You need to know both your deductible and out of pocket maximum numbers. You’ve said your deductible is $1500. For the sake of this example let’s say your out of pocket max (OOP from now on) is $2500.
For simplicity, we’ll go with your insurance’s negotiated rate for the procedure is $1000*. Meaning at the end of the day you and your insurance combined will pay the hospital $1000.
Basically any bills up to $1500 for the year you pay 100%. Between $1500 and $2500 (or your OOP), insurance pays 50% and you pay 50%. Over $2500 insurance pays 100%.
Some examples to illustrate:
You’ve paid $400 this year so far. You pay the full $1000: $400 + $1000 = $1400 which is less than your deductible of $1500
You’ve paid $1000 so far this year. You pay $750 and insurance pays $250: $500 gets you to the $1500 deductible limit so you have to pay all that, plus you pay 50% of the remaining $500 bill = $250.
You’ve paid $1700 so far. You pay $500 and insurance pays $500. $1700 + $500 = $2200 which is less than your OOP of $2500
You’ve paid $2300 so far. You pay $200 and insurance pays $800. 50% of $1000 = $500 but $500 would put you over your OOP of $2500. $2500 - $2300 = $200. You pay $200 and insurance pays the rest.
You’ve paid $2500 so far. Insurance pays $1000
If your insurance’s negotiated rate for the procedure is $1000, this means that’s what the hospital and insurance have agreed to pay. A lot of times you’ll see the hospital “charge” a larger number and then have an insurance “discount” but ignore this. It doesn’t factor into deductible or out of pocket maximum calculations.
For bonus points let’s also assume that the user is 2100 away from their lifetime cap in scenario three: then instead of you and your insurer splitting the 1k bill evenly your insurer would split 800 with you (400 from each of you) before saying “peace bro im out” and leaving you with the remaining 200 dollar bill.
Additionally the user above was assuming that insurance would cover half the bill - that’s actually a variable that your personal plan might disagree with called your “coinsurance” rate, you could have a 50% coinsurance rate, an 80% rate (an awful plan) or a 0% rate which would mean you’re fully covered after you hit your deductible (assuming there aren’t any annual coverage cap shenanigans).
Also fun is out of network stuff, different plans may vary but let’s take scenario three again but assume the HCP you went to was out of network and their charge master (see parent’s footnote) says the actual raw cost of the procedure is 23,000 dollars. Your insurer might handle this in two ways:
“get fucked” - your insurer offers no coverage at all for out of network charges - in this case the 23k bill goes against your bank account directly and you likely end up declaring bankruptcy or delinquenting on the loan.
“get (slightly less) fucked” - your insurer looks at what you would have paid at an in network HCP and partially pays for your procedure assuming you had it done at an approved HCP. In this case your insurance pays 500 and you just need to cover the remaining 22.5k… so you once again may consider bankruptcy.
In both cases, for shits and giggles, this extreme medical cost does not count toward your OOP - except for 1000$ in the second case if partial coverage is awarded. This is why people Uber to specific hospitals after traumatic injuries.
All very valid points and part of why American health insurance is such a joke
I had an incident recently where my spouse had to go to the ER because of a life threatening incident. One of those fix it right now or they might die things. (They’re fine now, thank goodness.)
We went to an in-network hospital and all doctors were also in-network. However the one who actually did the life-saving procedure was a specialist. Under our insurance plan seeing a specialist requires a referral, which of course we didn’t have time to get. So insurance tried to nope out of that doctor’s entire bill.
They did. It’s one of the few songs sung by Chris Difford instead of Glenn Tilbrook even though they almost always get co-writing credits and rarely do other band members (who rotate in and out all the time anyway). Unfortunately, his voice is not what it used to be. Tilbrook, on the other hand, sounded almost as good as he did 50 years ago.
The really funny thing about Difford is that I always heard he was shy, but he spent most of the show so that the lights weren’t on him. Which is fine with me. I could still see him play.
because on windows or Mac it may have just worked. …until it doesn’t, or leaves your windows scaled wrong or placed on monitors that don’t exist or some other failure condition. at which point you reboot and hope for the best.
when it doesn’t work on Linux I’d check logs, actual configuration, and even the source if I need to.and then I’d hopefully improve things and make it work the way I want it to.
I don’t believe it works “flawlessly” and I’m tired of people exaggerating their experience in such a misleading way. There’s always some hitches and I don’t get why people basically have to cake their OS experience with makeup like this.
Because you’re making stuff up. Literally every install of an OS has some little issue here and there-- but this is my mistake for assuming any Linux community could be humble enough to cut the BS and stop acting like Linux is a flawless experience. I’m out, keep hanging out at that ~5% market cap and wondering why folks don’t flock over despite it being free.
The chameleon wireless PS2 pelican controller. Fits hands perfectly, light weight, just feel perfect, I’d pay so much to be able to use it on modern systems.
Phone calls used to be such a quick, convenient way to talk or get info and uselessly governments have paved the way for scam companies to completely ruin the modern day phone call.
As of right now, there’s not much available for the X Elite processors.
I did actually buy the Yoga laptop with the X Elite from Lenovo about a month ago. I’m not sure I’ve ever had a better experience with Windows. I can leave the thing in standby mode for days and see maybe 4 or 5 percent battery drain. If I’m using ARM native apps, I can use it for 8 hours without charging easily and get through a work day with about 20 to 30 percent battery to spare. With x86 apps, it does use a bit more power, but battery life is still pretty good. I’d estimate 8-9 hours before totally dead.
Hopefully development picks up more on the Linux side because I can’t wait to see how much better the battery life would be.
Arch Linux is a great platform for learning about the world of Linux and how it works in the world of the Linux kernel and the Linux kernel itself and how it can be used to improve the way the kernel is used to make the kernel and the kernel itself and the kernel is a great way to learn about the kernel
Switched to linux with ububtu, had good experience until snap Firefox became default.
Switched to arch linux with i3 wm through some random installer. Struggled a lot and couldn’t understand anything. Watched a few videos on manual installation and got basic idea like systemd, compositors, etc. Followed wiki and youtube videos to manually install again and never looked back.
Currently using arch linux with hyprland and quite happy with my setup. I don’t think I can use any other distro as a user cause aur is so good.
I really struggled with learning about how to learn linux things. Like nvidia drivers, kernels, etc. Once there are enough people documenting their experience I think linux will be very easy. Endeavor, mint, kde plasma, now upcoming cosmic should be user friendly.
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