Hi guys! I'm a researcher and am working on answering a question about primary care access.

We are finding that many patients on high deductible plans do not have consistent access to primary care because visits beyond an annual check-up are not covered. This means a lot of people will skip the doctors for small things, waiting for them to become bigger.

The question is - would you sign up for an additional $25/month service that grants you one free primary care visit (including labs, tests) every month?

You would bill your insurance, as normal, but we would cover the full cost of the visit, no questions asked. We're wondering whether this is a good first step to enable everyone to access primary care without financial or administrative burdens. Thanks in advance for any insights!

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Copied from my post on r/Ontario over a year ago. Curious what this subs insight is.

Ok, so I don’t need to travel for healthcare or anything, this is just a question out of curiosity Healthcare is a political topic I find important and in the context of the U.S. and Canada, it’s interesting given how similar these 2 nations are, but how different their healthcare systems are. Within both countries, their healthcare systems are infamous in a few similar but in mostly different ways.

Curious if anyone from either country has stories of travelling to the other country for medical purposes.

There’s stories of Canadians going to the U.S. for medical reasons (long wait times in Canada, treatment not available in Canada, nearest “big hospital”, etc..). I live in Ontario, and based on what I see on our subreddit, it’s not uncommon to travel to Buffalo, New York for an MRI if someone doesn’t want to potentially wait 6+ months here.

There’s also stories of Americans coming to Canada for medical reasons (cheaper prescriptions, special clinics like Shouldice, nearest “big hospital” as well, etc.).

The talk of this was big when Donald Trump talked about Canadians travelling to the U.S. for healthcare due to our “catastrophic” system. However, the numbers are truly unknown.

The question I have is what, in your experience, have you witnessed medical tourism along the U.S./Canada border (Having gone yourself, seeing license plates of the other country in a nearby border facility, knowing someone, etc…)?

So my grandma is obsessed with the idea of welfare. She wants free healthcare, which I don’t think is possible in the US. She has Medicaid right now but wants more benefits like lower bill costs and free food. I would love to help her move to welfare but only issue is that she lives with my family and my dad works for the government. Don’t know if that’s an issue or not. I’m not sure on what the other options are or if there are any at all. Sorry for long post.

Just as the title says I am working on a project and wondered if there are any published average ER costs for the health system per visit. There are some for insurance charges and copays but not like an average cost for an er visit in terms of burden on the hospital. Based on USA

To do this (you can too), i created a place where the perfect (or close too) healthcare systems works. AI fills in the pieces. And so off to Planet Z we go.

Healthcare on Planet Z: A System That Works

On Planet Z, healthcare is streamlined, universally accessible, and designed to prioritize prevention and well-being. The system works harmoniously to keep everyone healthy and happy, blending advanced technology, AI, and a culture of collective care. Here’s a basic overview of how healthcare works, followed by 12 key features:

Basic Overview

Healthcare on Planet Z is built on a foundation of prevention, personalization, and equity. It’s a seamless, AI-driven system that integrates health into everyday life. Instead of reactive treatment, the focus is on proactive measures that enhance physical, mental, and emotional well-being. The result? A society where everyone thrives, and healthcare feels less like a system and more like a natural part of life.

12 Key Features of Planet Z’s Healthcare System

1.	Universal and Free at the Point of Use:

Healthcare is seen as a shared responsibility and human right. All services, from routine check-ups to advanced treatments, are universally accessible and funded collectively.

2.	AI-Driven Health Monitoring:

Advanced AI monitors everyone’s health in real time through wearables and implants. These devices detect early warning signs of illness and recommend interventions before problems arise.

3.	Personalized Health Plans:

AI tailors individualized health plans for each person, considering their genetics, lifestyle, and preferences. These plans include exercise, nutrition, mental health support, and more.

4.	Integrated Preventative Care:

Preventive care is embedded into daily life. Schools, workplaces, and community centers provide regular health screenings, wellness programs, and education.

5.	Mental Health as a Priority:

Mental health is considered as important as physical health. Everyone has access to therapists, AI-guided mental health tools, and mindfulness spaces.

6.	Decentralized, Community-Based Care:

Instead of large hospitals, healthcare is decentralized into smaller, community-focused wellness hubs. These hubs provide a welcoming, accessible environment for routine care.

7.	AI and Human Collaboration:

While AI handles diagnostics, routine tasks, and data analysis, human healthcare providers focus on empathy, counseling, and complex decision-making.

8.	Open-Source Medical Research:

All medical research is open-source and globally shared. Breakthroughs are immediately available to everyone, accelerating innovation and equitable access to treatments.

9.	Focus on Longevity and Quality of Life:

Healthcare doesn’t just aim to treat illness but to optimize health. Anti-aging therapies, regenerative medicine, and advanced nutrition science ensure everyone thrives physically and mentally until age 120.

10.	Environmental Health Integration:

Healthcare integrates environmental factors. Air and water quality sensors, green spaces, and sustainable living practices are part of the health ecosystem.

11.	Empowered Self-Care:

Individuals are empowered with tools and knowledge to manage their health. AI assistants provide daily guidance, such as reminders to move, hydrate, or rest based on real-time needs.

12.	Community-Driven Happiness Metrics:

Healthcare isn’t just about physical health—it includes metrics for happiness and life satisfaction. Programs ensure people feel connected, purposeful, and supported in their communities.

How They Keep Everyone Happy

1.	Collective Ownership of Health:

Everyone understands their role in maintaining personal and community health. It’s a shared mission that creates a sense of purpose and pride.

2.	Reduced Stress:

With AI automating much of the healthcare process, people don’t worry about navigating complex systems, costs, or insurance. This reduces stress and increases happiness.

3.	Community Bonds:

Decentralized wellness hubs and regular health events foster a sense of belonging and shared responsibility, strengthening community ties.

4.	Transparent Governance:

Decisions about healthcare are transparent and inclusive, ensuring public trust and satisfaction with the system.

5.	Celebration of Well-Being:

Health is celebrated on Planet Z. Milestones like reaching age 60, 90, or 120 are marked with festivals and community gatherings, creating a culture of gratitude and joy.

By focusing on prevention, embracing AI, and fostering a culture of shared care, Planet Z has created a healthcare system that’s both efficient and deeply human-centered. It’s a system Earth could aspire to emulate—one where everyone is healthy, happy, and thriving. 🌟

Hi All,

I wanted to thank folks for their advice on support on my prior post. I really appreciated it! I have an update for folks who might be interested in my story about not getting a medication refilled in 8 months.

- Spoke with my insurance company who advised me that the situation was strange and that they would need to investigate why I was not properly treated in an 8 month time span. They advised me to seek out another provider, and even gave me some reccomendations for alternatives !
- Spoke with the patient adovocate at the hospital who reviewed my records, confirmed my diagnosis in my records and informed me that it was strange they did not medicate me in 8 month and they proceeded to escalate my situation to their leadership team.

-Confirmed with a friend in the same area of work that my situation was extremely strange and they even tried to provide me an alternative since it was a strange an unusual situation that they have never seen or experienced in their decade in the field.
-Spoke with my states licensing department who advised me that the clinic may be commiting insurance fraud in this situation for billing 8 months for a medication refill and would be investiating the providers as well. They then advised me to reach out to my state's Attorney General's office.

- Spoke to my Attorney generals office about the lack of treatment, the bills, and they will be investigating.

I have a plan with a new providor on the 24th of December (I know but thankfully it's telehealth) and I will hopefully be able to close this process out soon after 9 months.

Wanted to once again thank folks so much for the support in getting access to my medication. I know it's restricted due to its abuse by the general public, but I really appreciate folks giving me support and suggestion so I can get back on my effective treatment plan.

hi yall, hope you guys had a good thanksgiving! this is my first time shopping for my own health insurance since independance

ive always had keystone first my entire life and every urgent care/doctor/er visit has been free of cost to my knowledge

this may be common sense, but do i really have to pay full price of every urgent care/doctor/er visit until i hit my deductible?

so far in 2024, i visited urgent care twice and paid $400 in total because i did not have health insurance. i always assumed that it wouldve been cheaper if i had enlisted in health insurance..

sorry for my ignorance, thanks for the help!

My sweet son is autistic. He works at the local McDonald’s and enjoys it. He’s smart enough for Uni, lettered in academics, but we can’t afford that.

He turns 26 in February. But now the ACA as well as Medicare and Medicaid are on the chopping block, what do I do? Do I do anything or can he just not get insurance? Do I need to B force him into a dangerous factory job he will hate?

My doctor billed my old state medicaid insurance for a lab test. I don't even know how they could, since I started seeing this doctor only after I got a Marketplace plan. Now I have to pay $122.

If I called my current insurance company, could I get them to cover it, or would I have to go to my doctor and tell them to re-bill it to the correct insurance company, or am I SOL since I already set up a payment plan?

Thanks.

Hi All i just got a $300 dr visit for a physical. I spoke with a rude billing person who said they did only bill me for one type of appointment (establishing care), but there are 3 claims that go with this. I've never had such a high bill for an annual physical. They said ti was bec I hadn't met my deductible yet (550). Do you know why they put so much of this appointment toward the deductible? How do they determine how much of the appt goes toward deductible?

Hello everyone, I am new to insurance and healthcare bills as I just got out of the military.

Last month, we had to take our one year old to the ER as he was projectile vomiting so much he wasn’t breathing. Went to the ER at about 3am, we were in and out, literally. Went in, they looked at him and said “there’s a bug going around” gave him half of a 5mg zofran and sent us on our way.

A week or so later, received one bill as insurance didn’t cover all of it. The bill was for $300, labeled as “Emergency Medical Services, TX”. Paid that bill as I assumed it was normal. (There is no link on that bill to view an itemized receipt).

Today, we received another bill from the SAME VISIT. This bill was for over $500, and luckily it had an itemized receipt so I knew they were scamming the hell out of us. There were two things listed, 1. “Emergency Room Lvl 3, $2500” and 2. “Zofran 5mg x4, $370”. It was billed from “HC Houston” (the hospital we received the care from).

Two issues with above bill, 1. Why were we charged a lvl 4 room, when the care wasn’t even lvl 5? Literally in and out in 20 minutes tops. 2. We were charged for 4x 5mg zofran, and given HALF of one.

Is there a way to fight this?

Disclaimer: This is based purely on a personal anecdote, but I thought it was weird that it happened twice.

In 2021, I was working for a public university. I had insurance that was pretty mid, but it did cover one preventative care office visit per year. I schedule a well woman exam with a gynecologist, only to find out insurance won’t cover it because I had an annual physical earlier in the year. Basically, women on the plan could choose one per year: an annual physical or a routine gynecology exam. I remember asking the gal on the phone with the insurance company, “That’s… kind of wild, right? Like… those are different things?” And she said something to the effect of, “You’re telling me, sis.” I scheduled the gyn appointment for after the first of the year.

Fast forward to this year. Different state, different insurance. I’m privileged to work for a private company that provides phenomenal healthcare. I don’t have to pay anything out of pocket, so I go to all my preventative care visits. I had a well woman exam scheduled for the spring. I get a ping in MyChart one day saying I’m due for my annual physical, so I call to schedule that with my PCP. Scheduler says, “Oh, I see you have a well woman appointment. That counts. I’ll mark that off for you and you don’t have to schedule anything, unless you have any other concerns you want to meet with the doc about.” At the time, I didn’t, so I didn’t schedule the physical. When I went to my gyn appointment, one of the first things the clinic does is give you a sheet of paper to sign stating that this is just gynecology and they don’t check other stuff, so see your PCP if you have non-gynecology concerns.

So this is twice now that I’ve encountered a situation where an annual physical at a clinic with your PCP and a well woman exam with a gynecologist seem to be considered interchangeable. What I’m baffled about is how. They are so clearly different types of preventative care and assess different things?! Is there nuance I’m missing that anyone can shed light on?

Hello everyone,

In 2018, my mom, myself, and my family member were informed that we were terminated as patients from public urgent care clinic located in Brampton, Ontario.

The termination was related to a negative Google review my mom had posted online. Myself, and my other family member were also terminated, though we had no involvement. The termination letter stated "disrespectful behaviour", which was not true.

I visited the clinic this morning because I've been experiencing asthma exacerbations and it is nearby my home. I thought, since its been many years and the clinic is now under new management and a new doctor, I would be able to receive service.

The receptionist advised me that I have a termination letter in my file, but she would speak to the new doctor and he can decide whether to see me under his discretion.

The doctor decided not to see me as a patient and I was told I cannot receive care in the future and I had to leave.

This seems very unfair, and I have not heard of being denied medical care for these reasons. The medical clinic has never been able to substantiate their cause of termination m, furthermore, myself and my family member would have had no involvement in what might have been the cause.

Any information on if this is legally allowed or advice would be appreciated. The doctor is not and has never been my family physician.

I am a foreigner, I have parents with diabetes (I don't know the type), I don't know if I will have it too but I read that diabetes insurance costs a lot. It is true?

So I’m (26m) a contractor, and only get a very small subsidy for a HDHP from work. AEP ended for them on 11/15, and since I wasn’t sure if the plan was HSA eligible I decided do decline coverage.

I did keep critical illness coverage and group accident policies through MetLife.

For 2025 the only expected health care costs I will have will essentially be psychiatry which will be effectively out of pocket under the plan I would’ve had through work.

I wanted to ask if it is a really dumb decision to just coast for a year off a group accident and critical illness plan? I know I won’t be HSA eligible, I’m just looking for truly the most bare bones coverage as I expect to be brought on full time with benefits at my current job in the next calendar year. I just want some protection if I get hit by a car, kidney failure etc.

Any help would be great !

Edit: I’m also open to getting additional coverage for accident for example with even a $50/mo premium. The lowest plan I can find that’s HDHP in California is like $230 / mo.

I go to an allergist at an allergy clinic where there are four doctors, an NP and a PA. My doctor there has awful bedside manner and response times, never remembers anything about me and has gotten several things wrong including mixing the wrong immunotherapy serum, not letting me know what was in it, and prescribing the wrong schedule (which a nurse let me know after he left).

Can I just ask to switch? I’m not sure how that works, if the clinic would reject my request or if that’s frowned upon and the new doctor wouldn’t be willing to take me. They’re the only allergy shots clinic anywhere near me so I don’t want to burn bridges here. Thank you!

Hi, I work as an outpatient speech language pathologist at a hospital. I have a patient who has shared with me he needs a procedure done (at my hospital) that requires anesthesia. The hospital is requiring someone to drive him home and stay with him in the recovery room.

This patient does not drive, has no family or other social support, and has severe expressive communication difficulties. They have told him that he cannot take the bus/uber/cab, etc. I have reached out to his social worker with no success (told me they don’t offer those services, wanted to call the office and “make sure” he couldn’t take a bus home). Services at the hospital told me Medicaid could provide someone but he applied to Medicaid and he wasn’t approved. Me and my manager have exhausted all of our hospital resources we know of.

I am trying not to overreach my scope as an SLP but social services only have availability to see him once per month and he cannot read/write emails or texts or speak on the phone. I want to provide him all the help I can within my scope and professional boundaries. Any advice or resources I’m not thinking of? Thank you!

Has anyone else run into a new policy requiring mandatory prepayment at Quest at the time of service? I've gone in twice in recent months and there's been a policy change. Earlier in the year, patients were given the option of being billed after their insurance payments, which makes sense because their "estimates" are often off. Now, we are being threatened with denial of service if we don't produce a credit credit card on the spot. I am trying to find documentation of this new policy change. No one should be denied blood work because they don't have a credit card especially when the actual cost of the blood work isn't even known at that point. I also wonder about the implications for the poor and people who don't have insurance.

I'm now paying 350 every 5 days for base medical dental and vision. IF there is one American tragedy this is it. I'm so fking tired of getting milked to death.

So I’m (26m) a contractor, and only get a very small subsidy for a HDHP from work. AEP ended for them on 11/15, and since I wasn’t sure if the plan was HSA eligible I decided do decline coverage.

I did keep critical illness coverage and group accident policies through MetLife.

For 2025 the only expected health care costs I will have will essentially be psychiatry which will be effectively out of pocket under the plan I would’ve had through work.

I wanted to ask if it is a really dumb decision to just coast for a year off a group accident and critical illness plan? I know I won’t be HSA eligible, I’m just looking for truly the most bare bones coverage as I expect to be brought on full time with benefits at my current job in the next calendar year. I just want some protection if I get hit by a car, kidney failure etc.

Any help would be great !

Edit: I’m also open to getting additional coverage for accident for example with even a $50/mo premium. The lowest plan I can find that’s HDHP in California is like $230 / mo.

Hey I’ve been trying to schedule an annual exam to avoid surcharge of $500 from my insurance before the end of the year. And I am out of luck. All appointments are couple of months out any suggestions?

Hi everyone, quick question, when do i lose medicaid insurance in illinois after turning 26? Is it at the end of the month, and do you just reapply? State of residence: IL

Follow up q as well: In addition to medicaid can you get a different dental and vision plan? For example a dental plan that will cover more with a wisdom teeth removal compared to medicaid?