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Hypothetical Insurance Situation
Old 11-02-2014, 08:14 AM   #1
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Hypothetical Insurance Situation

Suppose someone waits six months to report some medical problem to a doctor, hoping it would go away. The problem does not get worse, but doesn't go away, either. So the person goes to doctor, doctor says if patient had come in six months ago the cost to treat it would have been X, but now that six months have passed, the cost will be 3X.

With all the horror stories about insurance companies, I'm wondering if an insurance company would try to pay only x instead of 3x, since the patient waited six months.

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Old 11-02-2014, 08:32 AM   #2
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Doctors don't tell you how much something will cost.


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Old 11-02-2014, 08:37 AM   #3
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Would the treatment be the same if you'd originally reported it in the beginning, vs months later?
If so - I'd hypothetically challenge it.
Price should be based on treatment.
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Old 11-02-2014, 08:45 AM   #4
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Quote:
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Would the treatment be the same if you'd originally reported it in the beginning, vs months later?
If so - I'd hypothetically challenge it.
Price should be based on treatment.
Let's say that if patient came in right away, only treatment A would be needed, but after 6 months, treatment A, B and C were needed, costing more, of course.

And, the problem seems to patient to be not getting worse during the six months.
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Old 11-02-2014, 08:47 AM   #5
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Or you could wait six months to see if the condition clears up on its own and pay nothing if it does.
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Old 11-02-2014, 08:58 AM   #6
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In short, no.
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Old 11-02-2014, 09:08 AM   #7
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I've never had that happen. Can't see how an insurance company can play the woulda, shoulda, coulda game with people. If someone developed cancer, didn't recognize anything was wrong. Then needed 'more' treatment how could they prove what the treatment should have cost 6 months prior?

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Old 11-02-2014, 09:13 AM   #8
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Quote:
Originally Posted by heeyy_joe View Post
In short, no.
+1. Insurance will pay the cost of the care or 3x in your hypothetical.
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Old 11-02-2014, 09:13 AM   #9
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If there is different/more treatment because of the delay - I can see charging more.
If the treatment were the same - that's completely wrong.

Payment for services... the services are different in your hypothetical scenario.
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Old 11-02-2014, 12:41 PM   #10
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Thanks for the replies!
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