I am really trying to find out the truth behind USA healthcare. I've never had to use it extensively, but obviously many have, and I'd love to hear your experience with financing your care.
For example, suppose you are insured with Blue Cross and have an out-of-pocket max of 9k per year, which means that once you pay that amount out in a single year, the insurance company should cover the rest. But, that is of COVERED services only, IN NETWORK. So, how many services are usually not covered? Are many services required often out of network? Have you heard of people (or have experienced yourself) spending far beyond the out-of-pocket max of their insurance to cover their medical care? Is that normal? Or, could one count on the 9k being the MAXIMUM charges one could theoretically incur in a given year?
We hear all the time that even medically insured people go broke if they get really sick. It's well-documented. But why? Is that because they can't afford their out of pocket max each year? Or, are they paying thousands and thousands beyond their out of pocket max because a) some services are out of network and hence not covered, 2) insurance companies simply reject claims if they think they can get away with it, 3) patients choose for themselves services not covered by their insurance?
Are the bankruptcies due to people hitting 9k every year out of pocket and not being able to afford that? Or are they getting bills like crazy that are uncovered even though they have insurance? Which one of these is true?
Would appreciate any stories of real experiences either for yourself or for those you know. I am trying to financially plan for the future and possibly purchase private insurance, but would like to know whether I am at risk of bankruptcy if I ever got really sick. Or, am I most likely out 9k per year? (that I can plan for and afford if I set up my finances right).
What is the bottom of the truth here? Would appreciate responses as well from healthcare workers who know the system very well, are people going broke because they can't afford out of pocket max? Or because out of pocket max is an illusion if you get really sick or injured?
Thanks!
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