I am NEVER going to the hospital again.

[arewethereyet]

If only it were this simple.

If I oversimplified, it was done through ignorance - I’m not really familiar with private health insurance.

Say I buy a policy that will cover 80% of the cost of a broken bone - the doctor, the nurse, the meds, taking up space in hospital, any physical therapy I may need...all of it. Then I break my leg. If the bill for everything come to...I dunno...$20 000, are you saying my policy won’t pay $16 000?

Boru

In most cases you would have to pay a deductible before insurance kicks in.  There is also often a co-pay.  Your insurance won't pay 80% of $20K.  They will pay 80% of 20K after the deductible and co-pay...so the 80% is deceiving.  And that's dependent upon going to an in-network medical provider...and the whole thing is just a headache to keep up with and figure out.

Some insurance pays in full, without all those other costs, for preventative things like an annual physical.

I am ssssoooo thankful that insurance was different when I had breast cancer requiring a surgery in 2009 and another in 2010.  The policy my husband had through work had no deductible and the co-pay was negligible.  The 10s of thousands of dollars in medical care cost me very little out of pocket.  I can't even imagine how high the bill would have been had I done chemo and/or radiation.

Beginning in January I will have to pay $2K out of pocket before insurance pays anything.

Insurance will make a payment to a medical provider and then an agreed upon adjustment held between the provider and the insurance company.  The rest is left to the insured.

Don't get me started on dental insurance which is just about useless.