Understanding Health Insurance for Dummies?


Go Suns
May 18, 2002
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Las Vegas, NV
I'm feeling like I'm at a loss with health insurance and hoping someone can point me in the direction of an article that really explains what insurance covers, and how I keep it? To clarify, I've lived a very fortunate life where I've never really been injured, had my parents cover all health costs when I was a kid, and up until not long ago, my primary care physician was a family friend, so costs were either free or like "buy me dinner" levels.

So, I've never used my employer based coverage for more than an employer mandated physical, with one minor visit for an eye injury where I still had to pay 100% out of pocket for a doctor to tell me "I don't have the equipment for this" and write me a script for some eyedrops. Years later, I have reduced vision in that eye.

And now I'm on an ACA Silver plan, which seems to cover... nothing but a physical, even though I'm paying $400+ a month. I paid for two blood work tests out of pocket and was told it'd be cheaper if I got them without insurance. I'm now struggling with what I think is a hernia or an intestinal issue, but it doesn't appear I can go to a specialist without paying out of pocket without going to a primary care doctor first, I can't find one of those anywhere without a 2-3 month wait for new patients (which I'm assuming come with a "new patient fee" and won't be covered since this isn't my preemptive care visit but an injury), and not a single person is seeming to be able to quote me a price for treatment given I've spent $0 on my deductible. They say they can't quote me for care until it's known what's needed and been provided.

My deductible is apparently about as much I spend in rent in a year, which on top of my premium, is just a ridiculous amount of cash I don't have.

Is insurance really just only for catastrophic injury/illness? On top of this, I'm reading that if you get fired (which can happen at any time for any reason in my state, functionally), you lose it.

So, why do people even have it? Why aren't we just paying out of pocket for everything? Is everyone just going sick/injured/dead or making enough money to cover it? This is especially poignant right now because I'm looking for work and am wondering if I should just look for the most money while eschewing benefits.

Honestly, I feel like I'm missing something.


Supporting Member
Mar 25, 2005
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SE valley
Welcome to why we bitch about insurance all the time. Good thing you are now mandated to have it eh?

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