penguinsix

I was planning on updating the insurance wiki article with some 'real life' examples of the health care costs in the US. For those who would like to share, I was wondering what was the 'bill' for some treatment you had, along with what you had to pay after insurance. I want to give some real world examples so people can be a bit realistic of the risks should they opt to skip insurance.

For starters, my recent addition to the family cost $16,100. We had to pay $700 (as we had a private room which was $400) and insurance dealt with the rest.

elfman

The bill for my daughter's completely complication-free birth in September 2005 including two nights in a private room was $21,000. We paid $1,200, insurance the rest. When she was ten days old she had 48 hours under observation in the NICU, bill $4,300. I think we had to pay $400 out of that.

Jerseygirl

This is a very difficult area because it depends on the insurance cover.

I've had a colonoscopy...endoscopoy...and surgery for carpal tunnel syndrome in the last couple of years...at zero cost. I've also had x-rays...a pulmonary function test...you have to sit it an air tight booth for this and I've had a heart stress test and a nuclear heart test...again at zero cost. I have a yearly mammogram and PAP smear...I also see a gastro specialist every 3 months...all these appointments cost approx $10/$15 each.

I also have an annual check up with my MD. Last year the cost of my routine blookwork was $4K ...cost to me around $15 and that was to the MD.

dbj1000

A few weeks ago my daughter broke the tip of her finger. A minor, minor accident which required <30 minutes in a private emergency room. She had a brief examination by a doctor, an X-ray of the finger, a little aluminum and foam finger splint and no medication.

We paid $50 copay (2x our standard copay because it was an ER visit).

They charged $881 for the doctor and $246 for the X-ray and splints. Our insurance refused to pay the $881 for some arbitrary reason, and I was landed with a bill until I disputed it with the insurance, at which point they paid immediately.

A few months earlier, my other daughter broke her collar bone. Total billed charges (spread over >15 invoices) was $3,000. We paid $50 for the ER visit, but subsequently paid ~$300 in miscellaneous extra charges from the service providers. In future I'll dispute them all, since I don't think we should have paid about half of them.

dbj1000

Yikes! They did a colonoscopy and endoscopy for carpal tunnel syndrome? Seems rather drastic to me!

(but seriously, colonoscopies are no laughing matter... no... not funny at all...)

Jerseygirl

Haha...no the colonoscopy was age related...I'm over 25. The endoscopy was because of family history...thank god for the US healthcare system (if you have good insurance) because they found pre-cancerous cells in my oesophagus. This is something that most probably would not have been detected by the NHS until it was too late.

The colonoscopy was a piece of cake...no side effects at all. I can't say the same for the endoscopy but maybe that's because the doc had to remove bits of the oesophagus.

NC Penguin

Not a medical procedure but I think it's wise to include in the Wiki on US health insurance/healthcare about how the charges are determined.

My example is this. I was referred to an endocrinologist by my Primary Care Physician (PCP) in 2008. I saw this endocrinologist and was horribly shocked to discover when the bills came in that I had to pay 80% of the cost because despite going to what looked like a physician's office, the billing folks at this practice coded my visit as an outpatient visit.

The lesson learned is that I now ask in advance, by speaking to someone in billing at the practice, how my appointment is to be coded. Under my health insurance, an office visit means I pay 20% but an outpatient visit means I pay 80%. The 80% for the above endocrinologist resulted in a bill of $230 (spending less than 10 minutes with the specialist I might add) and that was before paying for any lab work.:curse:

tonrob

I had my appendix out the year I arrived (2005). The expat insurance I was on at the time paid for everything thankfully. The whole thing added up to somewhere over $15K. Didn't even stay in the hospital overnight.

Duncan Roberts

I was in the ER then the step down cardiac unit for about 18 hours in 2007, that costs about $13,000 and I paid $200, a $100 ER copay and a $100 deductible.

I was in the ER for about 2 hours when I sprained my ankle, x-rays, crutches and a brace. $6000 of which I paid $120, $100 ER copay and $20 coapy for the crutches.

My wife just gave birth and I just got the last EOB. The whole pregnancy including delivery cost about $60,000 and we paid $120, $100 deductible and $20 copay. The whole cost of the delivery and 3 day stay was the bulk of that money.

Hiro11

Both my kids were born via c-section (the first was breach and VBAC is a little risky). First was born at Northwestern, second at Hinsdale. Both private rooms, both three day stays. Prenatal was several thousand dollars. Out of pocket- $0. Actually births were both about $15K each before insurance. Out of pocket- $0. I guess we have had pretty good insurance coverage...

Rete

Answering for my one daughter who gave birth in a hospital (the other gave birth at home).


1. Cost $20.00 co-payment plus cost for television which was $10 a day for 2 days. No other charges.

2. Husband was hospitalized last year, again cost $20.00 to hospital for co-pay, $20.00 a day for doctor visit, $10.00 a day for television. No other charges.

Both have hospitalization. One was Oxford and the other Blue Cross/Blue Shield. Did not even look at the bills to be honest with you.

Noorah101

My alien husband had to go to the Emergency Room at Cedar Sinai Hospital in Los Angeles, turned out he had kidney stones. He was there about 4 hours, they gave him some pain med (a pill), and induced the stone to pass.

Total bill = $17,000.

Insurance paid = $16,900. We paid $100.

Thank God he's covered under my insurance through my work (United Healthcare EPO).

For regular doctor visits, we see a network doctor, and pay a $20 copay each visit. Prescriptions have a $10 copay. We pay a small portion of lab fees, which never seems to come to more than around $5.00.

I'll also add that our insurance premiums are $178 every 2 weeks, not sure what the company/employee ratio is, but that's what I get taken out of my bi-weekly paycheck. That's for 2 adults, no children.

Rene

helmet

you shouldnt read too much into what the bill you receive says , insurance companies never pay that and neither would someone paying cash , i had a bad boat accident needed hospital treatment and then surgerys on my knee told them i would be paying cash knocked 60% off straight away and then haggled them down another 15% , my friend just had a kid and payed himself cost him about $7000 for everything up to and including the birth.

Ash UK/US

http://britishexpats.com/forum/showthread.php?t=583847

Bob

Hard to say really.

We never got to see how much the birth of our daughter cost, just the initial $20 co-pay for the first visit, that included all the scans, check ups, emergency hospital visit, actual delivery which was induced.

That insurance was costing my employer around $1500 a month according to what COBRA wanted me to pay, whilst when I was working I was paying $65 a month for family plan including the $5 a month for the dental.

Insurance is now through the missus, from a pretty large bank, it's costing us $400 a month...not nearly as good cover.

Baby wellness check ups, 10 min visit costing around $350 a visit, for us we pay a $20 co-pay plus $40 per visit of that cost.

I had a mate who didn't have insurance when he was having a kid and they were paying between $250-700 per scan and per doctors visit. I don't know the final cost because he only needed to do that for the first 2.5 months of pregnancy until he had been working in the school district long enough to get insurance coverage.

Dentist, we were paying $50 to meet our annual deductible and the insurance paid the rest. Check up visit was $150 (that was $50 for the visit and check up, $100 for the cleaning). X-ray $200, filling, a new one was about $500, fixing a broken filling was about $250, replacing one that had fallen out was $100. All of which insurance had paid. We've not gone back since I lost my job.