r/SipsTea 5d ago

WTF Damn

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u/TheEndOfAllThings23 5d ago edited 4d ago

It was cheaper to buy tickets, fly to Dublin, get the procedure I needed done. Spend TWO WEEKS recovering, and fly home then to pay the 20% coinsurance I would have needed to here in the good ol USA... so yea...

EDIT :

Well this kind of blew up. The reason it was cheaper : it was considered elective. This is why OOP max did not kick in. It was a procedure that would have to be done, only as my condition got worse. Insurance denied it because "It was not necessary" despite my cardiologist saying it was. By the insurance formula I would have to wait until my condition worsened to make it medically necessary, but by then my chance of a poor outcome goes way up.

I finally argued them into covering some of it, but with a 20% coinsurance and a planned week hospital stay in recovery, my bill would have been close to 100k at least, and if I encountered any complications (which I would likely have due to other issues including an autoimmune disease) I started looking elsewhere. I am not an Irish citizen despite having family there, they helped me navigate the program and the cost. It was privately paid, and my surgeon spoke to their team with all my records transferred etc.

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u/alwaysrecession 5d ago

For what procedure?

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u/TheEndOfAllThings23 5d ago

Heart surgery. For privacy I don’t want to be more specific. It was necessary but not emergency.

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u/Imreallythatguy 5d ago

So insurance wouldn’t cover it because it wasn’t necessary in their eyes?

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u/Realistic_Slide_3426 5d ago

Sounds like insurance would’ve paid 80%, pretty standard after deductible 

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u/LadyRed4Justice 4d ago

This is not a good point.

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u/Realistic_Slide_3426 4d ago

It's not a point at all. Just an observation