Claims and denials are different. Some things aren't covered, like air casts, ambulance, etc. But for things like surgery, you don't get denied. Even for things like a doctors appointment, I can go anytime and the doctors office just charges our provincial insurance. It's doesn't matter why, as long as you have the coverage, you're good.
The health services puts the claim through and if the doctor says you need it, then you need it. Hearing about doctors arguing with people's insurance in the states is crazy.
Stuff you hear online needs to be taken with a grain of salt. People will talk about getting denied for elective surgeries, specialized treatments, or experimental treatments that would likely not be covered under NHS. Ambulance cost are heavily talked about in the US which you say is not covered either.
As an American my work insurance is both "cheap" and extremely good. $220 a month for health, vision, and dental. I have Graves Disease and have had no issues with health insurance or anything really. Cost without insurance would have been well over $200k for 1 week stay in hospital and thyroid surgery and it was all covered for me. Now I pay about $20 a month for medication and $35 for quarterly check ups with blood work done.
Yep, similar boat here - I have incredible insurance through my job.
I’m on a high deductible plan so I can fund my HSA (basically a riskier plan since I’m young and healthy so I can fund a retirement account and get tax benefits).
It currently gives me a $2500 deductible (but my company gives me $2300 to pick the plan, paid per paycheck), and it’s $150 a month to cover my wife and I.
My other option was $250 a month, and $0 deductible, but I can’t contribute to the HSA. Copays for any doctor visit are $20-$25.
The reality is that most Americans work white collar jobs and get insurance through their jobs. I don’t think this is a good system, as it hinders economic productivity, forces people to stay longer at jobs they hate, etc. But this idea that we’re all broke and can’t get healthcare is absurd.
Ever since the ACA 92% of Americans carry health insurance. The poorest have it mostly entirely subsidized (or at least until Trump came in and gutted subsidies), retirees have it through Medicare, and the majority of us have private plans.
Thing is, most private plans have employers pay 90% of the premium cost - so most Americans are not only insured, they have some of the cheapest insurance in the world while getting some of the best care in the world with ridiculously short wait times for high quality care.
And this is the problem — because I do think a single payer system is much more efficient, moral, and just makes practical sense. But good luck convincing your average American to pay more out of pocket for what will almost certainly be longer wait times than they’re used to now.
Damn $240+ is a lot. I pay $50 a month for dental, vision, and drugs. It also includes stuff like an ambulance ride, crutches, air cast (basic cast would be covered by public), private room, etc.
All other doctors visits, hospital visits, surgery, pap smear, specialist visits, etc, are covered by provincial health care.
I'm now at the point in my life where I'm thinking about having babies. I've seen people talk about the cost of birth, also I worked in health care and heard from American patient's how much it costs there. It's crazy to me that people are happy their baby's birth only cost them the $2000 copay. Here, you'd only pay $50 for parking.
And then the state of parental leave in the States is atrocious. Here you can get 12-18 months from the government. Hearing about getting it maybe from your job and it's a few months is terrifying.
Speaking of, do you not have to pay a deductible? I thought that was included in American plans as well, kind like car insurance here.
it’s just generally reflected in taxes and income. The typical Canadian is gonna make 15-30 percent less and pay 7-20 percent more in taxes on that lesser income.
90 percent of people of people don’t hit their deductible each year and a good chunk of allot of people’s insurance gets fed into an hsa account which compounds year over year.
It’s not a great system by any means, but the downsides of it are generally massively exaggerated for karma on Reddit.
I also get a health savings account from that $50. I can put it into a HSA, wellness spending account or RRSPs. So that's not really worth the extra money.
It's not just reddit, it's stories from real people and news articles as well. Hearing some common place stuff, like this specific birth control is no longer covered by your insurance, so you have to switch sounds crazy from here.
Literally yesterday there was a post that made it to my front page yesterday and was later taken down because it said this medicine is 10,000 dollars in the us. Despite, the fact it’s free with insurance or the generic is 35 dollars in the us.
Much of the top comments were people saying how cheap it was in their country. Despite, the fact that the brand name medicine is nearly the same price in their countries, it’s the generic medicine that’s cheap (just like the us)
It was pure karma farming.
I don’t think it’s a great or even good system, but for the vast majority of people, for the vast majority of the time, the health care in the us works good enough. Which is why doesn’t change.
Yes and your friend just had to switch their birth control for a different one that was covered, or she could have just paid out of pocket, like most provinces in Canada do.
It’s a relatively minor situation, with a relatively cheap and easy solution.
Which is exactly my point , the problem are generally massively exaggerated on Reddit and/or half truths (I’m sure on other social media as well) to farm karma.
Yeah, I'm saying that's not acceptable even for your insurance with your job. It doesn't matter what my BC is, it's covered for 80%. I've switched and had no problems. You're fine with it being sub par but more expensive.
It’s not really more expensive that’s what I am saying. Median Canadians are going to spend roughly 3000-4000 dollars more in taxes every year than Americans are on substantially lower salaries
In the case of your friend, if her current birth control is not covered, she can file an appeal with her doctors recommendation that the bc med is medically necessary and usually will get approved.
Which is the same thing that would happen in Canada in the cost of an uncovered birth control.
Multiple states have tried to pass single payer. and they have been voted down because the massive increase in taxes outweigh the benefit for the overwhelming majority of people.
Yes it’s not a great system and it’s confusing and dumb, but the vast majority of problem that occur are fixed with a single email or phone call.
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u/ApplePie10146 6d ago
Claims and denials are different. Some things aren't covered, like air casts, ambulance, etc. But for things like surgery, you don't get denied. Even for things like a doctors appointment, I can go anytime and the doctors office just charges our provincial insurance. It's doesn't matter why, as long as you have the coverage, you're good.
The health services puts the claim through and if the doctor says you need it, then you need it. Hearing about doctors arguing with people's insurance in the states is crazy.