Medical insurance for US 'resident' long-term cruisers

[Sawbonz]

I did it for a living for a long time. Even though I have retired from the business I still have some connections and yes, narrow networks are a thing, but not too many docs get to bill the “rack rate” because very, very few would pay it. And THAT’S only if that rate was somewhat reasonable. Insurers typically pay a percentage of Medicare. In my area it was only a very miserable 80-90%, but that stated bill of $200k plus would be probably 40-50 TIMES any Medicare allowable. If the insurer didn’t have a contract with that doctor and paid some “usual and customary” number they bought from somewhere else the patient is still liable for the difference. I can see no reason why they wouldn’t have pursued that if due.

[sagablu]

Originally Posted by Sawbonz

I did it for a living for a long time. Even though I have retired from the business I still have some connections and yes, narrow networks are a thing, but not too many docs get to bill the “rack rate” because very, very few would pay it. And THAT’S only if that rate was somewhat reasonable. Insurers typically pay a percentage of Medicare. In my area it was only a very miserable 80-90%, but that stated bill of $200k plus would be probably 40-50 TIMES any Medicare allowable. If the insurer didn’t have a contract with that doctor and paid some “usual and customary” number they bought from somewhere else the patient is still liable for the difference. I can see no reason why they wouldn’t have pursued that if due.

The claim in question was for an in-network physician. Nothing was due beyond the plan deductible and co-insurance. Just an example ( I could give many) of the insane price of care in the US. I have been giving talks to the medical students and newly minted Dr's at a University near me regarding healthcare reform and the state of the US system. Even they are shocked at some of these costs. They are even more shocked when I show then that a procedure reimbursed at $22,000 procedure under commercial insurance is paid at $1900 under Medicare. They are not so keen on single payer after that. One girl cried.

[arsenelupiga]

Originally Posted by sagablu

The claim in question was for an in-network physician. Nothing was due beyond the plan deductible and co-insurance. Just an example ( I could give many) of the insane price of care in the US. I have been giving talks to the medical students and newly minted Dr's at a University near me regarding healthcare reform and the state of the US system. Even they are shocked at some of these costs. They are even more shocked when I show then that a procedure reimbursed at $22,000 procedure under commercial insurance is paid at $1900 under Medicare. They are not so keen on single payer after that. One girl cried.

yeah cried from happiness to be in such a well paying profession.

why would anyone have us insurance when heading overseas. Everywhere costs are much cheaper, so just pay cash.

[sagablu]

Originally Posted by arsenelupiga

yeah cried from happiness to be in such a well paying profession.

why would anyone have us insurance when heading overseas. Everywhere costs are much cheaper, so just pay cash.

She cried because she had $400K in student loans and her out of touch with reality professor made them think that single payer was shortly coming to the US. What he didn't say and didn't know is what are the financial implications of it.

Anyway, you are correct, if you are not in the US, don't pay for insurance based on those costs.