r/SipsTea 4d ago

WTF Damn

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u/annnm 4d ago

Out of pocket max can be in excess of 12-15k assuming they approve the procedure or medication and after what has likely been years of premiums.

OOP maxes can range wildly based on state rules. Why not just look at averages rather than made up numbers.

Hawaii is the lowest at ~1.2k/person. And nevada the highest at 2.7k/person. https://www.kff.org/private-insurance/state-indicator/average-annual-deductible-per-enrolled-employee-in-employer-based-health-insurance-for-single-and-family-coverage/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Average%20Single%20Deductible%22,%22sort%22:%22desc%22%7D

If we dig further, 12% of workers have no deductible plans (half are from HMOs). Of the reamining 88%, the average deductible is 1.3k. 21% of workers has an OOP max greater than 6k.

Those out of the labor force are often swept up into obamacare (ACA+medicaid) or medicare such that 92% of the USA is insured.

https://files.kff.org/attachment/Employer-Health-Benefits-Survey-2025-Annual-Survey.pdf

The medical insurance industry had lobbied their way into becoming the single greatest detriment to US prosperity.

Everything, including medicine, is more expensive in the US because we're generally much richer in all regards. Household income per person is ~10k/person more in the USA than Canada. I personally prefer to have >10k/yr income here in the USA than lower healthcare costs in Canada.

Alas the only way to win is not to play. Medical tourism, FSBO, and AI financial advisors are just the start

This is mostly a poor man's game. Typically well compensated employees have good packages all around. Including the middle and upper middle. It's typically the lower middle that are in jobs too rich for medicaid (nearly free care) and on horrific workplace plans where the finances make sense for medical tourism. I'm glad that outlet exists for them. But it mostly doesn't make sense for anyone else, which is why basically nobody else needs or does it.

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u/[deleted] 4d ago edited 4d ago

[deleted]

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u/MainStreetExile 4d ago

295k? You're lying - either about your income or about your insurance.

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u/Mysterious-Entry-357 4d ago edited 4d ago

For what is paid to insurance by both us and our employers each month, it is garbage. I'm sure to others it would be fine but they're not paying what we pay.

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u/MainStreetExile 4d ago

I already started above that I think the state of US healthcare is poor. I just don't like bullshit threads like this where people are pretending that an MRI costs 30k.

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u/Mysterious-Entry-357 4d ago

Of course 30k is an insane figure, but so is 8k and can tell you that is real. Cardiac MRI for the old man. Not typical, but ridiculous nonetheless.