I should have known that my ER visit would not be as easy as a simple $200 co-pay. The optimist in me wanted to believe that the system works, that you get what you pay for through expensive insurance, and that the world is full of generally good people.
I got my bill from the hospital. I'm baffled. It has a bunch of codes and abbreviations. I can't figure out heads or tails from it. I did catch a $400 pregnancy test which I did not need or want, and $200 for a vial of morphine. Nice.
The total was $12,700. O.M.G. Because of my insurance, I got a 5K discount, bringing the total to $7,700. Of that, the hospital said that my insurance company agreed to pay $6,200, so I have to pay $1,500.
Uh, how about no. Not going to happen. I'm going to pay my $200 co-pay. There's very little I hate more in the world than phone tag with bureaucracies. But a $1,500 bill is enough for me to do it. Sad thing is, I have no idea where to start. None. I think I'll start with the insurance company. We'll see what a "platinum" plan is worth, after all.
5 comments:
I'm not sure why you're so surprised. All policies require a co-pay of some amount after which they will then pay a certain percentage of the bill -- usually 80% or 90%. After the insured party (that's you) pays the maximum out-of-pocket total for the year, then, and only then, the insurance company will pay 100%. You're apparently still young enough that you've never before incurred any major medical expenses or this would not surprise you. Welcome to the wonderful world of medical care in the USA. Now you'll understand why unexpected medical expenses can sink those without the income to pay them.
Barb1954
Yep, that's about right. If you have to pay 20% of 7700--I believe it would be $1540. It is even more likely that you have a deductible of several hundred dollars and then you pay the 20% after you pay the deductible. I have to pay $350 as my deductible before insurance even starts to pay. Then, I have to pay 20% up to $3000. After I pay out $3350 of my own money (excluding co-pays and other bogus charges not included $3000 total), insurance pays it all except for the co-pays and bogus charges!
Of course all that is dumped and goes back to zero at the anniversary of my policy each year and I have to start paying out again... :( Like Barb1965 wrote---medical bills can quickly destroy a family/person financially.
BTW, unless your insurance company or hospital has made a mistake in calculating your part of the bill, it will ruin your credit if you don't pay the bill. They'll match you up and make you feel better, but they'll destroy you when it comes to nonpayment when you have the means (and when you don't).
I'm sure you're paying $200 co-pay for the visit, but you're also probably paying the 20% for part of what was done during the visit. If you owe $1500 and only send them $200 because that's all you 'feel' you owe, good luck. Call them up and I'm sure they'll explain it to you.
Back in 1988, when on chemotherapy and NOT SEXUALLY active, I had a trip to the ER for a bloddy nose. (Bloddy noses are common with some treatments -- in my case, my blood counts were off, had very little clotting ability, a vein was rubbed raw from an oxygen tube and I'd bleed horribly.)
The ER fix would be pretty easy - but one ER - convenient to my home, but not my regular hospital, charged me a HUGE amount of $$ - they took all sorts of blood work. When I reviewed the bill, I too was charged for pregnancy test.
I did a 3-way conference call with the hospital billers and insurance company. I said "NO WAY" to the billers - neighter I nor my insurer would be paying for that test - if the doctors' had asked, then they would have known there was NO WAY for me to have been pregnant.
Over the past 20 years I've really learned that I have to be an active partner with my doctors and insurance company to assure I have the best care possible, but that no one over bills or miss bills for medication or treatment that is not necessary.
That pregnancy test is one small example of our healthcare system overcosts.
Just as Barb and everyone said, your portion above the co-pay seems reasonable. What I've found is if you call the hospital's billing office they will either (a) work with you to set up a payment plan or (b) give you a 20% discount if you pay for the bill during that first phone call.
Good luck. It's never easy to deal wtih them.
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