An example of unexpected medical bills
 

Early September I slipped going from the house to the garage. Missed the 3 steps down into the garage and landed on the concrete floor.

Three weeks later my shoulder was still painful and I had loss of movement and strength in my left arm. So visit to doctor which resulted in 2 visits to an orthopedic surgeon, 1 visit to a neurologist, 2 MRIs, 1 set of x-rays, another visit to my doctor and 9 physiotherapy sessions. Seems all that determined I had tweaked a nerve and muscles in my neck where I had surgery previously. I had sort of guessed that myself.

So one silly accident cost my Medicare Advantage plan in round figures $8500 and me personally in co-pays $500.

Re: An example of unexpected medical bills
 

Good example for those who say they will do without insurance for a while.

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You didn't want to claim it under your house insurance?

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For $9 grand you got confirmation that you hurt yourself falling over. Are you cured?:eek:

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It is. One slip was a costly accident.

That has a $1,000 deductible so I would have been worse off.

Just that. My doctor back in England would have said take some aspirin and come back in a couple of weeks if it still hurts. Cheaper and would have achieved the same result. Not yet cured still have restricted movement and less of strength in the arm but just using it improves it.

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I was recently hit by a car on my bike. I wasn't badly injured but the police were worried about concussion. I had an ambulance ride to an ER, a "level 5" ER visit, three xrays and a brief doctor visit. This came to an absolute astounding $10K total. Particularly galling is that the hospital charged my insurance $600 for EACH xray. $1,800 of expense for ~10 minutes of work using technology invented a century ago. All to prove I had some deep bruises, torn muscles and a slight dislocation where my clavicle meets my sternum. Give. Me. A. F%^&*ng. Break.

We weren't done yet. Oh no. A followup doctor appointment for a referral to a follow up orthopedist (both totaling an incremental ~$600 in cost) resulted in a recommendation for an MRI. The MRI required insurance pre-approval and would have cost an increment $3K.

At this point, 6 weeks later, my shoulder is feeling a bit better if still sore. I have some minor muscular pain and tightness when raising my arm over my head but nothing worse than I've had from overtraining back when I was a competitive swimmer. I'm able to do 60 mile bike rides without any pain, carry heavy weight with my left arm etc. I was so fed up with the cost that I didn't do the MRI. I'm doing some rotator cuff PT I learned from previous sports injuries and I'll likely be fine in a few more weeks.

This whole episode was completely ridiculous. I had a relatively minor shoulder injury and a tight IT band in my left leg for a few weeks and it resulted in almost $15K worth of expense. The hospital and doctors offices I visited were all appointed like luxury hotels. All offices were teaming with smiling highly paid professionals in beautiful clothing, a Rolex on every wrist. I received numerous beautiful custom printed and bound materials indicating what they had done, next steps and recommended additional appointments. It was ABSURDLY over the top.

This is one of numerous examples of my health care costs being out of control. For example, a few years ago I had a bloodtest after running a marathon that resulted in wacky results and $5K worth of worthless tests to prove I'm fine and that you shouldn't run bloodtests within a few days of the patient running a marathon. My daughter injured her shoulder (fairly seriously but not catastrophically) and it resulted in ~$30K worth of surgery and care. Etc. I'm an employee of a large company, I make a good income and I am lucky enough to have gold plated, low deductible and extremely comprehensive insurance. My out of pocket was maybe $500 for the entire "hit by a blind driver" experience. As such, I had little motivation to question if any of this was necessary and the medical professionals had every reason the pile on the charges and tests. It's clear to me that something is wrong with incentives in healthcare in the US. We need to fix it. We need to reduce the cost of care. My entire experience was infuriatingly wasteful and frankly disturbing.

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Thank goodness you did not have a high deductible plan. Friend of ours just had a baby. They called before the baby and were told it was going to be around $1000. After the baby they got a bill for just over $1000. 2 months later they got a bill for over $6000, the insurers reply, was that they had made a mistake with the first bill.

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Amateur numbers.

One machete accident cost my insurer over $30k. That included time in ICU for what was an inch and a half cut.

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Did that happen when filming for the walking dead?

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DH was taken into hospital last week, and got all sorts of MRI and CAT scans and a few days in hospital, so we're dreading the bills, even with insurance.

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Hope he is doing OK and nothing too serious.

I was lucky with my 2 MRIs. Thought my co-pay was either 20% or 50% but when the bill came in both MRIs cost $1740 and my co-pay for each was $49.95.

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Are there medicare supplemental healthcare plans with high deductibles?

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Yeah. I pay through the nose for it (even after employer subsidies), but at least I have the comfort of knowing my out of pocket will be reasonable. Still, IMO that's part of the problem. Perhaps if patients like me were confronted with ~$15K bills for minor injuries, we'd be more proactive about demanding evidence that care was necessary, cross-shopping, negotiating cost of care etc. Today we have the worst of all worlds: astronomical costs, no incentive for consumers (meaning me) to be efficient and heavy incentives for doctors based on quantity of care rather than care outcomes. All of it is further larded by employer subsidies and governmental subsidies. Everything seems designed to drive costs ever higher, driving healthcare increasingly out of reach for those who can't afford it. Messed up.

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High deductible plans go some way towards that. It creates far more awareness of costs. High deductible, with much lower premiums and combined with an HSA, is still a very good alternative.

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oh yeah, I saw this the other day, which looks like it could be a very useful tool for finding out medical costs.
https://amino.com/

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Unfortunately not, I would have been covered at 100% probably.

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A friend of mine in Florida found her husband collapsed on the floor in the morning, he was taken to the local hospital and diagnosed with a stroke and helicoptered to the stroke center in Orlando and recovered.
They then ended up with a $70,000 bill as there was a dispute over what was in and out of network.
It was resolved in the end with a massive reduction in costs.

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Funny isn’t it!

I fell off a curb I didn’t see in the summer.

That evening I decided to go to the hospital as my wrist and ankle were really sore and I had hit my head.

They did an X-ray or my wrist and ankle didn’t seem concerned about my head and sent me on my way.

Being in Canada I wasn’t charged anything. I received a sensible amount of care without any OTT expenses.

I love living in Canada! 🇨🇦

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Interesting site!

I have a friend whose husband needs his gall bladder removed (laproscopic). In our area it will cost half what it would cost if done in a city 12 miles away.... :blink:

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I not sure how accurate that site is. For the hospital where I had my MRI done the site gives a cost of between $350 - $650. The actual cost was $1740, and the hospital is owned by my insurers so I don't see them inflating the cost to themselves.

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My insurance which is administered by Aetna but the company pays it all - the website has a section where you can search for the costs for the procedures you need to get done. I had a look for the cost of the shoulder MRI which I had had already done - costs ranged from $500 to $3500 within a 10 mile radius of my home. The cheapest was a local radiology "chain" and the most expensive was the local hospital.

There's an article about insurance costs - which I will find and post. It is very interesting reading and may explain why your own insurance owned place may not be the cheapest.

Can't find the post that talked about the requirement for health insurance companies to pay out 80% of the premiums in claims but I started here and went down a rabbit hole.. Basically, your insurance owned hospital will bill the insurers ( your insurance company) and there is not a lot of incentive to keep the bill low because of this 80% requirement.
https://wealthyaccountant.com/2017/1...thcare-crisis/

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We are not too bad in BC for emergency/urgent healthcare at the ER, but the system is failing when it comes to finding a GP for regular routine medical care, and mental health isn't treated on par with physical health making it difficult to obtain services.

Upside to BC health system if I have a heart attack, stroke, or fall, little out of pocket costs.

Downside is if you need a GP you likely can't find one quickly and may even take years.

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There is NO good reason why this wealthy country I live in could not provide health service in the same way.

There are, however, several bad reasons - the profit-driven health care "industry" comprising insurers, pharma companies, hospitals, doctors, and more.

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Why should the costs go down? The senior execs and chief surgeons have Cessna payments to make.

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Price controls create shortages, as has been true since the dawn of time.

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We know someone who's kid had to go into rehab, as he had a bit of a drinking problem. Insurance didn't cover it and it was $275 a day. He's been in rehab for 6 weeks now.

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Seems to on par with the going rate for self paying patients in BC, the few places I found that list prices were in the 225-275 range.

Some patients may qualify for gov't medical coverage for drug/alcohol treatment but its not universally covered.

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It is the same down here in Mississippi. Drug and alcohol rehab is not covered by healthcare. Throw your kid out and let the state pay for it.

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Costs really out of control in USA. A visitor we had needed to visit the emergency room, unspecified illness, 2 hours in waiting room then 15 minutes with doctor who basically said this isn't an emergency , take care of it in your own country. Bill came in at $1,800. However kind of hilarious- clerk asked if he was a veteran, he said yes, and somehow ended up they said bill should be sent to the military- not recognizing it was the military of another country. In any case how could hospital in good conscience send a bill for $1,800 for 15 minutes ?

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Issues involving alcohol or drugs are almost never covered, and in fact a number of coverages can be voided if there is an incident where someone has been using either. I don't particularly think that's an American thing - I know it is true in Australia as well.

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What was wrong with urgent care? Not available where you live?

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About 10 years ago, the NHS in Newcastle showed that the cost of treating a drunk in the hospital ER was about 2k. Not much to do really except possibly a stomach pump and rehydration. I think if you thought about how much it costs to run a hospital you'd realise that $1800 for having all those facilities available should you need them is not too bad really.

I'd have taken the guest to an urgent care facility btw.

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Hope you pointed out that the military referred to was in a different country to the US - and that your guest paid the bill.

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He didn't quality, as he was living alone and had insurance or some such.

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At that day and time no it wasn't.

In any case the type of charges hospitals and doctors get away with in America is quite unbelievable at times- and so many simply cannot afford to get medical care.

I know another instance where a heroin addict wished to get off the addiction. The medicine prescribed cost $15 a day, but (a) had to go to only one approved doctor 50 miles away ( person had no car and there was no pubic transport) (b) Medicaid didn't cover cost (c) and every other visit was supposed to pay $100 for examinations. In the end such people return to their habit, steal or other criminal activity to support it, end up dead or overdosed ( with obvious charges for emergency room treatment). While system almost seems designed to increase costs.

Same area- factory work IF wasn't temporary work, starting wage $2100- premium for worker with family $250 a month with a $6,000 deductible, company portion of premium about $1,050 per month : obvious for company whenever a temp worker could do same job ( though invariably lower quality) they would get temp worker at $1,300 per month, without incurring the company portion of medical premiums. But at $1,300 per month few temp workers through agency could afford $250 a month premium, and worker needs to pay the fixed percentage for social security + locally a school tax ( most schools in the are always have new buildings while test scores decline). A more idiotic system I can't imagine in a developed country.

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I speak 5 foreign languages, none of which along with English did the admittance clerk seem to understand too well. I did point out the address on the military ID card was in another country but was rudely brushed aside , they said they just needed a copy of the ID card. The amount of the charge we didn't know until months later as their bill never arrived in the foreign country, when a collection agent called me as I was the emergency contact threatening to sue me for the bill. The following year same guest visited and if I recall settled the bill at a discount with the collection agency. What a wonderful 'first world' country !

The point is the over-charging doctors and hospitals get away with, and then all the expense of the complicated, convoluted billing system and putting people on collection. If I recall correctly a significant percentage of bankruptcies in America are from medical bills.

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Sorry I do not accept that the costs in hospitals for medical care are reasonable, $1800 for 15 minutes no way does it cost that much no matter how they allocate the costs. I worked in cost engineering fro a while so I am familiar with cost allocation- considering the overhead that some hospitals believe is normal, and then try to allocate to operations, I just don't accept such charges are reasonable.

A few years ago I was at a dinner with a family who all worked for the same hospital, and one of youngest ones was assigned to the finance department. They wanted to offer to employees a free diagnostic test, so they asked the finance department to figure out the true cost. They charged patients and insurance companies for the test between $150 and $250, usually as standard procedure charging more than what they thought they would be reimbursed. Ends up in the end the true cost of the test was $12. And to add insult to injury, half of the diner conversation was complaining about poor patients who came to the hospital, or how Obamacare was affecting their personal finances - all of course had fancy cars and homes. While anecdotal I admit, I found the whole lot quite disgusting.

There wasn't an urgent care open or reasonably accessible (we were in rural area) at that particular moment.

Whatever the faults of NHS, I certainly prefer !

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A few years back, we got a collections bill over a 32c underpaid bill, because we had moved and not gotten it. The stamp on the envelope cost more than that :lol:

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I don't see how any test could actually cost so little. There's the time for the receptionist who greets the patient and provides the records to the nurse or technician, the time that said nurse or technician spends administering the test, the time for the lab technician who processes the test (if relevant), the time for the doctor who reviews the results and communicates them to the patient. And then before the patient even arrived there was the person who cleaned the floors and made sure the facility was clean, the people who made sure it was warm, the cost of said heating, light, all the other overheads, etc. etc. The cost of a test is a lot more than the drawing of blood for a minor test, or the hour for an MRI.