NJ Health insurance Marketplace

[DannyHobkins]

Originally Posted by ocnjgirl

You think my fiance's son was planning on tearing his ACL? Who ever plans to get sick??

Nobody does, but its all risk based. If you're young and healthy, it might be worth taking the risk.

Lets just say hypothetically I went with the insurance offered. $1,800 a month (for 6 months) with a $9k deductible. If I had an ACL injury i'd be out of pocket $19,800 ($9k deductible + $10,800 for Cobra). How much was the hospital bill, and after negotiations? If less than $19,800 it would actually be cheaper out of pocket than insurance.

[ocnjgirl]

Originally Posted by DannyHobkins

Nobody does, but its all risk based. If you're young and healthy, it might be worth taking the risk.

Lets just say hypothetically I went with the insurance offered. $1,800 a month (for 6 months) with a $9k deductible. If I had an ACL injury i'd be out of pocket $19,800 ($9k deductible + $10,800 for Cobra). How much was the hospital bill, and after negotiations? If less than $19,800 it would actually be cheaper out of pocket than insurance.

I wouldn't advise anyone to take Cobra in the first place. There is absolutely no reason to pay $1800 a month for a policy with a $9000 deductible. That is not a typical policy at all. I had a $3000 deductible, but I could have chosen $1500. When I paid for it in full it was $700 a month, under GetCoveredNJ it was $0.

The bill was much higher than $19,800. The ER visit alone would be about that (including x-rays, etc). But he needed surgery, which is probably $25,000 for anesthesia alone not even counting the surgeon, use of the rooms, recovery, etc. Then he needed 6 months or so of PT. It probably was somewhere between $100,000 and $200,000 or so total.

[DannyHobkins]

Originally Posted by ocnjgirl

I wouldn't advise anyone to take Cobra in the first place. There is absolutely no reason to pay $1800 a month for a policy with a $9000 deductible. That is not a typical policy at all. I had a $3000 deductible, but I could have chosen $1500. When I paid for it in full it was $700 a month, under GetCoveredNJ it was $0.

The bill was much higher than $19,800. The ER visit alone would be about that (including x-rays, etc). But he needed surgery, which is probably $25,000 for anesthesia alone not even counting the surgeon, use of the rooms, recovery, etc. Then he needed 6 months or so of PT. It probably was somewhere between $100,000 and $200,000 or so total.

That's a crazy amount. I know hospitals put up absorbent pricing so that the insurance companies settle. $25 for a Tylenol, but at the end of the day its settled for something more reasonable.

If you're out of pocket, hospitals will settle for pennies on the dollar.

[ocnjgirl]

Originally Posted by DannyHobkins

That's a crazy amount. I know hospitals put up absorbent pricing so that the insurance companies settle. $25 for a Tylenol, but at the end of the day its settled for something more reasonable.

If you're out of pocket, hospitals will settle for pennies on the dollar.

After the fact, after they have failed to collect they will, but your credit will be ruined by then. If you go in ahead of time without insurance, you're going to be screwed. They aren't going to say "normally we bill $50,000 for this surgery, but we'll do it for you for $5,000. And the PT wasn't in the hospital, they aren't going to give much of a discount if any at all.