I use to go to therapy and see a psychiatrist but I am scarred from all these insurance problems. this is usually how it goes…I sign up to see a doctor, for instance in this case a psychologist. I ALWAYS ask before hand what the copay is. I’m told “your copay is going to be 50 dollars”. I thought that meant it was all I had to pay. Few months later I get a bill in the mail saying I have to pay 100 dollars on top of the 50 for each visit for some reason I don’t understand. Same thing with going to therapy, I’m getting charged an extra 100 or bills MONTHS down the line for when I was told the copay was gonna be 30 for each session. Why in the hell would I even take the visit in the first place if I knew I was going to pay 150? I feel like I’m going crazy, why are these people not telling me what I actually have to pay when I make the visit? Do I just not understand how insurance works?
I’m a broke college student and being hit with these bills is killing me. And there’s nothing I can do about it because they have my card on file. I tried to better myself for a year and now I’m full of regret because these random bills don’t stop. I feel like sueing these companies because how can you tell someone “hey all you need to pay is this 50 dollars to get treatment actually sike it’s 300!”
why do I feel like I’m constantly getting scammed? I HATE insurance.
byu/Cultural_Cap7084 inInsurance
Posted by Cultural_Cap7084
11 Comments
Insurance is a total scam. We’re all fucked. The system is fucked and stacked against us. Not much we can do about it other than move to another country that actually has decent health care.
This isnt being scammed. This is not knowing how it works.
Everytime you visit you have the copay.
The other number to pay attention to is the out of pocket deducitable. This is your.total out of.pocket that you need to pay before insurance takes over full payment minus the deductable.
This deductable amount varies from person to person due to specifics chosen.
I think mine is $1,500 per person on my policy.
The person on the other end of the phone is answering the question you’re asking. How much is my co-pay is what you’re asking not how much will my visit cost me which is what you should be asking. Nobody scamming you.
Please for the love of god just call and ask why you’re being charged. While you’re at it ask what else you may be charged with.
Knowledge is power.
But I agree, these ins. companies are something else to deal with. Your not alone. Not to mention they change plans every year.
You watch too much TV to think the answer is to “sueing these companies”.
Welcome to the real world. You have to read the fine print. Therapy sessions probably have a different copay than your doctor visits.
Read your insurance plan’s SBC. You can see it in your insurance carrier’s online account.
Not an expert in health insurance, but I feel your pain. As someone coming out of relatively poor health that required tests and things, I get bills like this all the time. I’m used to it, and I’ve learned to ask some more questions like making sure everyone is “in-network,” from the surgeon to the janitor. Only slightly kidding about the janitor.
But you’ll get there with time. It does feel like a scam, but they put these things in fine print. Of course, they’re kind of banking on you not reading the fine print. Which is a hard lesson to learn, but it is unfortunately a part of this phase of your life. Learn to ask about the details before you sign your name to anything.
There is a difference between copay and coinsurance.
Copay is the fixed, upfront payment you make at the appointment. This does not cover the cost of the treatment.
Co-insurance is the amount you pay (usually a %) of the billed amount. This is usually charged after. This % varies based on your insurance plan.
For example, suppose you have a $20 copay, and your insurance plan says you need to pay 30% coinsurance. If each visit the doctor charges $200, you owe 30% of of that, so $60. Since you already paid $20, you would be billed on the difference , which is $40. This holds true until you reach your deductible, after that the %s may change.
I highly recommend you call your insurance and have them explain your plan to you. Then, log into your insurance website, and look at the claims to see what you are being billed for each visit.
It isn’t always fully accurate but take pics of your insurance coverage through and ask for it to be explained for each use like what if info to the ER for a broken bone, what about urgent care, how about a psych appointment. Ask pitfalls to look out for.
It’s annoying how much work you have to put in to make sure they are billing you correctly, and to make sure you follow all their arcane rules.
You have to study whatever plan you are on, then ask for a either detailed invoice of where all these $50 bills come from or if you can get a human on the line, ask them similar questions. Also log onto the healthcare website and look at their EOB.
I like to look at as many details as I can find before calling so I am prepared.
Just today, my wife texted me (she works, I am retired) to “take care of, as she should not have been billed” a $90.00 bill the hospital she had surgery texted her. I hate this sort of work, but she can’t call and be put on hold while it means little to me, I could be playing a game while holding.
This surgery was related to a workman’s comp claim.
So I first logged on to the hospital website to see what details that it provided. Ok the bill was for a crutch.
Then called the billing dept, and ask why wasn’t this filed under workman’s comp? She asks what is the guarantor number, which is supposed to be on the invoice. My response is, I have no idea since we are paperless. I do ask where it is on the website, but that goes nowhere. So I explain about workman’s comp. She then asks me for details on workman’s comp policy, stuff like that.
I respond, the surgery was coved, it’s in your records, just look into your computer.
Ok, another 10 min hold, then she comes back on and says she will take care of it.
The explanation is equipment is billed separately, not that that should have mattered.
The missing link here is you never called your insurance to clarify anything about your policy. Never take your provider’s word for it, always always always check with insurance. They have customer service reps for a reason.