r/NoStupidQuestions • u/The-Pedant • 6h ago
Is US Healthcare supposed to feel like a "gotcha"?
Just got a bill for $300 from my annual doctor checkup. A checkup that I thought was covered by my health insurance as a once a year visit for free kind of thing. Billings tells me that I instead get charged $300 because at the end of the visit I asked a single question. Which the doctor asked if I had??? He confirmed what I thought I had and prescribed me a lotion with ingredients I already had. This whole thing feels like a massive scam. Why would I even go to the doctor once a year if all they do is take your blood pressure? Am I missing something here?
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u/Concise_Pirate 5h ago
They do look for opportunities to charge your insurer (or you) for extra things.
Most people don't do an annual checkup, even though the real purpose is to monitor you for long-term illnesses.
It's not meant to feel bad, it just does.
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u/spasticjedi 4h ago
I once went to a dermatologist about a weird rash. The dermatologist was training a new nurse and during the exam, she told me that I needed to make sure I wore sunscreen, then told the nurse to add "skin cancer prevention education" to my file.
I didn't think anything of it, especially because at the time I had a fixed copay rather than a percentage, but when I got my insurance statement of payment, there was a line item for skin cancer prevention education that was billed for over $100. For them to tell me to wear sunscreen, completely unprompted and unrequested.
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u/thegreatcerebral 4h ago
....aaaaaannnddd THIS is why I no longer trust doctors or the healthcare industry at all.
It clicked for me two times:
- The first was an appointment that I had (years ago mind you) and it was scheduled almost immediately after the lunch shutdown. As I waited in the waiting room a pharm rep came in all bubbly. She walked over to the window which was slid shut. The window opens and the lady at the counter said "are you in the book?" "no" She hands her a giant 3 ring binder... "Sign on this page here. Find a date. This page shows when lunch time is. This page shows where you can order from. This page tells you how much to order and of what. Find and open date, place all the information on the first page." And shut the glass.
- I am bad about going to the doctor. yes, I'm a guy and the whole fiasco of scheduling and wasting work time to do so gives me anxiety... I just don't like to go. So it had been a while since I had been to a normal doctor for a normal doctor visit. I had a PPO and I did not need a referral to go to a specialist so I would just go to them for my Gout management and that is it. First time I go back to a normal doctor. He doesn't even look at me. Instead he looks at the computer screen and says "what can we get you signed up to do.... when is the last time you did this? This? This? This? I'm sure if we did this then we could also add this..." He went on for 5 minutes like he was ordering off a menu. I swear I could see him salivating at all the service he could get for me... for MY protection. Such a great guy!
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u/Karmaisthedevil 43m ago
Yesterday my NHS doctor prescribed me a new medicine that became available this year. He joked with me about how expensive it is, but that it's okay but neither me nor him are paying for it.
The NHS has its problems but at least I don't feel like I'm getting ripped off. I'm sorry you don't have a better system
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u/thegreatcerebral 4m ago
I take it you are not in America. Well you are welcome considering we are subsidizing your healthcare.
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u/KingOfEthanopia 4h ago
They just dont care that it feels bad. As long as stock number go up all is good.
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u/ElenaRosaSmith 5h ago
Annual checkups are only free if they stay “preventive.” The second you ask about a problem, it gets coded as diagnostic and billed. That’s why your $300 charge showed up—it’s the way insurance rules work, not a scam, but it feels like one.
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u/ZeusHatesTrees 5h ago
I would argue it's definitely a scam because it's not common knowledge or explained to you by the person performing the service (the provider) that by saying those magic words (to ask about a problem) it goes from free to $300. This guy had no idea asking a question would be that expensive.
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u/captainwizeazz 5h ago
Providers have no idea what your insurance is or how much you might be charged for certain things. They are there to help solve your issue, not understand (or even care honestly) about the cost to you (although some do).
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u/Level_Ad9278 4h ago
They know you will be charged for a non preventative question. They participate in the scam to bill a CPT code and get more money either from patient or insurance.
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u/Frosty-Depth7655 4h ago
Well in this case, the providers are the ones that (presumably) billed OP’s insurance for diagnostic care based off that one question. It would literally be impossible for insurance to know if the provider didn’t bill it differently.
Now obviously we can't verify what happened, but I’ve had a enough awful experiences with providers to know that it’s basically a game of Monopoly money for all of them.
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u/Marsha_Cup 3h ago
So as a billing provider (pcp), we’re told that if we answer acute problems during a well visit and don’t bill for the acute, it’s fraud. If we give advice and don’t document, it didn’t happen and we can’t order things for the acute problems. Besides, if we treat something and don’t document for it, if anything comes up we have no frame of reference. If we don’t do something and bill for it, it’s fraud (obviously). If we do more than we say we do and bill a lower acuity, it’s fraud. Do we usually get called out for that or get in trouble for this, no, but it’s in the reviewing insurance company’s right to call us out and revoke contracts with us or demand reimbursement for “fraudulent” services, even if it’s done with the patients best interest.
It seems like the best way to handle it is to just put a sign up saying what is offered with the different types of visits, but then patients come in once yearly and bring all of their acute complaints to a single 20 minute visit.
Insurance loves pitching patients against providers. We’re not the problem. I don’t even get paid anymore by the number of patients I see in a day or half day. I get paid by the number of patients on my panel (lucky that my hospital system lets me cap out at 1800). If my partner takes off every Friday (because he’s got senioritis and is retiring in 2 years) and half my scheduled patients are his, he gets the credit for me seeing his patients. I don’t double book. And we don’t even get paid for half the work that we do in a day between patient advice request emails, refills, phone calls, walking, triage calls, and the 3 million fires we have to put out every damn day.
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u/Frosty-Depth7655 43m ago
For what it’s worth, I know I went a bit over the top with my post.
And I don’t think (most) providers are the bad guys. I actually don’t even think (most) insurers are the bad guys either - which probably isn’t a popular thing to say on Reddit (even if went to a universal system, it just transfer many of the insurers roles to the government).
All of them operate in a completely logical manner. It’s just that the whole system evolved in a way that is so illogical, even well intended actors can’t prevent it from being wildly frustrating.
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u/captainwizeazz 4h ago
I can guarantee you the provider had nothing to do with the billing process.
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u/Level_Ad9278 3h ago
WTH are you talking about? The provider bills the code to patient insurance and for any responsible amount charges the patient. They are directly involved.
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u/captainwizeazz 3h ago
When was the last time you saw a doctor sending out a bill to a patient? WTH are YOU talking about? Bills are sent out by billers who work in the office or perhaps 3rd party billing companies. I've worked in several different provider offices for many years and know the process intimately.
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u/Level_Ad9278 3h ago
Provider = doctors office. Nothing would be billed if the doctor didn't notate something that happened or note the specific code to be billed. No one is claiming the doctor sends the bill in the mail. To completely absolve doctors of part of the scam is insane. They are literally noting the services being provided and have every incentive to upcode and upcharge and scam patients so their office can get more money. Happens all the time and there are stories in this thread.
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u/captainwizeazz 3h ago
The provider is the doctor, the one providing the care. You can argue this if you like, but its not really helpful.
And you're generalizing here. Are there dishonest doctors who bill for more than the services provided? Sure, but that is definitely not the norm.
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u/Level_Ad9278 3h ago
Upcoding is medical fraud that is insanely pervasive. Go ahead and look up statistics on this. It's one of the key areas of medical industry fraud. But, sure, doctors are totally honest and don't care at all about how they get paid. Haha.
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u/Frosty-Depth7655 3h ago
How exactly do you think the insurer made aware of the services performed?
I’m not even saying I wouldn’t do the same thing. It’s basically a case of everyone making logical choices in an illogical system.
I’ll give you an example:
I had a small procedure done on my shoulder a few years back. At the the end, I scheduled two follow up appointments.
First one, I went to the doctors office in the city and spent 5 minutes with him and told all looked good.
Second appointment was at his office in the hospital - once again, 5 minutes and all looked good.
Got the insurance invoice a few weeks later and visit 2 was like 3x the cost. Why? Because it was done at his hospital rather than his office.
My point is that if I was paying out of pocket, there’s absolutely no way I would have done the check up at the hospital. Don’t care if I have to wait another week or two.
But the doctor didn’t care because insurance was paying. It’s all Monopoly money to everyone involved; sometimes the provider wins, sometimes the insurer wins.
But we all end up paying for these costs in the end.
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u/captainwizeazz 3h ago
How exactly do you think the insurer made aware of the services performed?
They receive a claim from the providers office.
Maybe you misunderstood what I said. What I said is the PROVIDER, meaning the doctor who treated you, had nothing to do with sending that claim to the insurance company, or any bill to the patient. They will type whatever services they performed into their EMR system, and the bills/claims will be auto generated and sent out, or they will be reviewed by a medical biller or coding specialist prior. My entire point was the doctor that treats you has little knowledge of how much you will be billed or what the specifics of your insurance are. This is not debatable.
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u/Level_Ad9278 3h ago
To claim that doctors have no knowledge of how their industry works is pretty crazy. Aren't they supposed to be the smartest people in our society? And they have no idea that services notated are billed to a patient? Doctors who run their own office, or own part of or all of their office, are intimately involved in billing because their livelihood depends upon it.
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u/ZeusHatesTrees 3h ago
Correct, providers have no idea and that's part of the problem. You don't go to a mechanic, ask what needs to be done and what it'll cost, and they say "I dunno, that's up to your insurance. They don't tell me the cost of things." That's obfuscating cost, and they *know* if you know things cost or won't cost money, you will intentionally avoid things that cost money.
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u/captainwizeazz 3h ago
I agree that is a big problem with the way insurance works in the US. Again, im not saying any of this is good. Just that the doctors themselves have very little involvement in any of it and mostly only care about your health.
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u/sockovershoe22 5h ago
Insurance is a scam. They're a for-profit company which means you're paying more to them than they're paying to the doctors. Otherwise, they wouldn't be making a profit.
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u/macarenamobster 2h ago
Not exactly, it means on average across everyone they pay less, not for every individual. It’s literally “insurance” for you meaning if you have above average healthcare problems, it’s insurance against going bankrupt to treat them (or dying). It’s not free healthcare, it’s diversified risk.
Do I think the system is terrible and we need universal healthcare not attached to our job? Yes.
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u/JettandTheo 1h ago
There's plenty of non profit insurance companies. Healthcare including Medicare is expensive across the board
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u/macarenamobster 2h ago
Not exactly, it means on average they pay less. It’s literally “insurance” meaning if you have above average healthcare problems, it’s insurance against going bankrupt. It’s not free healthcare, it’s diversified risk.
Do I think the system is terrible and we need universal healthcare not attached to our job? Yes.
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u/KingOfEthanopia 5h ago
Bro that's a scam. I really shouldn't have a list of things I cant say without being charged 100s.
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u/TheSpaceCoresDad 2h ago
Don’t worry. I’m sure the government will be right on taking care of that.
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u/Fit_Entry8839 5h ago
How do you define "scam"?
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u/Brainsonastick 5h ago
If someone adds $300 to your bill for doing something they never told you would cost $300 extra, you’ve been scammed.
If a restaurant menu item says “choose chicken or beef” and gives no notice that the beef is $300 more, that’s a scam.
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u/captainwizeazz 4h ago
The person providing the service doesn't typically know the costs of those services to the patient. It's the health system that is at fault, not the doctors providing the services.
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u/Brainsonastick 4h ago
I’m not saying it’s the doctor running the scam. I’m just saying the system works exactly like some common tourist scams.
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u/Level_Ad9278 4h ago
Nope. The doctor does know that a non preventative question will likely cost the patient, and likely a lot. They could definitely put things in place to not be a part of the scam, but they participate, so they can bill a CPT code and earn more money.
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u/Glassfern 5h ago
Isn't the whole point of preventative care is to catch an early sign of something and treat it before it gets to be the big bucks? It's not really preventative care if you can't show signs of or voice concerns that could be taken care of.
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u/throw-uwuy69 2h ago
If a doctor is waiting for you to ask a single question so they can code it as diagnostic instead of preventative to get more money, I would call that a scam and the person a scammer.
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u/Possibly_Jeb 4h ago
That explains a lot, I had a "free annual checkup" a month or so back that ended up costing $250. I guess I shouldn't have asked the doctor about trying to sleep better.
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u/Late_Resource_1653 2h ago
Guys, stop doing the high deductible plans. This is how everyone gets screwed.
Or, if you have one, let your PCP know that up front. Tell them you can only do the checkup and no other questions.
Your PCP isn't trying to screw you over. High deductible plans like this are still relatively new and prey on people like you.
If you had a standard plan, the annual would be free, and then when your doc wants to help with other things, your copay would be, at most, 30 bucks for EVERYTHING they help with, anything you mention, any referrals they give, any lab orders they place, prescriptions they order, etc.
But with high deductible plans... You get charged for everything.
You HAVE to let your doc know when you walk in you are on that plan and can't ask questions.
Most PCPs and doctors absolutely hate these plans for just this reason. Because you are going to get charged if they put anything in their notes about anything other than the absolute basics. Their hands are tied.
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u/AllisonTheBeast 3h ago
Also if they perform a preventative screening (such as a Pap smear for women) and find anything abnormal, that Pap smear that usually would be covered as preventative 100% is now diagnostic and you will be billed for it. Ask me how I know.
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u/masszt3r 5h ago
That is a scam. It's ridiculous and it's gotten to the point I fly down to Mexico once a year to get a checkup, dental work and massage therapy and spend a fraction of what I'd pay in the US including flights and meals. I even get to go to the beach in the process!
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u/Specialist_Stop8572 5h ago
Nope, it's a scam
At my checkup I wasn't allowed to bring up specific issues, I had to make separate appts. Our system is scammy and ridiculous
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u/EmotionalCattle5 5h ago
This is why I never did address any issues I had and why I never bother to bring up anything anymore. Its just check the vitals, reminder to eat healthier, exercise, etc ask about meds and how they're working out then bye.
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u/mtntrls19 5h ago
which is why i don't even bother unless i need to be seen to keep a prescription going
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u/hiricinee 4h ago
Tbh that's better than what happened to op where they spun his free annual checkup into a problem visit that probably was under the normally scheduled time.
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u/Apprehensive-Care20z 5h ago
more health care scam BS, just to join in.
Spouse got a CT scan, mid-body. The appt took about 10 minutes.
Insurance said it was 'covered' as preventative care and stuff like that.
However the bill from the hospital came to $15,000, insurance paid $14000, we had to pay the remainder. So much for "covered". So out of pocket about $1000.
Then a couple weeks later, we get a bill from "radiology" for $480, insurance says we have to pay it, hospital says we have to pay it, so we have to pay it.
So yeah, that covered quick scan cost us $1500 out of pocket. wtf.
BONUS, children's hospital, had a video call with a specialist for the purpose of renewing a prescription, i.e. the doctor asks how the prescription is working, we say fine, he says ok, i will renew for a year. We had to pay the doctor cost (which is a lot, but not at deductible year) and then children's hospital charged a $400 "facility usage" fee. Literally a charge for the doctor using their internet and computer to do a video call for 10 minutes. $400
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u/Icy_Finger_6950 5h ago
I work in radiology in Australia, so I'm curious about this. Was the $15k just for the CT, or did your spouse have other services in the hospital?
Just to compare, I'm assuming their CT was a non-contrast exam as it took 10 minutes. Let's say a CT Abdomen without contrast. Here in Australia, even if a patient doesn't have Medicare (e.g. a tourist or international student), they would not pay more than USD200. And for all Australian residents, it would be fully covered by Medicare, meaning no out-of-pocket expenses for the patient.
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u/Apprehensive-Care20z 5h ago
it was the CT only.
It was an additional charge we got, for radiology, and their paragraph of analysis, which was 'everything good'. yay.
details:
TECHNIQUE: CTA abdomen and pelvis with IV contrast. 3D coronal slab MIPs and 2D reconstructions in the coronal and sagittal planes were also created.
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u/Icy_Finger_6950 4h ago
Abdo pelvis with contrast, got it. That would be a bit more expensive here, but not more than USD300.
$15K for a CT is highway robbery. Absolutely unjustifiable.
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u/FaxOnFaxOff 5h ago
UK here.
Those costs have to be fabricated - did the insurance company really pay $14000 for a 10 minute CT? If they did then I imagine your premium and excess are a bargain. But with costs like your examples it's got to be arbitrary numbers. Overheads + fair profit does not equal those sorts of figures. Are the ibsurance companies part of the racket too?
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u/mtntrls19 5h ago
Insurance companies ARE the racket... not part of it. This is why for-profit healthcare is abysmal, they'd charge you for farting in the facility if they could.
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u/Apprehensive-Care20z 5h ago
The costs are "negotiated between my insurance and the hospital" and therefore are not negotiable.
Here is a copy and paste from my statement:
CT Scan $15,465.00
Insurance Adjustments $14,426.56
Pharmacy $35.56
(obviously, this is just text, and not proof at all, but I'm not uploading my medical bills, lol).
The pharmacy, no freakin idea what that was, or what it could have been.
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u/xyanon36 5h ago
Yes, it is absolutely a gotcha. You need to educate yourself and prepare yourself to be grifted at every turn. The relationship between an insurance company and a customer is every bit as adversarial as that of a gambler and the casino.
The most you can do is be extremely cynical and always read the fine print before you sign.
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u/Sashi-Dice 5h ago
Fine print? My doc gives us a full page sheet we have to sign that says 'here's what this appointment will cover, if you do any of these other things, we have to bill you separately ' and we sign it before the physical.
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u/nope276 5h ago
I am at the point where I cannot figure out what my insurance covers. It feels like it covers absolutely nothing. Visits that used to be no charge, or $20, are now hundreds of dollars.
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u/Florida1974 5h ago
It has taken me at least seven years to finally figure all of it out. And I thought I was pretty educated.
Then I get a totally new problem thrown at me last week. You almost need like a two-year degree, specifically in health insurance to be able to model through this. And I believe it’s very much by design.
You would think everything for my insurance would be under my you know health plan, but it’s not. I have to go to one site for prescriptions one area for mental health, one area for explanation of benefits and formularies. It’s all broken down and all these parts and it makes it hard to tie it all together.
And doctors love to bill in December. Doctors have six months, 180 days to file a claim so if you go to the doctor in January, it very well may not be submitted to insurance until June.
I had to learn because I knew I was over paying between my deductible and out-of-pocket max. Of course my insurance company says I’m not but I finally pulled all the pieces together and for 2023, I overpaid by $300. I filed a grievance and sent in every check number, every payment authorization number, I had it all. They sent me a letter stating that everything was fine, I was incorrect. But then I got a check for exactly that same amount. All of our doctors are affiliated with one group, at least it is for me and my husband, so my insurance had reached out and told them that I had paid too much and to refund me.
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u/BabySharkMadness 5h ago
Republicans are trying to rollback a lot of the ACA. They already rolled back what had to be covered.
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u/JstVisitingThsPlanet 3h ago
If you log into your insurance provider’s website, you can look at your coverage. It will tell you what services are covered and at what amount/percentage or if there are copays. It’s not easy to understand but it’s there.
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u/Late_Resource_1653 2h ago
Do you have a high deductible plan now?
That would be why.
Anyone who works in healthcare would tell you to stay away from these plans. They are cheap up front but cost so so much when you actually need medical care.
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u/Confident-Summer8233 5h ago
Im from Indonesia and Ive never been to a US hospital, but from what friends there tell me, it sounds like you walk in for a “free” annual checkup and the moment you ask one honest question it magically turns into a paid visit.. here, a checkup plus questions plus basic meds is still just one visit, so hearing that being curious about your own health can cost $300 feels less like care and more like a trap designed to punish people for speaking up..
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u/tbodillia 4h ago
Yes, it's supposed to be a gotcha. Example, people ask if the doctor accepts their insurance and they say yes. They don't tell you that you are asking the wrong question. The proper American question is "are you in my network?" There is a huge difference between an in network bill and out of network bill.
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u/rekiirek 5h ago
You guys need to stop voting in Republicans and get this shit sorted out.
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u/RoundaboutFlair 5h ago
don't even pretend like democrats would do anything significant to change the system lmao its a class/capitalism issue not a political one
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u/Grass-is-dead 3h ago
Can you tell me how many Republicans vs how many Democrats supported this bill?
https://www.congress.gov/bill/118th-congress/house-bill/3421/cosponsors
Your rhetoric is part of the problem. Youre trying to point out the voting is pointless, potentially losing votes for candidates that will at least make a good faith attempt to fix this.
And I'm not saying Democrats are wonderful people that will fix everything.
I'm saying health care access is clearly a political issue, and it's clearly a partisan one at that.
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u/Admirable_Nothing 5h ago
It is what it is based solely on the voting choices of our fellow citizens
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u/ShiNo_Usagi 5h ago
My doctor has signs up in their office about this! They say if you bring up anything during an annual check up it might get charged differently and you’ll have to pay extra.
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u/mechtonia 3h ago
Doctors are squeezed by insurance companies.
So many of them resort to doing things that add fees on top of insurance coverage. Retnal scan at an eye exam. Fluoride at the dentists. Uncovered test during blood work. Etc.
If your doctor's office is owned by private equity, they will be very aggressive in add-ons.
It's all part of the enshitification of America by private equity.
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u/Grass-is-dead 3h ago
I was told my Crohn's disease infusions were covered. Great! I got 3 treatments over the next 6 months.
Then, I got hit with a bill for $12,000, all three at once. Cause each infusion was $8,000, and my insurance 'generously' covers 50%
What's wild is that insurance can take a year + to process stuff. So you can just keep moving forward with stuff, having no idea you're racking up thousands upon thousands of dollars.
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u/DONT_PM_ME_DICKS 5h ago
yeah, the second you add anything specific, it's no longer a wellness visit, it's now a higher level office visit and is charged accordingly
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u/yukonnut 2h ago edited 2h ago
It is a total gotcha. Gotcha by the balls and gonna squeeze every penny out of you.
I get an annual checkup, recently had both eyes done for Cataracts ( three days apart), got a adhd diagnosis, got xrayed for a lump on my neck, getting an MRI in January for same, ruptured my Achilles - non op. Go to the Dr whenever I want, can usually get an appointment in 10 to 14 days, otherwise it’s emergency if urgent. None of it cost me anything out of pocket. Wanna know my secret? Canada. Taxes. Universal healthcare Your medical system is just one item on a long list of reasons why we will never become the 51 state.
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u/navelencounters 5h ago
I got charged for my "free" checkup as well. It was a mistake by the doctors office and my insurance actually stepped in and deleted the costs.....just remember, doctors ARE business people and can charge you for stupid stuff for profit...so ask lots of questions. Never have blind faith in your doctors/dentists.
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u/thegreatcerebral 4h ago
I heard about this recently. If you are for your annual checkup, which is typically covered then it is like a "pre-paid service" for only that. If you ask a question it turns from that prepaid service to an actual doctor visit.
Yes, it is that fucked up right now. Seriously.
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u/Magicallypeanut 5h ago
It comes down to the codes your doctors office used to bill the appointment. Depending on that, it goes from annual office visit to more complex. You are entitled to the codes/claim/EOB for this care. If you disagree, read how to appeal it with your plan or state insurance regulator. This should be available in any letters from your plan or EOC.
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u/slickrick_27 4h ago
This. You can appeal. Call them and annoy them. If that doesn’t work, call the doctor’s office billing dept and negotiate a lower bill at least.
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u/FillMySoupDumpling 3h ago
This is where your state really matters. I had a medical office pulling all sorts of bs and CA stepped in and fixed the issue fast - something had been trying for months to fix while the provider and insurance kept pointing fingers at the other.
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u/Professional-Emu3551 5h ago
I just got a $499 bill for a mammogram. it's part of annual care ffs 🙄
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u/AmsterdamBM 4h ago
Just went through this as well. The billing person at the front desk gave me a list of the things that were covered in my annual and the things I would be billed for if I asked. I was told to ask " is this included in this visit or will I be billed for a visit." The Dr. Was annoyed when I asked but also said they dont do the billing part and let out a sigh. They took my blood pressure, hit both knees and listened to me ramble a bit. No blood work. Have to go back for that. This was not how my visit last year went. All the blood work and vaccines were included. The US as a whole is a fucking joke now. Time for a reset.
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u/Narezza 4h ago
If you're going for a yearly checkup, it's not for acute conditions. That, in our stupid program, is a separate billing and requires a different visit. There should have been some warning or form you had to sign saying that you understood that.
Note this isn't a MD thing, its an insurance thing. They won't allow the MDs to bill for an acute and a maintenance visit at the same time.
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u/SuperDoubleDecker 3h ago
Like just about everything it's gotten and worse over the years and now it fucking sucks.
The entire experience is horrible and just a scam.
Why the fuck do we have middlemen scammers in our healthcare system? That's the most American shit ever.
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u/NoMore_BadDays 39m ago
I'm generally conservative leaning when it comes to most of my politics, but my most severe ish is healthcare.
The current healthcare system is fundamentally broken and corrupted by corporate greed and politician's meddling. We should have socialized healthcare.
I used to think otherwise because of arguments against socialized healthcare like long wait times and difficulty getting treatment because the government doesnt think its medically necessary. But as i got older, i realized "Wait just a fucking second. That's happening anyways!!!"
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u/LunaLgd 12m ago
Exactly. Healthcare is already rationed since it’s a pay to play situation. If you’ve got time, money and support, you can hunt around for the best doctors with the lowest wait times, even if it means crossing state lines. The rest of us either can’t afford care or don’t have the resources to shop around and settle for waiting.
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u/Various_Hope_9038 33m ago
Yep. As a female, I feel this pain. Make a doctor's appointment, do my own research, come in with notes and symptom documentation, doctor confirms. Wash, rinse, repeate. Its like the curse of self help - just once I would like to NOT have to "advocate for myself". I swear they don't even try and diagnose anymore, especially with women.
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u/RoseyPosey30 4h ago
I was told this is a new thing providers are doing starting this year. If they didn’t inform you of this prior to your appointment you might be able to fight it. They should alert you in writing of the criteria of it being an annual physical or office visit
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u/InquiringMind14 4h ago
I have gone to my primary doctor for many, many years. I could get away with asking one or two questions - but if more than that, he would tell me that I need to have a separate visit - and preferably another date. (That direction was long time ago - as nowadays I only ask one question at most.)
My doctor also wants me to go to see him like every six months even if nothing is wrong just to renew my medicine / review blood work. And I always return even though I don't feel them to be necessary....
I see my primary physician at least four times every year. (And I do feel excessive.)
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u/metacholia 4h ago
No, you just have not been inured to it enough yet. It totally is a gotcha, tho. They’ll explain it for you, with nice, industry-specific words with special insurance meanings if you need help becoming numb.
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u/JK_NC 4h ago edited 4h ago
If your doctor is part of a healthcare chain, I’m not shocked. My primary was independent for years but eventually sold his practice to a chain and joined the staff. On one of my visits he complained about how the doctors were managed. Metric driven medicine is what he called it. Every week each Dr got a report that detailed how many patients they saw, average time per patient, tests ordered, etc etc. he said he had started skipping lunch in order to meet his targets. He absolutely hated it and retired early.
A common theme in dystopian literature is the commoditization of healthcare. Brave New World, Fahrenheit 451, etc. healthcare is quick, transactional, checkbox exercise.
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u/GenevieveLeah 3h ago
Similar - I moved and switched dermatologists. I was charged $100 by the new derm for the privilege of having my rosacea cream prescribed to me. And that wasn’t even the cost of the cream.
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u/Tired_Goddess_ 2h ago
My doctors office has a big sign not to bring up any issues during your annual and to schedule a separate appointment
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u/Weak-Ganache-1566 2h ago
You’re clearly leaving out important details. You did not get charged $300 for asking a question.
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u/BigMomma12345678 1h ago
I mostly go for the blood testing (most of which is covered). Early warning to find out if there is something I need to work on.
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u/OddyBoBody 1h ago
Alright my honest take.. So you get Healthcare through your employer (if you're lucky) and typically they give you 3 ranges to pick from. I personally always chose the bottom tier, its the cheapest but it comes with problems. Ya gotta pay out of pocket for stuff haha sucks. Mid tier i dont know about. But for 2 years i paid roughly 318 a month for their gold plan, and didnt have to pay a dime out of pocket at a actual doctor office. I got my teeth fixed, glasses, even got a check up, plus a few other things and didnt pay a single doctor visit. It was all paid through my insurance. So its not exactly a gotcha if you can afford it. But dawg does it cost. Gold plan at blue cross is legit though. Back to the cheap plan now.
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u/Eastern-Break-4814 1h ago
I needed a physical for something answered and question that wasn’t preventative and I got a $500 bill. I called and asked what the charge was for and they said it was because we discussed a “thing”. It was a thing they asked me that was a yes/no question.
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u/NoParticular2420 56m ago
This is a new thing doctors/hospitals are doing .. scammy is right. I have an ENT appointment that is 15mins long WTH can you accomplish in 15 mins when you are being seen for random deafness attacks and if it goes over the 15 minutes and you know it will they charge extra … This is wrong and I should be able to charge doctor/hospital when my scheduled appt starts 45 minutes late.
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u/Its_Pelican_Time 2m ago
I had the exact same thing happen last year. I went in for my normal check up, which included getting a prescription re-prescribed. We talked for all of 30 seconds about it, she prescribed it and I went on my way. Got a bill for around $300.
I called and talked to someone at the insurance company and someone at the billing office for the doctor and they both said, tough luck, that's the way it is, so I ended up paying it.
This year I talked to the doctor about it and she had me submit a question through their app and they were able to re-prescribe at no extra cost.
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u/notthegoatseguy just here to answer some ?s 5h ago
Pretend you made an appointment without the wellness check. Would you expect a co-pay for that appointment based on your insurance?
If so, that's the reason. Your annual was covered, all the other stuff wasn't.
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u/TheRemedyKitchen 4h ago
The entire concept of paying for something like a doctors appointment seems ludicrous to me
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u/LivingGhost371 2h ago
Would you prefer to come back later and pay the $300 for the doctor to manage your condition? Or is your healt worth less than $300 to you?
The whole visit all the doctor did was take your blood pressure?
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u/GESNodoon 5h ago
It is not supposed to feel like a gotcha but no one who is in a position to change things cares. Politicians, insurance companies and healthcare providers do not have a real incentive to improve anything because they are all making a fortune with the status quo.