where I'm going to get the money for my obamacare

[ieoeja]

93. Can anyone explain what a medical deductible even is?

The problem, my dear datasuspect, is that you do not -- no offense intended, but to be brutally honest and hopefuly helpful -- you apparently do not know how medical insurance works. In all the ACA discussions, I've never seen mention of the dirty, little secret that once you have insurance, everyone tends to ignore the rules of that insurance.

To your benefit!

When I have had to use car insurance, I had to pay the deductible amount before the insurance would kick in. But not so with medical. Everything goes to insurance first.

I have a $400 deductible. But I have never, ever seen it applied. To anything. Not to surgery. Not to doctor visits. Nada.

Disclaimer: I've never had a hospital stay. I think it might apply to that.


I sometimes pay a copay. More often than not, they waive the copay.

Then I get a bill. Since you are new to the insurance game, let me pass along what I long ago learned is rule #1 when receiving the first bill following a medical procedure:

[font size=2]Always Ignore the First Bill[/font]

The medical industry has pre-negotiated rates insurance companies. Those rates are lower than the rates people without insurance are charged. Your first bill will not reflect that rate. Nor will it reflect the fact that they have already sent the same bill to your insurance company.

I suspect they trick a lot of people into paying a bill this way that patients would not otherwise have to pay.

Next, you will probably receive an itemized statement including the insurance information (I did not last time which caused some confusion). This statement should include:

- initial charge
- insurance agreed rate
- insurance payment
- the portion you are supposed to pay

This will probably come from your insurance company, not from medical. As you do not make medical payments to your insurance company:

[font size=2]Store and Ignore[/font]

Wait til you get a 2nd bill from medical. Chances are, you won't. I usually don't. They're generally satisfied with what they get from insurance, and don't want to bother with it after that.


You know, they actually offer Associates Degrees in "Medical Billing". That is how totally fucked up it is. But if you follow the above rules, you should be in the clear. And end up paying very little for actual medical care.


Unless they put you on a prescription. Then you're royally fucked. But that is a whole other can o' beans.