this post was submitted on 30 Sep 2023
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U.S.A., I have a "high deductible PPO" plan, more or less what my parents would have called "Major Medical".
It covers only some preventative care, for $0 out of pocket, whatever is mandated by the government basically so annual wellness, annual woman-care, birth control, one dermatologist visit.
Then nothing, until we spend some ridiculous amount in one year, I think it's $7,000? At which point it starts paying 80% until we have paid an even bigger $, then it pays 100%.
So we don't have healthcare, exactly, we have limited liability for healthcare cost.
Specialist I can just schedule, do not need to be referred by GP. Prescriptions are subject to that same high deductible.
This plan costs, out of my paycheck, kind of a lot for family coverage, and employer puts back some of it onto a "health savings account" that can be used to pay towards the cost. Not anywhere near that $7k but some, and what is not used stays in there. I also put money in that account out of my paycheck to build it up so that when we do eventually have a bad year again, the money will hopefully be there to use.
Yes it's complicated.
This is the plan the vast majority of people in the US have. It's dogshit.
Yes it is. And besides the premium and other costs, we also pay taxes for care for the sickest and the oldest. These private insurers are cherry-picking the group they insure and still charging the outrageous fees, raking in profit and outsourcing the more expensive groups to the rest of us to pay for. So I get about half of my paycheck as netpay after medical, tax, HSA and 401k; same as someone in a socialized nation, but without the assurance of healthcare or a pension.