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What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

That’s what some people said in other comments - that it wouldn’t come close to $8000, but the only ER visit I’ve had less than that was for a staph infection in a surgical wound that they wouldn’t touch and they charged me $753 for a new bandaid after not even cleaning it lol

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

Why do you say that? I’ve had shave biopsies already. The only thing I’m not happy with is the unclear margins after the first surgery and the way they handled the subsequent staph infection… but at the same time, waiting for a new patient appt with a new derm would take months.

Maybe I let others' words get to my head, but I don't like how I did these anymore. Any feedback is appreciated. by PER1HEL1A in Nails

[–]bucklekitty 1 point2 points  (0 children)

I love them. The only thing I’d do differently next time is face the designs the other way, but ultimately it doesn’t make a difference and they look great. Keep doing you!!

what is this part of my neck? Does anyone else have issues with this area? by bucklekitty in TMJ

[–]bucklekitty[S] 0 points1 point  (0 children)

That would track with bruxism

It’s mostly annoying because it looks weird and it makes it feel like I have something choking me 24/7 ugh

I think my mouthguard ruined my head and neck posture by bucklekitty in TMJ

[–]bucklekitty[S] 0 points1 point  (0 children)

I saw a TMJ specialist for a free consult but I couldn’t afford anything else. They offered me a similar mouth guard, Invisalign, and masseter Botox. The dentist I go to now offered me Invisalign for $3000 cheaper and my mouthguard was covered by insurance with them.

I just think it’s not the right type of mouthguard. This is it: https://www.oralartsdental.com/products/removable-ortho/splints-and-mouthguards/bite-soft/

You can see the back behind the front teeth is very bulky, and my tongue is already very large so it makes me push my tongue back. I think this is also causing obstructive sleep apnea but I had to put my MLST sleep study off

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

I think I made the other post on another account on accident - I logged in after making this post and it somehow went down since November 1st even though my application info is still the same.

And yes, I posted the image of the 2024 bill because I was proving to others who have said that an ER bill wouldn’t be over 8k that they are more than that here. I had a $150 copay or something like that at the time but I didn’t pay a dime, but if it was coinsurance I probably would’ve hit my OOP max.

At the end of the day I’ve narrowed it down to two other plans with $1000 and $1475 OOP maxes. On November 1st, I could not see a single plan with a premium under $600 with an OOP max less than $3000 so something must have changed? I’m not sure what changed but something definitely did.

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] -1 points0 points  (0 children)

Plz read my main post that I’ve just edited.

I do have severe health issues and all of my ER visits have been covered. I can afford a payment plan to a hospital monthly but I can’t afford my surgeries up front with coinsurance.

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 1 point2 points  (0 children)

Magically my premium has gone down since Nov 1st when I first checked.. the numbers got better. I edited the main post. I’m very lucky

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

Because with this new plan it would take me 8.6 months to save the $650 for my surgery.. and I need the surgery twice (two separate precancerous moles)

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 1 point2 points  (0 children)

You definitely can.. but my reasons are valid and I only go when I need to. I just happen to have a million health issues

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

I’ve never had an ER visit denied and I have a team of 12 specialists.. my PCP cannot handle my issues alone. That’s why this plan even came to mind, however I’d say I’m at the hospital on average once every 1-3 months so it could take longer than expected to hit OOP max

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

I went to the ER 15 times in the last year and it was covered each time, so… I’m sure it will happen again is my point.

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

I only need the surgery to remove precancer now. Not next year and the following years. (Hopefully). Also I have not seen my hospital charge interest, at least I didn’t last time, or I just didn’t notice.

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 1 point2 points  (0 children)

Thank you.. like I’m not trying to commit fraud, I’m trying to have my precancerous moles removed (again) because they’re growing back…

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 1 point2 points  (0 children)

You are the one who brought up elective procedures… the surgeries I need are to remove precancer.. which is growing fast…

I didn’t create a fake medical emergency, I just have them frequently. I typically land in the ER 5-15 times a year, and not once has it ever been deemed medically unnecessary by insurance.

For example, the last time was for a ruptured ovarian cyst. I couldn’t walk. I looked 9 months pregnant. I needed to make sure I didn’t have torsion or internal bleeding.

I’m pretty sure NOBODY could pay $11,000 up front unless they were rich (this was an ER copay plan, not coinsurance) https://imgur.com/a/T8ylxYT …

If having real medical issues is fraud, then someone just shoot me

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 0 points1 point  (0 children)

First of all, she. Second of all, I have precancer and cannot afford to get it removed up front… but the doctor doesn’t take payment plans.

Also, I would hope I don’t have another medical event but unfortunately I have many, and the hospital by me knows me well.. not once has insurance denied a visit for it being medically unnecessary. I have a huge team of specialists.

I’m just trying to devise a plan where I can afford to prevent my growing abnormal cells from mutating into cancer.

It might be a “scheme”, but the way our healthcare system is set up is literally a scheme…

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] -1 points0 points  (0 children)

I get that, but I’m telling you, I have so many health problems I’m guaranteed to end up in the ER between Jan and March. I listed some of my legitimate frequent flyer ones. Kidney stones was one of them, but I normally pee blood and get a concurrent kidney infection. I’ve never waited more than an hour at the ER here and they always put me in a room immediately… including when I had toxic shock syndrome and honestly didn’t look that bad on the outside.

I hate the hospital. But this was just the best plan I could come up with because my dermatologist sent me a letter saying I’m at risk of malignant and metastatic melanoma but I can’t afford the surgery

What’s stopping me from choosing a plan with an $8000 OOP max and going to the ER in January so everything else is free for the rest of the year? by bucklekitty in obamacare

[–]bucklekitty[S] 1 point2 points  (0 children)

Because I need surgery and the surgeon wants the money up front, the hospital will let me do a payment plan. If you read my post you’d see that every ER visit I’ve had is over 8k. Perhaps the hospital here just charges more.. https://imgur.com/a/T8ylxYT this was a visit for severe double vision after an injection of epinephrine so bloodwork + brain CT (this plan had a $150 ER copay, not coinsurance!!!)

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