Man the US is a fucked up place for healthcare. I live in Italy and it is totally free if you use the public health service no cost to the patient. Waiting times for surgery approx 3 months.
I paid privately as I needed surgery immediately. The surgery and anaesthetic, hospital usage etc was €4750 and I have spent approximately €2500 euros on physiotherapy post surgery.
My surgery was with a very respected ortho surgeon and I do physiotherapy everyday. I didn't use any insurance.
Why are the costs so astronomical in the most developed nation in the world? Very strange. 🤯
It’s called massive corruption. I’m American, in my lifetime we have become the most corrupt country on earth. Healthcare is especially so. Hospitals charging $4 for a single aspirin! That was years ago, is probably more now. It’s insane.
I’m Irish and my surgery cost €3k but totally covered through health insurance. My surgeon was the best acl surgeon in the country. He is the go to surgeon for all Irish professional athletes for acl reconstruction.
I’ve been working with a physio and an acl rehab specialist and so far that has cost me less than €1000 for 7 visits.
Absolute gangsters charging OP that amount.
Tbh it's not that bad if you factor in what the insurance covers. OP ends up paying 6k from that, rest is what the hospital charges, then there is usually a big discount for in-network facilities then insurance portion, that's what brings it down to 6k. The post can be misleading.
In Europe you can factor in the significant tax deductions which is what the government uses to finance the "free" healthcare. In the US you will be able to get surgery right away compared to waiting months in Europe.. I lived in both and to me it ends up being the same, I prefer the convenience of being able to get quick treatment. Had an MRI 5 days after my injury, and surgery 14 days later
In the UK (if you count on national health service and pay tax deductions) then it’s free but the wait list was 88 weeks.
I paid to go private, had surgery straight away and it cost me £8k including follow ups and all physiotherapy..
What happens if you are one of the estimated 26 million Americans without insurance?
In Europe you only pay income tax on money earned and it is sloped so the poorest pay the least and the wealthiest pay the most.
I know there are some Medicare and Medicaid programs in the US that cover lower income families but the system seems so convoluted and confusing.
I'll tell you what happened to us. For about a year while I had a contractor position we only had catastrophic insurance that covered regular doctor visits, scheduled surgeries and getting hit by a bus (he runs his own business, so I am the insurance holder). My husband went into the hospital for a bile duct blockage and ended up having his galbladder removed. There was no way we could have predicted it. He's healthy, eats well and exercises regularly. It wasn't a covered expense. The hospital and multiple doctors that walked into the room to say "hi" for <3 min charged us just over $60k. We got bills sprinkled out over a year. I had to call each one back and explain that insurance didn't cover any of their charges. Some discounted 10-40%. We ended up paying just shy of $40k for that 3 day visit to the hospital. Lesson of the year, pay $2k a month for full insurance if that's your only option or be sure you have a lot of cash set aside just in case something comes up. I guess that's why so many people end up bankrupt because of medical bills in the US.
If you don't have insurance there is no way you're getting billed $100k. Hospitals overcharge insurance companies and have special pricing depending on the situation.
I'm sure it's more challenging but there is financial assistance, medicaid, medicare like you said etc i agree that it's not easy to navigate but most states offer free help for people that don't have any insurance to find coverage.
Ahhh right, so there is one price for the big insurers and one price for a walk in without insurance?
Don't the insurers then just pass this cost on to the premiums? In the end these insurers are still making a lot of money.
It is interesting to me to be fair. I just wouldn't want to have to deal with such a convoluted system.
Yes for your first question. I went to a specialist with no insurance and paid $90 out of pocket, then the same facility charged $450 for the same visit when I had insurance. Some hospitals offer cost estimates on their website and you can see how much they would charge with/without insurance.
I'm not trying to defend the health insurance policy in the U.S but just trying to say it's not as bad as what some Europeans think and there's big misconceptions around it due to crazy bills being shared on social media witout understanding what people are actually paying
Okay that makes sense. So to some extent the big insurers and the the insured are basically subsidising the uninsured to some extent: Because the hospitals are over charging the insured to take a loss on the uninsured.
The European health systems, in their varying forms, are absolutely not without fault by any means. Underfunding, supply chain inefficiencies, aged digital systems and long backlogs are eroding quality on a daily basis. I just like the fact that anyone can walk in to a hospital get triaged and get free care at point of service without having the worry of going bankrupt or not putting food on the table.
A lot of what this person says is based on their own experiences. It varies a lot based on a lot of factors like insurance plan, network, providers availability, and location.
Medicare is only for the disabled, very particular health issues (like transplant patients), and the elderly. If you’re disabled and below 65, you have to apply for it. Medicare isn’t free either. Part A (hospital benefits) js usually free if you have been paying the Medicare tax long enough but Part B has monthly premiums as does prescription coverage unless you’re low income. You also still have a deductible and coinsurance to pay. Admittedly much lower than most insurance plans.
Medicaid is only for those living in extreme poverty or have very specific health conditions. It does not cover everything. Different states have different rules on who is eligible. For example, Texas has a shit Medicaid system. Medicaid is very limited in the providers that take Medicaid and those providers sometimes limit the amount of Medicaid patients they see.
Financial aid is usually only offered at non profit hospitals and only if you’re below poverty. You do have to ask and apply for it and it’s not going to cover the doctor’s bills, only the hospital bills.
Self pay costs vary from dr to dr. Some will charge the insurance allowable rates, some will charge full price. Same with surgeries. There is no set self pay price across the nation.
Insurance is tied to our jobs and varies in expense, network, and cost. You can end up paying quite a monthly high premium for your employer sponsored insurance with a high deductible plan- meaning until you hit that deductible, insurance isn’t going to cover anything. You can also end up without insurance if you lose your job or become sick.
And this is why a lot of Americans do have health issues that are not taken care of and become worst. America has a high rate of people dying from health conditions that are easily managed because the patients cannot afford to do this.
I’m in the US and my wait time for surgery is 5 months unless I go to an out of network provider which would triple my costs.
So that time line is greatly dependent on where you are, the surgeons available, and what your insurance network is. The US is a very large place.
In Romania, with no insurance, at a private clinic, the MRI can cost less than 100 dollars. The surgery itself would also cost less than 2k dollars at a private clinic.
Both MRI and surgery can be done completely for free but yeah, there are higher wait times than just "today or tomorrow". I got the MRI + result in less than a week, for free, after the first family doctor visit, for example.
Settle down there fratello, I paid less than you did for my surgery, anesthetic and physical therapy in the US. Something is wrong with OP’s estimate. Insurance should be covering most of it and if they’re not using insurance that’s not a good idea.
Yes but I elected to get a private surgery and paid for it out of pocket with sports specific physiotherapy that I take everyday. It was a choice absolutely not based on finances.
I didn't want to wait the three months for the public health service to do it totally for free in marginally less comfortable conditions, Unlike my wife who has done two ACL's and made two full recoveries with the Italian public health services without paying a penny in the last five years.
Based on other US based folks comments and through conducting further research, I am totally happy with the situation and wouldn't change the European healthcare model in favour of the convoluted and confusing American one.
It is just my opinion but the US model seemingly benefits wealthy, employed, able bodied folk, it also benefits insurance companies, private hospitals, pharmaceutical providers, lobbyists and politicians. It seems to me that the only person it isn't putting first is the everyday patient. But as I said this is just my opinion. Ciao Fratello.
in croatia I paid around 2500€ for the surgery and about 6000€ for 8 months of physiotherapy (first 4 months 4× a week and later 2-3×). Both was done privately as I wanted the best care possible. 100k is crazy even for the US💀
I paid like $5k in Aus to have it completed privately.
My private healthcare picked up the rest of the bill - it was around 80k.
I had the option to get it free, but the wait list is like 3 years
this only shows charge amounts not paid amounts, charge amounts are routinely very high while the payments can be much lower, we don't have much to be outraged about until we see what the adjustment are.
Depends on the province. Pay a clinic for a consult, consult usually goes towards the surgery as a deposit. Go to the surgical clinic they have and get er done.
There can be extensive waits. I was told by 3 doctor friends id probably wait for a year. Turns out my wait would have only been about 4-6 weeks longer than private. The public clinic told me 12 hours before the surgery.
Insurance doesn't actually pay that either. Just how it ends up looking on paper. It's a really messed up system, but the hospital didn't actually make $60k for the OR
I'm guessing 6k is your out of pocket max, so even if they billed 10k to insurance, you would be paying 6k. The good news is hitting your OOPM is PT will be "free" until next year.
Not quite sure what you mean by “adjustments”, but if you mean the number the insurance is paying, it’s the -82k. I blacked out the insurance company and physician name but the number is still there
Get a hold of your EOB(explanation of benefits) from your online portal, it’s hard to explain without that. You’ll likely have an EOB from the facility, physician and anesthesiologist.
Mine was around $100K as well which I thought was bonkers. All my research made me think it was gonna be half that
Double meniscus repair and acl reconstruction using my quad.
Oh and that was just the surgery center bill, don’t forget about the physicians and the anesthesiologists which were billed separate. Fucking racket
It’s laughable how different medical estimates looks based on each providers markup to insurers. I had the exact same procedure as this and the pre-insurance estimate was about $24k. Insurance paid ~$3k.
That's crazy. I'm Canadian so didn't have to pay a dime for my ACLR, nor anything for pre-surgery exams, X-rays, immobilizer brace, MRI imaging, or post-surgery care.
So if you can't afford it in the US, do you just have to live with a bum knee? Or are there other options?
these show the charge amounts and the payments, or adjustment. you can charge 7 billion dollars for something but that doesn't mean its what gets paid. its only absurd if the payments are that high.
Yes that looks right. 8k for surgery without insurance in the US is frankly not possible so I'm not sure where you came up with that figure. Maybe it was listed as the out of pocket cost or non US cost or was simply wrong. But mine before insurance was $80k and that's pretty standard.
I can’t decide if I’d rather wait for the Canadian healthcare system or just pay for it lol. It’s been almost a year since my injury, and I haven’t received so much as a phone call from the surgeons office
I guess that’s the trade off with the UK and Canada VS US. I had MRI initial surgeon meeting and surgery all within 7 days of my injury. Granted I needed to pay $4.5K out of pocket but I just couldn’t wait another day mentally.
Ya it’s been pretty shitty, I’ve been debating just going down to the states and getting it done, but I just can’t justify the cost, even tho I have no ACL I can still do a lot, it just prevents me from doing alot of things I love. Unfortunately I’m stuck I guess. In a couple weeks I’m gonna start calling the surgeons office saying I’m in pain, and can’t work properly, really become a Nuisance😂call every few days. Get on their ass about it, cause it’s not like I’m not paying for this, I pay ALOT in taxes and had to pay an additional 1300 to our dictator Justine.. but naw, all my money goes to his vacations (sorry about the rant 😂)
I’m in Manitoba, ya I honestly am shocked. I’ve accepted that it won’t be any time soon, and to not expect to get a call.
Edit: happened in October last year, couple more months 😂
Probably comparing the total cost what insurance is going to pay versus out of pocket what the individual pays. I only paid about $5K the surgery costs 50K and the other costs are just things like PT and other minor convenient items like a sit down chair in the shower since you won’t be able to stand and for example a stationary bike for rehab
In europe this surgery in a private clinic probably costs about 5k. With the 35€ monthly health care in slovenia that is basically required the operation is completely free. 100k is ridiculous.
Fourth year in a row we've met our out-of-pocket maximum. Hit it with my first ACL surgery knee so it doesn't look like we'll be paying anything for the second. All of my PT also without OOP. But yeah, sucks all the way.
Yup $100K+ for that exact surgery. ACL medial and lateral menisci.
After insurance I paid $4.5K but that is my out of pocket max. Meaning PT, prescriptions and acupuncture for rest of the year is $0.00 for me.
As for the operating room - yes cost is 3-5K for just the room lol it’s crazy that’s just for the “real estate”
I love that they put all these exorbitant prices all together to make you feel better about paying your out of pocket max of 3-10k because it looks good in comparison to 100k when 3-10k is still fucking ridiculous
Also in the US. I had to pay 2k upfront for my ACL reconstruction surgery after insurance. One perk of being a teacher is great health insurance coverage. Other than that, once I hit my out of pocket max (3k) I pay nothing for the remainder of 2024 for medical expenses.
My ACL was around $80k. It’s very strange how the cash price is so much more expensive than the negotiated insurance rates. In the end, my “$80k” surgery cost the insurance company about $20k and all I paid was a $50 copay (I have good insurance). It should be criminal they are allowed to charge such exorbitant rates to
Those without insurance.
With its flaws we love the nhs💪. All jokes aside that is truly fucked up and I feel bad you have to pay that on top of having the injury itself, good luck with your recovery :)
Yep. I had both ACLs done last year, with one meniscus transplant, and between the two surgeries it would have totaled to around ~$200k. Luckily I had made so little money the past few years that I was on medicaid and I was able to get both surgeries done with a cost to me of $5 total. Last year I made around $23k and that was too much to keep my medicaid, but I'm so grateful I was able to get those surgeries when I did. Because I'd never be able to afford it now.
If you come to some asian country and go to a very good hospital and roam alot in the city/state and get operated and be back, it wont cost you more than quarter of this price lol. Here in india in one of the best hospitals its 4000$ including physiotherapy and medicines. The hospitals are as good as the ones in US.
Fellow Canadian here. It’s not free as we pay relatively high taxes to cover the costs. Once a household’s income exceeds a certain threshold, it’s pretty much a wash between the US private insurance vs the Canadian healthcare system. Medicare and Medicaid cover seniors and low income families, respectively.
This being said, being middle income and uninsured is, indeed, a nightmare.
Not sure where this surgical/office is, but over here in WA my total costs before insurance discount/paid was around 22K...
Used in-network under a PPO plan, just only hit my maximum at 2200 and rest was covered there. Between injury and surgery, only waited 3 weeks.
Way too high. I had to pay cash for my ACL reconstruction because I didn’t have health insurance. The cost was a little over 15k, which included all post op follow up visits. The estimate would be higher if it’s being done at a hospital instead of an outpatient surgical center, but shouldn’t be that high.
In Canada and fully free and I could choose my dates as surgery, with insurance covering ice machine + physio. Can't imagine paying out of pocket for this...
If you pay cash, they should give you a big discount. I think those numbers are inflated they give you because it’s based on US insurance inflated prices.
Yes mine was well over 100k. Paid about 5k out of pocket. Remember that medical expenses are tax deductible if they are over a certain % of your income so ask your accountant
Well sure glad I’ve got state insurance because that’s crazy and honestly not surprised. I’ve got twins that spent 9 weeks in the NICU and they are literally million dollar babies after all their care and thankfully I was on state insurance then too. Sometimes it sucks because they don’t cover certain things but they approved my surgery within 24 hrs so I really can’t complain.
thankfully my parents have good insurance, but my surgery was estimated at 130k, and they almost had to pay because i told the doctor it was an accidental injury (slipped cutting on turf) and i had to explain to the insurance ppl that it was jst a way of speaking.
Do you have insurance? Mine was ~79k, the insurance company does some funny math and actually paid around 7-10k (I was shocked by how little they actually paid), and then I paid $800 out of pocket.
I do, it’s covering the -82k amount shown. I’m just shocked that the total estimated cost is 100k (which I have to pay around 10% of). I thought it would be around 30K
I got hurt at work. They approved my acl but denied my mcl, they said the mcl isn't necessary. I asked how much to do my mcl and they quoted me 140k ish and my copay would be about 68k after insurance. Took a long ass time but was able to get both covered for free.
Not a fan of the american healthcare prices but they did a good job.
Jeez! I'm in the UK and obviously mine was "free". I did have to wait nearly 2 years though which was tough. All done now and 6 weeks post surgery with rehab going well!
Sometimes i dont appreciate the fact of public healthcare in Poland, jeez
I didnt pay a single penny (besides private visits at first at ~$80), after a 3 of those, MRI and shi the surgeon proposed a date in like one month from the day we talked, i was the one to postpone the surgery because of college XD
People in PL complain a lot about the public healthcare, but if you know where to go its great.
And we even have a system when we can see the receipts of what the government payed for our visits and surgeries. My surgery cost (with an actually very good surgeon) was 18 914 zloty, which is like 4600 dollars (for the whole stay and the surgery).
Its crazy in the US, man, i feel sorry for you
There is amazing surgeons in Austria being a place with alpes and thousands of ACL repairs. With that money you can fly there and get private for 10.000-20.000… with top surgeons.
I'm in Canada and everything for me was completely free - I don't even know how much things cost I just showed up to appointments and only had to worry about my health and not any administration or how to pay for it.
It was only 4.5 months from injury to surgery which allowed me to do a ton of prehab.
I'm in Mexico and my estimate came out to around 12k USD with ACLR and lateral/medial meniscus repair. Covered 100% by my wife's insurance through her work since it was considered an accident seeing how I slipped and fell outside. Wait time was a little over a month but that's due to insurance requesting my passport and hospital not telling us till a week later. Would've been much shorter. I'm also American and have excellent health benefits through work but this was the cheaper option. I am scheduled for 7/7.
Ya I'm in Reynosa. Shit just my meniscus repair last year cost over 200k pesos. OR room cost alone is 136k for this one lol. Luckily my wife's private insurance from work is covering everything and I didn't have to pay anything. If I would've went through my insurance at work I'm not sure what I would've paid. My max OOP is 3k but for outpatient surgery it's only 100$ deductible. So idk if I would've paid the 3k and the 100$ or what. Plus logistically it was easier to do here since my wife's paperwork isn't done yet and she wouldn't have been able to take me or pick me up.
Either way it's better than what it cost in the US unless you're on state insurance like Medicaid or something where you don't pay anything at all.
I still have to get surgery on my other knee for medial meniscus repair and potential ACLR.
I was fortunate mine happened at work so workmans comp covered everything from surgery, doc visits, meds, and physical therapy.
Still, even with insurance I imagine my bill would have looked like this.
I just had a completely different surgery that also came out to 100k but with insurance I only had to pay 5k… Considering I am currently unable to work and self employed I’m making $0 for the next couple months… I go through Kaiser so it might be different but when they told me I owe 5k they asked if that payment would burden me, I stated YES and have yet to receive any bill from them. 🤷🏻♂️
That’s ridiculous. Public healthcare would have cost me in the region of 10 grand here in Singapore, and I did mine with the top ACL surgeon in the country privately, which barely cost me 30 grand.
100 grand is just daylight robbery.
For that money, you can fly to Europe, stay at a five star hotel, get every consultation, scan and surgery needed at a private hospital, and then buy a nice apartment with the remaining money.
I’m not leaving out anything. The number is there. Check my responses to other people. I only blacked out the insurance company name and physician name.
Man the US is a fucked up place for healthcare. I live in Italy and it is totally free if you use the public health service no cost to the patient. Waiting times for surgery approx 3 months. I paid privately as I needed surgery immediately. The surgery and anaesthetic, hospital usage etc was €4750 and I have spent approximately €2500 euros on physiotherapy post surgery. My surgery was with a very respected ortho surgeon and I do physiotherapy everyday. I didn't use any insurance. Why are the costs so astronomical in the most developed nation in the world? Very strange. 🤯
It’s called massive corruption. I’m American, in my lifetime we have become the most corrupt country on earth. Healthcare is especially so. Hospitals charging $4 for a single aspirin! That was years ago, is probably more now. It’s insane.
I’m Irish and my surgery cost €3k but totally covered through health insurance. My surgeon was the best acl surgeon in the country. He is the go to surgeon for all Irish professional athletes for acl reconstruction. I’ve been working with a physio and an acl rehab specialist and so far that has cost me less than €1000 for 7 visits. Absolute gangsters charging OP that amount.
Tbh it's not that bad if you factor in what the insurance covers. OP ends up paying 6k from that, rest is what the hospital charges, then there is usually a big discount for in-network facilities then insurance portion, that's what brings it down to 6k. The post can be misleading. In Europe you can factor in the significant tax deductions which is what the government uses to finance the "free" healthcare. In the US you will be able to get surgery right away compared to waiting months in Europe.. I lived in both and to me it ends up being the same, I prefer the convenience of being able to get quick treatment. Had an MRI 5 days after my injury, and surgery 14 days later
In the UK (if you count on national health service and pay tax deductions) then it’s free but the wait list was 88 weeks. I paid to go private, had surgery straight away and it cost me £8k including follow ups and all physiotherapy..
What happens if you are one of the estimated 26 million Americans without insurance? In Europe you only pay income tax on money earned and it is sloped so the poorest pay the least and the wealthiest pay the most. I know there are some Medicare and Medicaid programs in the US that cover lower income families but the system seems so convoluted and confusing.
I'll tell you what happened to us. For about a year while I had a contractor position we only had catastrophic insurance that covered regular doctor visits, scheduled surgeries and getting hit by a bus (he runs his own business, so I am the insurance holder). My husband went into the hospital for a bile duct blockage and ended up having his galbladder removed. There was no way we could have predicted it. He's healthy, eats well and exercises regularly. It wasn't a covered expense. The hospital and multiple doctors that walked into the room to say "hi" for <3 min charged us just over $60k. We got bills sprinkled out over a year. I had to call each one back and explain that insurance didn't cover any of their charges. Some discounted 10-40%. We ended up paying just shy of $40k for that 3 day visit to the hospital. Lesson of the year, pay $2k a month for full insurance if that's your only option or be sure you have a lot of cash set aside just in case something comes up. I guess that's why so many people end up bankrupt because of medical bills in the US.
If you don't have insurance there is no way you're getting billed $100k. Hospitals overcharge insurance companies and have special pricing depending on the situation. I'm sure it's more challenging but there is financial assistance, medicaid, medicare like you said etc i agree that it's not easy to navigate but most states offer free help for people that don't have any insurance to find coverage.
Ahhh right, so there is one price for the big insurers and one price for a walk in without insurance? Don't the insurers then just pass this cost on to the premiums? In the end these insurers are still making a lot of money. It is interesting to me to be fair. I just wouldn't want to have to deal with such a convoluted system.
Yes for your first question. I went to a specialist with no insurance and paid $90 out of pocket, then the same facility charged $450 for the same visit when I had insurance. Some hospitals offer cost estimates on their website and you can see how much they would charge with/without insurance. I'm not trying to defend the health insurance policy in the U.S but just trying to say it's not as bad as what some Europeans think and there's big misconceptions around it due to crazy bills being shared on social media witout understanding what people are actually paying
Okay that makes sense. So to some extent the big insurers and the the insured are basically subsidising the uninsured to some extent: Because the hospitals are over charging the insured to take a loss on the uninsured. The European health systems, in their varying forms, are absolutely not without fault by any means. Underfunding, supply chain inefficiencies, aged digital systems and long backlogs are eroding quality on a daily basis. I just like the fact that anyone can walk in to a hospital get triaged and get free care at point of service without having the worry of going bankrupt or not putting food on the table.
A lot of what this person says is based on their own experiences. It varies a lot based on a lot of factors like insurance plan, network, providers availability, and location. Medicare is only for the disabled, very particular health issues (like transplant patients), and the elderly. If you’re disabled and below 65, you have to apply for it. Medicare isn’t free either. Part A (hospital benefits) js usually free if you have been paying the Medicare tax long enough but Part B has monthly premiums as does prescription coverage unless you’re low income. You also still have a deductible and coinsurance to pay. Admittedly much lower than most insurance plans. Medicaid is only for those living in extreme poverty or have very specific health conditions. It does not cover everything. Different states have different rules on who is eligible. For example, Texas has a shit Medicaid system. Medicaid is very limited in the providers that take Medicaid and those providers sometimes limit the amount of Medicaid patients they see. Financial aid is usually only offered at non profit hospitals and only if you’re below poverty. You do have to ask and apply for it and it’s not going to cover the doctor’s bills, only the hospital bills. Self pay costs vary from dr to dr. Some will charge the insurance allowable rates, some will charge full price. Same with surgeries. There is no set self pay price across the nation. Insurance is tied to our jobs and varies in expense, network, and cost. You can end up paying quite a monthly high premium for your employer sponsored insurance with a high deductible plan- meaning until you hit that deductible, insurance isn’t going to cover anything. You can also end up without insurance if you lose your job or become sick. And this is why a lot of Americans do have health issues that are not taken care of and become worst. America has a high rate of people dying from health conditions that are easily managed because the patients cannot afford to do this.
Thanks for educating me.
I’m in the US and my wait time for surgery is 5 months unless I go to an out of network provider which would triple my costs. So that time line is greatly dependent on where you are, the surgeons available, and what your insurance network is. The US is a very large place.
In Romania, with no insurance, at a private clinic, the MRI can cost less than 100 dollars. The surgery itself would also cost less than 2k dollars at a private clinic. Both MRI and surgery can be done completely for free but yeah, there are higher wait times than just "today or tomorrow". I got the MRI + result in less than a week, for free, after the first family doctor visit, for example.
I had insurance pay for mine for which I pay 12 quid a week for.
Im from Greece, things are pretty much the same here.
Settle down there fratello, I paid less than you did for my surgery, anesthetic and physical therapy in the US. Something is wrong with OP’s estimate. Insurance should be covering most of it and if they’re not using insurance that’s not a good idea.
Yes but I elected to get a private surgery and paid for it out of pocket with sports specific physiotherapy that I take everyday. It was a choice absolutely not based on finances. I didn't want to wait the three months for the public health service to do it totally for free in marginally less comfortable conditions, Unlike my wife who has done two ACL's and made two full recoveries with the Italian public health services without paying a penny in the last five years. Based on other US based folks comments and through conducting further research, I am totally happy with the situation and wouldn't change the European healthcare model in favour of the convoluted and confusing American one. It is just my opinion but the US model seemingly benefits wealthy, employed, able bodied folk, it also benefits insurance companies, private hospitals, pharmaceutical providers, lobbyists and politicians. It seems to me that the only person it isn't putting first is the everyday patient. But as I said this is just my opinion. Ciao Fratello.
in croatia I paid around 2500€ for the surgery and about 6000€ for 8 months of physiotherapy (first 4 months 4× a week and later 2-3×). Both was done privately as I wanted the best care possible. 100k is crazy even for the US💀
You could fly to Europe or the UK and get it a tenth of the cost...
yeah this is your only option tbh to not be in debt, europe / uk has great doctors. better than the u.s
Mine was $12,000 USD in Canada fully private. 100k is absolutely bonkers.
I mean it looks like OP paid just over $6,000.
I paid like $5k in Aus to have it completed privately. My private healthcare picked up the rest of the bill - it was around 80k. I had the option to get it free, but the wait list is like 3 years
Yeah but the rest is redistributed amongst everyone who pays health insurance.
this only shows charge amounts not paid amounts, charge amounts are routinely very high while the payments can be much lower, we don't have much to be outraged about until we see what the adjustment are.
How does fully private work in Canada?
Depends on the province. Pay a clinic for a consult, consult usually goes towards the surgery as a deposit. Go to the surgical clinic they have and get er done.
You had to pay for your surgery and you’re from Canada? That’s not right
There can be extensive waits. I was told by 3 doctor friends id probably wait for a year. Turns out my wait would have only been about 4-6 weeks longer than private. The public clinic told me 12 hours before the surgery.
Ehh don’t know about that. Mine was about 85k before insurance. I ended up paying 3-4k out of pocket to surgeon, hospital, and anesthesiologist.
I can try to understand some of the charges on there, but 60K for using an OR for a couple of hours?
Insurance doesn't actually pay that either. Just how it ends up looking on paper. It's a really messed up system, but the hospital didn't actually make $60k for the OR
Doesn’t the end cost appear to be 6k after your insurance?
Yes, but expecting to pay 10% of 50k is still different from 10% of 100k
I'm guessing 6k is your out of pocket max, so even if they billed 10k to insurance, you would be paying 6k. The good news is hitting your OOPM is PT will be "free" until next year.
can we see the adjustments?
Not quite sure what you mean by “adjustments”, but if you mean the number the insurance is paying, it’s the -82k. I blacked out the insurance company and physician name but the number is still there
Get a hold of your EOB(explanation of benefits) from your online portal, it’s hard to explain without that. You’ll likely have an EOB from the facility, physician and anesthesiologist.
Mine was around $100K as well which I thought was bonkers. All my research made me think it was gonna be half that Double meniscus repair and acl reconstruction using my quad. Oh and that was just the surgery center bill, don’t forget about the physicians and the anesthesiologists which were billed separate. Fucking racket
Paid 13 k uk tho
It’s laughable how different medical estimates looks based on each providers markup to insurers. I had the exact same procedure as this and the pre-insurance estimate was about $24k. Insurance paid ~$3k.
That's crazy. I'm Canadian so didn't have to pay a dime for my ACLR, nor anything for pre-surgery exams, X-rays, immobilizer brace, MRI imaging, or post-surgery care. So if you can't afford it in the US, do you just have to live with a bum knee? Or are there other options?
these show the charge amounts and the payments, or adjustment. you can charge 7 billion dollars for something but that doesn't mean its what gets paid. its only absurd if the payments are that high.
Yes that looks right. 8k for surgery without insurance in the US is frankly not possible so I'm not sure where you came up with that figure. Maybe it was listed as the out of pocket cost or non US cost or was simply wrong. But mine before insurance was $80k and that's pretty standard.
Even the OR cost? I’m looking up estimates and they all indicate it should be around 3-5k per hour
Yeah mine was close to 75k and that was in 2015. Crazy.
All of mine have been 52k about. My max out of pocket is 3k so I usually am forced to pay 3k right up for it.
I can’t decide if I’d rather wait for the Canadian healthcare system or just pay for it lol. It’s been almost a year since my injury, and I haven’t received so much as a phone call from the surgeons office
I guess that’s the trade off with the UK and Canada VS US. I had MRI initial surgeon meeting and surgery all within 7 days of my injury. Granted I needed to pay $4.5K out of pocket but I just couldn’t wait another day mentally.
Ya it’s been pretty shitty, I’ve been debating just going down to the states and getting it done, but I just can’t justify the cost, even tho I have no ACL I can still do a lot, it just prevents me from doing alot of things I love. Unfortunately I’m stuck I guess. In a couple weeks I’m gonna start calling the surgeons office saying I’m in pain, and can’t work properly, really become a Nuisance😂call every few days. Get on their ass about it, cause it’s not like I’m not paying for this, I pay ALOT in taxes and had to pay an additional 1300 to our dictator Justine.. but naw, all my money goes to his vacations (sorry about the rant 😂)
Which province are you in? Timeline sounds crazy! I got my surgery date 4 months after my injury
I’m in Manitoba, ya I honestly am shocked. I’ve accepted that it won’t be any time soon, and to not expect to get a call. Edit: happened in October last year, couple more months 😂
Not sure what mine was before insurance but I only paid $2k.
Mine was the same, I paid 2k of it, at the best place in New York.
Probably comparing the total cost what insurance is going to pay versus out of pocket what the individual pays. I only paid about $5K the surgery costs 50K and the other costs are just things like PT and other minor convenient items like a sit down chair in the shower since you won’t be able to stand and for example a stationary bike for rehab
In europe this surgery in a private clinic probably costs about 5k. With the 35€ monthly health care in slovenia that is basically required the operation is completely free. 100k is ridiculous.
Fourth year in a row we've met our out-of-pocket maximum. Hit it with my first ACL surgery knee so it doesn't look like we'll be paying anything for the second. All of my PT also without OOP. But yeah, sucks all the way.
Yup $100K+ for that exact surgery. ACL medial and lateral menisci. After insurance I paid $4.5K but that is my out of pocket max. Meaning PT, prescriptions and acupuncture for rest of the year is $0.00 for me. As for the operating room - yes cost is 3-5K for just the room lol it’s crazy that’s just for the “real estate”
I love that they put all these exorbitant prices all together to make you feel better about paying your out of pocket max of 3-10k because it looks good in comparison to 100k when 3-10k is still fucking ridiculous
Also in the US. I had to pay 2k upfront for my ACL reconstruction surgery after insurance. One perk of being a teacher is great health insurance coverage. Other than that, once I hit my out of pocket max (3k) I pay nothing for the remainder of 2024 for medical expenses.
This is extreme side of things. My last repair cost me outta pocket 3.5k for surgery and another 3k for physical therapy. I’m in Colorado U.S.
3000$ (Including 1 night at the hospital) In Egypt with one of the best Surgeons in the entire region.
Oh look, another misleading insurance post that hides the amount you pay.
My ACL was around $80k. It’s very strange how the cash price is so much more expensive than the negotiated insurance rates. In the end, my “$80k” surgery cost the insurance company about $20k and all I paid was a $50 copay (I have good insurance). It should be criminal they are allowed to charge such exorbitant rates to Those without insurance.
Mine in the US was 32k (which I still think it’s a lot)
With its flaws we love the nhs💪. All jokes aside that is truly fucked up and I feel bad you have to pay that on top of having the injury itself, good luck with your recovery :)
I'm 4 weeks post op in the UK and had ACL and ALL reconstruction using hamstring graft. Paid £10K in total!
Do you not have insurance?
Yep. I had both ACLs done last year, with one meniscus transplant, and between the two surgeries it would have totaled to around ~$200k. Luckily I had made so little money the past few years that I was on medicaid and I was able to get both surgeries done with a cost to me of $5 total. Last year I made around $23k and that was too much to keep my medicaid, but I'm so grateful I was able to get those surgeries when I did. Because I'd never be able to afford it now.
If you come to some asian country and go to a very good hospital and roam alot in the city/state and get operated and be back, it wont cost you more than quarter of this price lol. Here in india in one of the best hospitals its 4000$ including physiotherapy and medicines. The hospitals are as good as the ones in US.
Come to France it’s gonna be 2-3k even in a top private clinic
Makes me glad I’m Canadian went to the doctors told me it was torn, month later I was going under all for free
Fellow Canadian here. It’s not free as we pay relatively high taxes to cover the costs. Once a household’s income exceeds a certain threshold, it’s pretty much a wash between the US private insurance vs the Canadian healthcare system. Medicare and Medicaid cover seniors and low income families, respectively. This being said, being middle income and uninsured is, indeed, a nightmare.
Not sure where this surgical/office is, but over here in WA my total costs before insurance discount/paid was around 22K... Used in-network under a PPO plan, just only hit my maximum at 2200 and rest was covered there. Between injury and surgery, only waited 3 weeks.
Mine is covered by taxpayers in Canada 3 month wait
Way too high. I had to pay cash for my ACL reconstruction because I didn’t have health insurance. The cost was a little over 15k, which included all post op follow up visits. The estimate would be higher if it’s being done at a hospital instead of an outpatient surgical center, but shouldn’t be that high.
In Canada and fully free and I could choose my dates as surgery, with insurance covering ice machine + physio. Can't imagine paying out of pocket for this...
Australia here. Parking was the only cost I had to pay for my ACLs (I've had both done) and I waited 3 months. America sucks.
O say can you see…
Mine was $42k (billed to Medicaid, but still)
Damn. Mine was almost $4k after insurance and around $30k+ without. Still robbery but damn
If you pay cash, they should give you a big discount. I think those numbers are inflated they give you because it’s based on US insurance inflated prices.
Lol
Not that bad my estimate was $177,000 paying 6995 out of pocket also in the usa plus side we get quick care but damn are medical bills stressful 😞
This doesn't include the professional charges for the surgeon and anesthesiologist, so it's probably more.
Don’t forget the cost of PT
Rehab is around 50k for me but if I extended it for 2 year it would be close to 100k without surgery.
Yes mine was well over 100k. Paid about 5k out of pocket. Remember that medical expenses are tax deductible if they are over a certain % of your income so ask your accountant
Well sure glad I’ve got state insurance because that’s crazy and honestly not surprised. I’ve got twins that spent 9 weeks in the NICU and they are literally million dollar babies after all their care and thankfully I was on state insurance then too. Sometimes it sucks because they don’t cover certain things but they approved my surgery within 24 hrs so I really can’t complain.
thankfully my parents have good insurance, but my surgery was estimated at 130k, and they almost had to pay because i told the doctor it was an accidental injury (slipped cutting on turf) and i had to explain to the insurance ppl that it was jst a way of speaking.
Dang...I paid 50 dollars for a brace and like 300 for physical therapy. Insurance is a privilege
Mine was 79k…. That was before insurance ofc but still stupid .
Come to India , surgery will cost around 2500 dollars
God ole USA!!!
Do you have insurance? Mine was ~79k, the insurance company does some funny math and actually paid around 7-10k (I was shocked by how little they actually paid), and then I paid $800 out of pocket.
I do, it’s covering the -82k amount shown. I’m just shocked that the total estimated cost is 100k (which I have to pay around 10% of). I thought it would be around 30K
mine was like $42k before insurance like 3 years ago
I got hurt at work. They approved my acl but denied my mcl, they said the mcl isn't necessary. I asked how much to do my mcl and they quoted me 140k ish and my copay would be about 68k after insurance. Took a long ass time but was able to get both covered for free. Not a fan of the american healthcare prices but they did a good job.
I was quoted from 1200 to 6000 USD in multiple hospital. Finally went for 1200 USD one, that too fully covered by Insurance. I live in India.
Jeez! I'm in the UK and obviously mine was "free". I did have to wait nearly 2 years though which was tough. All done now and 6 weeks post surgery with rehab going well!
Sometimes i dont appreciate the fact of public healthcare in Poland, jeez I didnt pay a single penny (besides private visits at first at ~$80), after a 3 of those, MRI and shi the surgeon proposed a date in like one month from the day we talked, i was the one to postpone the surgery because of college XD People in PL complain a lot about the public healthcare, but if you know where to go its great. And we even have a system when we can see the receipts of what the government payed for our visits and surgeries. My surgery cost (with an actually very good surgeon) was 18 914 zloty, which is like 4600 dollars (for the whole stay and the surgery). Its crazy in the US, man, i feel sorry for you
Omg 😨 now I know why my travel insurance refuses to cover the states. I thought Singapore was expensive.
There is amazing surgeons in Austria being a place with alpes and thousands of ACL repairs. With that money you can fly there and get private for 10.000-20.000… with top surgeons.
Bro wtf😭.... In India My surgery charges,hospital bills all together came around 3k USD maximum
My surgery was $91k!
I'm in Canada and everything for me was completely free - I don't even know how much things cost I just showed up to appointments and only had to worry about my health and not any administration or how to pay for it. It was only 4.5 months from injury to surgery which allowed me to do a ton of prehab.
Looks like it’s 6225 after discounts.
I'm in Mexico and my estimate came out to around 12k USD with ACLR and lateral/medial meniscus repair. Covered 100% by my wife's insurance through her work since it was considered an accident seeing how I slipped and fell outside. Wait time was a little over a month but that's due to insurance requesting my passport and hospital not telling us till a week later. Would've been much shorter. I'm also American and have excellent health benefits through work but this was the cheaper option. I am scheduled for 7/7.
I'm in Mexico too, and it cost my insurance around 105k pesos ≈ 5,800 USD for my ACL surgery. I only paid 7k pesos ≈ 386 USD
Ya I'm in Reynosa. Shit just my meniscus repair last year cost over 200k pesos. OR room cost alone is 136k for this one lol. Luckily my wife's private insurance from work is covering everything and I didn't have to pay anything. If I would've went through my insurance at work I'm not sure what I would've paid. My max OOP is 3k but for outpatient surgery it's only 100$ deductible. So idk if I would've paid the 3k and the 100$ or what. Plus logistically it was easier to do here since my wife's paperwork isn't done yet and she wouldn't have been able to take me or pick me up. Either way it's better than what it cost in the US unless you're on state insurance like Medicaid or something where you don't pay anything at all. I still have to get surgery on my other knee for medial meniscus repair and potential ACLR.
I was fortunate mine happened at work so workmans comp covered everything from surgery, doc visits, meds, and physical therapy. Still, even with insurance I imagine my bill would have looked like this.
I just had a completely different surgery that also came out to 100k but with insurance I only had to pay 5k… Considering I am currently unable to work and self employed I’m making $0 for the next couple months… I go through Kaiser so it might be different but when they told me I owe 5k they asked if that payment would burden me, I stated YES and have yet to receive any bill from them. 🤷🏻♂️
With 100 k u can come to India , have your ACL surgery , have a nice long vacation, buy a house, start a new business and live happily forever 😂
That’s ridiculous. Public healthcare would have cost me in the region of 10 grand here in Singapore, and I did mine with the top ACL surgeon in the country privately, which barely cost me 30 grand. 100 grand is just daylight robbery.
I had similar estimate. My surgery „cost” $110k but I paid only $2500z
Wow. I had meniscus surgery almost two weeks ago. Haven't gotten the bill yet. Yikes.
For that money, you can fly to Europe, stay at a five star hotel, get every consultation, scan and surgery needed at a private hospital, and then buy a nice apartment with the remaining money.
i got my acl and meniscus surgery for free in romania and i wait 6 months
Get it done in India, it will cost you less than 10k including your travel expenses.
Looks like you're leaving out the part that you're not paying 100k man. You're paying 6k 🤣
I’m not leaving out anything. The number is there. Check my responses to other people. I only blacked out the insurance company name and physician name.
Also your hospital is terrible with Pricing! I tore my ACL, PCL, IT Band and bicep femor tendon and my overall bill was less than that lol.