I have been working for a new company for a year now, and have been on their insurance through Aetna the entire time. It’s the first time I’ve had health insurance through work.. So I’m paying monthly out of my check for the health insurance, but then im still going to owe my health provider out of pocket at the end of the year if i don’t pile up enough medical bills?
In: Economics
Be aware, USA health insurance is bad and many argue a racket/scam. I’ve been told this by people who **work** in insurance.
So yes, it’s confusing because that’s how the system is built.
•you pay a “premium” which is the monthly cost for insurance “coverage.” Premium = monthly charge— aka your paycheck deduction monthly.
•go to doctor, that doctor sends a bill to insurance company.
•insurance company pays a *percentage* if that doctor bill. The scam here is that percentage is sometimes 0% and rarely 100%.
•insurance will pay that percent
•you owe the other percent.
Example: doctor visit costs $250. Insurance pays $220 for it, so (250-220=30) so you owe $30 to the doctor.
There are a lot more vocabulary terms Involved and it’s more annoying than anything. Also this is NOT exactly how it works but an over-simplified version. There are many ways insurance will pay for your bills— sometimes a percent, sometimes all of it, sometimes all of it minus a few dollars (leaving you with a $[some integer like 30] “copay”). Or it can pay $200 of a $10,000 bill, leaving you with $8,800 to pay
Tldr you effectively pay insurance for a “chance” at them paying your medical bills. It’s almost like a lottery, will they pay the bill in full or not? Also remember it’s built in part to scam (insurance employee words, not mine).
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