In the US, how do people go bankrupt from medical bills when most insurance have a max out of pocket?

Question

Just was thinking about this the other day while looking at my insurance. How do people in the U.S. accumulate huge bills without hitting their max out of pockets? Are cancer treatments not usually covered by insurance? Are the doctors that provide the treatment just happening to be out of network?

I guess I’m wondering if there is anyway I can plan to not be in a situation of me or my husband rejecting treatment and dying or having huge medical bills cripple us. We’re relatively healthy now, but the future is near.

I’d like to understand better how it seems to be so *common* for people to not be covered by their out of pocket max.

Thanks.

In: 4623

Answer 1

You can have really bad insurance. You might have a deductible that’s like, 3k for family or 1k for individual. And sometimes the medical offices try to collect it when you see them. And then, after that, the insurance might only cover 70% of fees.

* so, once I noticed my nose was swollen. I go to ENT. My copay is 30, but they inform me I still have a 800 balance on my deductible that I have to pay. I tell them I can’t pay it and they try to deny me from being seen. So I call the insurance directly and they say I can pay 400 for now. So I pay 430. Turns out I had cellulitis in my nose. I was so close to leaving that day. I wasn’t making that much so 400 was a lot for me at the time. It’s ridiculous. Mind you I still owed 400 so I had to charge it and pay it off via my credit card.

* another time, again when I made less, I went to the dentist and I needed a root canal and implant. My out of pocket was 800 for the root canal and 3k for the implant. I literally paid 200 a month to the dentist for what seemed like forever- and after a while they started working on my teeth.

* both times my insurance premiums cost 250 a paycheck, before I got a job w the union. So on top of all those fees I was paying 500 a month.

* when I got the union job, insurance had no premium (nothing deducted from pay) the doctors weren’t the best but I never paid as much out of pocket again.