General Discussion

grantcart

(53,061 posts)

33. If its a deductible then there is no risk for not getting paid

Sun Oct 13, 2013, 10:54 PM

Oct 2013

They will not pay a dime until they see that $ 5k has been charged and paid first by the patient.

In an insurance policy, the deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses.[1] In general usage, the term deductible may be used to describe one of several types of clauses (see below) that are used by insurance companies as a threshold for policy payments.

If it is paid out of pocket first then how is it a risk of 'not getting paid'.

A policy that has a $ 5K deductible is essentially a catastrophic plan that only is going to kick in coverage in a major medical event. Virtually no one is going to have $ 5K worth of care under normal care without some major medical event occurring.

I really think that you have the terms mixed up because your explanations aren't matching with the terms.

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The ACA deductibles cap the providers' losses [View all] jberryhill Oct 2013 OP

I don't give a shit about a hospital's bottom line leftstreet Oct 2013 #1

Whoosh.... jberryhill Oct 2013 #2

Provider losses are a myth leftstreet Oct 2013 #4

Even that reinforces the point, though jberryhill Oct 2013 #8

The average person DOES have insurance though leftstreet Oct 2013 #9

Stabilized and discharged is not the same as treatment jberryhill Oct 2013 #10

?? leftstreet Oct 2013 #11

You should. Ms. Toad Oct 2013 #3

Sorry, that's a myth leftstreet Oct 2013 #5

Hospitals are mandated to provide emergency care Ms. Toad Oct 2013 #23

Correct. And most collections are people with insurance leftstreet Oct 2013 #25

You would be wrong Ms. Toad Oct 2013 #28

So we'll look forward to hospitals lowering prices leftstreet Oct 2013 #29

Many things contribute to the cost of medical care Ms. Toad Oct 2013 #30

Bingo jberryhill Oct 2013 #6

Fine with me. Helps me, too, by limiting my losses if I need medical care. kestrel91316 Oct 2013 #7

You can "write it off as a loss," but you get nothing for that. Hoyt Oct 2013 #12

They will come after your house if you own one though and in a heartbeat. Mojorabbit Oct 2013 #13

Let's say the hospital charges $1,000,000 and the guys deductible is $5000. dkf Oct 2013 #14

Since the insurance co gets to keep 15%-20% of the total it's a win-win for them when prices rise Fumesucker Oct 2013 #15

Exactly. This is going to be like college expenses soon. dkf Oct 2013 #16

Except, when you and I go to the exchange we are likely to buy policy Hoyt Oct 2013 #22

But for the fact that the insurance market is more competitive jberryhill Oct 2013 #38

Insurance (and Medicare/Medicaid) Revanchist Oct 2013 #17

It's negotiated via contract. dkf Oct 2013 #18

You can't negotiation with HHS Revanchist Oct 2013 #19

If insurance companies laughed in the face of hospitals it wouldn't be so expensive. dkf Oct 2013 #20

You haven't spent much time reading your insurance EOBs, have you. Ms. Toad Oct 2013 #24

Why would they write it off, when they can sell it to a collection agency? Travis_0004 Oct 2013 #21

More than just the deductible madville Oct 2013 #26

I believe that you have mixed up deductibles and caps grantcart Oct 2013 #27

That's not the point jberryhill Oct 2013 #31

No, it's the Out of pocket maximum Yo_Mama Oct 2013 #32

If its a deductible then there is no risk for not getting paid grantcart Oct 2013 #33

If the bill is $15K, how much does the hospital risk? jberryhill Oct 2013 #34

Hospital or insurance company? grantcart Oct 2013 #36

Medical providers.... jberryhill Oct 2013 #37

Thank you for this post treestar Oct 2013 #35