I don’t know the actual answer. My theory is it’s this confusing so it’s hard for the general population to catch the mistakes. This allows insurance companies get out of paying as much as they’re supposed to. And hospitals don’t really care who does the paying, as long as they get paid

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.

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:

1. You’ve paid $400 this year so far. You pay the full $1000: $400 + $1000 = $1400 which is less than your deductible of $1500
2. 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.
3. You’ve paid $1700 so far. You pay $500 and insurance pays $500. $1700 + $500 = $2200 which is less than your OOP of $2500
4. 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.
5. 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.

And then you go put more peanuts out, I assume

I believe this is the recipe

Very true. I play what I like to call “brain candy” games. Nothing that requires too much thinking, as most of the day my brain is trying to run a marathon at a sprinting speed.

Yeah, Cozy Grove is on my switch. As you advance in the game, you unlock more map. More map means more NPC critters roaming around. I think I unlocked 8-9 bears before it got noticeable, but there are 17 in all and I don’t know if my switch can make it to that many.

I just started Ring Fit last week, as I found a good deal on an open box game. I’m still trying to get the leg sensor to register my movement correctly, but so far the levels are fun.

Thank you

I can. I wouldn’t be so arrogant as to assume I know what everyone’s experience is, or to claim my experience is the single universal experience.

Surely you can accept that it is the case for some

It happened to me when I was 8 (not by Woody Allen). I can still remember every detail. It sticks with you

I’m very boring - most likely Animal Crossing and Ring Fit Adventure on switch and Slime Rancher 2 on xbox. Maybe do some stuff in my family’s Minecraft realm

Thinking about restarting Cozy Grove since I haven’t played it in so long, but I stopped because the lag got worse every time I got a new bear

Same ones I use every day, my 10x42s

Find out if your local county or municipality has a required timeframe. By us it’s every 3 years.

As far as how to tell in the short term, is there a tank between your house and the drain field that you can access (has maybe a round metal or concrete cover or a plastic riser with lid)? If so, lift the lid and see if you can see the top of the pipe going in the direction of the drain field. If so it’s likely draining fine. If the liquid is near the top of the tank and you can’t see a pipe, you’ll want to get someone to look at it sooner rather than later.