‘I truly don’t understand the point of a copay’: Patient pays $230 a month for health insurance. He’s still on the hook for this large copay


Like death and taxes, health insurance is something every American has to deal with in their lifetime. Whether it’s finding new policies to cover a variety of illnesses, getting their first policy at 26, or finding providers who will accept their plan, it can be an overwhelming and frustrating process.

One TikTok creator recently made his foray into independent healthcare after aging out of being eligible for his parents’ insurance, and he shared his frustrations with the current system in a video that has drawn over 349,000 views.

Comic and content creator Jony (@john__hedrick) took to the social media platform to share his frustrations with the American healthcare system, in particular the copay plan model. He explained that he recently turned 26, which meant he had to find his own insurance coverage under federal law. The plan he was able to get started at $500, he said, and he was eventually able to whittle it down to $230 per month by removing coverages he would not need.

However, he claims, his frustrations came to a head when he used his insurance’s online portal to find a new neurologist but still ended up at an out-of-network provider.

“If I don’t get my meds, my brain will implode once a week, okay. That’s how it works,” he says in the video. “So I’m looking for a new neurologist, I find one on the portal, I go to the neurologist, and by the time I’m there, they’re like, hey, we don’t take your health insurance. I found you on the portal, are you kidding me? How does that even make sense? That doesn’t even make any godd*mn sense. What the hell is going on? I swear to god the American government just wants their citizens to suffer. This should be free, none of this should be an issue.”

Even with an in-network provider, Jony says he had to pay a copay on top of his monthly insurance premium, which he found to be another source of frustration.

“I pay $60 to get seen by a doctor?” he says. “I’m already paying $250 a month. Are you f*cking kidding me? That’s insane. This should be free. There are first world countries that have already figured this out.”

@john__hedrick livid #usa ♬ original sound – jony

Multiple users agreed with Jony, complaining about exorbitant copays and also writing that they did not totally understand the point of a copay if they were already paying an insurance premium..

“I truly don’t understand the point of a copay,” one commenter wrote.

“Having surgery in 2 weeks and they told me that luckily my insurance covers a lot so I ‘only’ have to pay $5k,” another wrote.

“Just had to pay 850 dollars for a MRI with insurance coverage… I hate it here,” someone else vented.

Others shared that they had also experienced difficulties when it came to confirming whether their insurance would be accepted by a certain clinic or doctor, despite the doctor being listed as in-network.

“At a walkin clinic, said do you take my insurance?” one commenter wrote. “They say yes. Saw the doctor and turns out THAT doctor didn’t accept it. Billed me 600.”

“Hell yeah. The portal led me to a surgeon,” another commenter wrote. “He was in network, but surgery with him wasn’t in network. Wasted time and money.”

“Don’t call the Doctor’s office, call the insurance company,” a commenter wrote. “I called the Dr, they told me they take it, saw the Dr. And then they billed me. Both Doctors Office and Insurance were like, ‘too bad.'”

The Daily Dot has reached out to the creator via Instagram direct message regarding the video.

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Source: https://www.dailydot.com/news/230-dollar-health-insurance-60-dollar-copay/