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I am curious on this insurance thing.

I live in Norway, and privat health care is sort of frowned up on. Our goverment principle is that everyone is entiteled to health care regardless of income. If you spend more than about 200 USD on deductibles you will have a free pass for the rest of the year, meaning health care won't cost you anything other than medication. And even that can be prescribed free of charge if you have a chronic ilness that requer medication. F.ex metformin is free for diabetic patiens.

I am very glad to live in this health care system. Even though things might take some time. That is one of the reasons I decided to pay for my own operation, because I didn't have "time" to go through all the public paper mills nd I just bought myself to the front que abroad.. We have health insurances, but that is mainly as an insurance that in case you lose income, you'll get some sort of payment to compencate for loss of it. F.ex if I break a leg or get cancer and lose my job, my insurance will cover the difference bwtween benefits (around 65% of my yearly income), meaning the insurance will cover 35% so I can keep living my life like I'm used to.

SO; US citizens or other; What does a health care insurance cost you? Is it "the more you pay the more it covers"?

Can everyone get an insurance? Do you have to have an employer? What's the hops on this? What is the coverage? Do one have to "buy" an insurance that covers bariatric surgeries and will you get it approved if you were already obese or sick when signing on the insurance?

Edited by MsMocie

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1 hour ago, MsMocie said:

I am curious on this insurance thing.

I live in Norway, and privat health care is sort of frowned up on. Our goverment principle is that everyone is entiteled to health care regardless of income. If you spend more than about 200 USD on deductibles you will have a free pass for the rest of the year, meaning health care won't cost you anything other than medication. And even that can be prescribed free of charge if you have a chronic ilness that requer medication. F.ex metformin is free for diabetic patiens.

I am very glad to live in this health care system. Even though things might take some time. That is one of the reasons I decided to pay for my own operation, because I didn't have "time" to go through all the public paper mills nd I just bought myself to the front que abroad.. We have health insurances, but that is mainly as an insurance that in case you lose income, you'll get some sort of payment to compencate for loss of it. F.ex if I break a leg or get cancer and lose my job, my insurance will cover the difference bwtween benefits (around 65% of my yearly income), meaning the insurance will cover 35% so I can keep living my life like I'm used to.

SO; US citizens or other; What does a health care insurance cost you? Is it "the more you pay the more it covers"?

Can everyone get an insurance? Do you have to have an employer? What's the hops on this? What is the coverage? Do one have to "buy" an insurance that covers bariatric surgeries and will you get it approved if you were already obese or sick when signing on the insurance?

there are about a billion different policies - all different - some are provided by your employer, or if your employer is small enough and doesn't legally have to provide it, then you can buy your own.

costs are all across the board. Deductibles are all across the board. What you have to pay once you've met the deductible is all across the board. This is what makes US health care such a nightmare.

as for mine, I have a $500 deductible. Once I meet my deductible, I pay 10% of whatever the cost is. There IS an out-of-pocket limit meaning whenever you get to that point, everything is paid 100%, but I almost never get that high (I think one of the few times I did was the year I had bariatric surgery)

I don't think there's a "typical" health insurance policy, though, so there's not really an "average".

as far as bariatric surgery goes, some policies cover it, some don't.

oh - and most people have to pay a monthly amount, even if the insurance comes with their job. I think ours is around $250 a month. We didn't have to pay anything per month originally, just the deductible, but that was YEARS ago.

for example, if my surgery was $30,000, I would pay the first $500, plus 10% of whatever is over $500. I can't remember what our out-of-pocket limit is, but let's say $5,000. So once I've paid $5000 of my own money, then insurance pays 100% of anything over that.

Edited by catwoman7

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Yep, that's about right. It's insane how individual the requirements are. My personal insurance is through the school district but mandated by the state. I pay about $100 per month for just myself to be covered for medical, to the tune of $1200 off my paychecks each year. I didn't cover the family, as we are all covered by my husband's union insurance as well. He pays a percentage per hour, but it's paid by his employer over his hourly wage, so we never have seen it on his paycheck, so it never feels like an expense to us since it's negotiated and run by the union.

My insurance deductible is $200 per year. My husband's insurance deductible is $200 per year. Anything I'm billed goes first to my insurance, which pays 85% (leaving me responsible for 15%) and then to my husband's, which would have paid 80% so they cover the remaining 15% then put the leftover 65% they would have paid into a health savings account for me if I lose my other insurance. So basically once I meet those deductibles, I'm covered for 100% of medical charges. Up in the air are the co-pays my insurance has ($75 for Emergency visits and $200 for In-patient hospital, which are normally due at time of service). My husband's insurance doesn't have any co-pays upfront, so if I have to pay those things, I might have to submit reimbursements for those fees, such as when I'm admitted to the hospital for my VSG surgery.

The upside, neither of my insurances have any requirements for weight loss programs for bariatric surgery if I meet the BMI/comorbidity levels and they have very similar plans for what is allowed versus not allowed for coverage.

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My first consult was January 30th and dietitian Feb 6th. I needed an EKG, Labs and medical clearance from my primary. My surgery is May 13th, earliest date I could get because he is booked solid.

I do not have coverage for weight loss surgery BUT it is needed for a hiatal hernia. My doctors are confident what they can get it approved on appeal (we know it will initially be denied).

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Paying out of my own pocket and using insurance out-of-network benefits for a portion of it, so I scheduled literally the day after I submitted a consult application to the surgery center.

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My first consult was January 27. Insurance required 3 visits (90 days). Finished those last week of April. Insurance approved a week later. Surgery is scheduled for June 11. So overall about 4.5 months for me.

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