General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsMedical bills are fucking killing me.
Every day is a surprise.
$50 here.
$140 there.
$300 there.
We supposedly have very good insurance (non medicare) that costs about $1,200 a month for two people (my spouse's work plan), and that $1,200 does not include the employer contribution portion of the premium), and I'm still getting surprise bills EVERY DAY.
And here's the thing...we have a medical flex plan that helps pay for these bills via payroll deduction, but it's a huge pain in the ass.
Somewhere along the line, medical providers decided to start texting you a bill with no detail. Just "pay this amount". This means that your flex plan will not reimburse you because there is no documentation.
It feels like a slap in the face. "Pay this amount"? Fuck you. Send me a fucking bill with some detail, assholes.
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live love laugh
(16,383 posts)
beaglelover
(4,466 posts)website and you use that to get reimbursed from your FSA for any amounts you paid out of pocket. It's not that difficult.
LuckyCharms
(22,648 posts)it literally takes me AT LEAST 45 minutes to scan both the EOB and the actual medical bill (because my plan will not reimburse without both), and then go to the flex website and create a claim, and then actually maintain a spreadsheet to keep track of that claim because the flex administrators keep hosing up the reimbursement of $30 OF MY OWN MONEY.
45 minutes to an hour of my time to have some idiot flex administrator return $30 of my own money to me for a legitimate charge.
Not to mention the endless emails I get questioning my documentation.
Part of the blame is on the medical providers expecting you to just puke up hundreds of dollars BASED ON A TEXT that they send you, because they do not want to pay for a properly staffed billing department to generate proper documentation.
beaglelover
(4,466 posts)log on to the FSA website, fill out the online claim form, upload the EOB and hit submit. Get the reimbursement into my bank account 2 days later. Not sure why your FSA would require the actual bill if you provide the EOB. That seems ridiculous.
LuckyCharms
(22,648 posts)I think it depends on the flex administrator, and how rigorously they interpret IRS rules.
I've also spent hours on the phone over the past few years, having to elevate my call to a supervisor, because some trainee bounces my claim erroneously.
I used to manage a consulting company that, among other things, administered FSA plans, so I know what is required and how it all works.
My flex administrator refuses to accept a lone EOB without proof of payment, a receipt that shows that you actually paid the amount shown on the EOB, and I won't pay a bill until I can see what I'm paying for.
When I think about it, say you are in, I don't know, a 10%-15% federal tax bracket for argument sake?
If you contribute $3,000 a year to your flex plan, you get a tax benefit of $300-$450 per annum. That's not worth it to me for all of the work that is involved on my end, just to get my own money back.
beaglelover
(4,466 posts)Payflex. It might be that my employer told them what documentation employees needed to provide and they said just the EOB is sufficient. Our FSA also has very generous rules upon employee termination....let's say you pledged to contribute $3,000 during the year to your FSA and you have expenses in January that reimburse you for the entire $3,000 and then you terminate in February.....you don't have to repay the amount that you received that was never contributed to the FSA. My employer just writes it off.
Quakerfriend
(5,882 posts)My eye doctor gives me the printed receipt like I’d get from the gas station- worthless!
I have to ASK them to give me the full itemized print out- but, they try to avoid doing that- to save on paper & printing- very annoying!
ET Awful
(24,788 posts)So someone with limited funds has to pay out of pocket when they're already stressed from whatever medical issue they are going through, then jump through multiple hoops and spend a ton of time to get their own money which is set aside specifically for that purpose, the whole time likely paying interest to a credit card they used to pay up front (which interest can equal the amount they saved by saving pre tax money in an FSA in the first place) and "it's not that difficult" is the response?
beaglelover
(4,466 posts)of pocket expenses at the time you are asked to pay them, like a co pay at the doctor's office for a visit to see the doctor. But those actually require more time after the fact as you still need to prove to the FSAs that the cost was eligible to be reimbursed from the FSA by providing them a copy of the EOB and/or receipt after the fact.
Unfortunately, in our current medical system, nothing will be super easy, but getting reimbursed from your FSA is not that difficult.
ET Awful
(24,788 posts)Yet, somehow, nothing you said justifies the "it's not that difficult" statement. The fact that someone has to jump through hoops to utilize their own money for approved purposes which meet the requirements for pre-tax utilization of the funds is ridiculous. A properly run system would utilize the same interconnected systems between providers, insurance companies and FSA funding entities. They would not require someone to provide multiple forms of documentation to gain access to their own funds. They also would include the information in the billing from the provider without the need to seek out itemizations.
I can go to a pharmacy, put together a combined order of items, and it can immediately be ascertained at the point of sale which items are FSA eligible and which are not. There is absolutely zero reason a medical provider can't do the same thing.
beaglelover
(4,466 posts)onethatcares
(16,992 posts)is, Don't get cancer. One day to the next you won't know if you've been admitted to a hospital for observation or treatment and tho they're both expensive as hell, one is actually cheaper than the other. Tack on the tests and scans and a person can go insane.
maspaha
(745 posts)…before the ACA…our deductible was 10K, max out of pocket, 16K. Treatment spanned 3 years…kid’s college fund was depleted to keep me alive. And now, she’s paying off HUGE student debt and insurance CEO’s are buying multiple yachts. Bastards.
anciano
(2,256 posts)First, you are entitled to an itemized bill with CPT codes, and secondly, medical bills are negotiable.
There is an excellent book that addresses this process that is available from Amazon titled "Crush Medical Debt" by Virgie Bright Ellington MD. It's the best sixteen dollars that I ever spent.
Good luck.
maveric
(17,044 posts)I’ve had it for over 40 years.
Small office visit charges, $5.00. Most of my meds are free. What’s not fever exceed $10.00. They have their own pharmacies. Their own doctors…. Seems to work out well.
Autumn
(48,962 posts)Seven fucking hundred dollars. With a fucking coupon. I hope the whole fucking sysyem collapses. Sooner rather than later.
erronis
(23,879 posts)Even if much cheaper generics exist.
Sometimes you need to argue with them to write a generic prescription (which may not be covered by your insurance), and look up the price with something like GoodRx.
My case is with a glaucoma medication (combination brimonidine and timolol) which is marketed as Combigan (by Allergan). This is covered by Medicare. For a 90-day dose it runs around $400.
A much cheaper generic (same formulation, also FDA approved) is available with no coupons for about $150. With a GoodRx coupon about $40 (all 90 day supplies.)
I believe the doctors/practices are getting kick-back for these prescriptions. They cannot be so terminally dumb to not see the disconnect.
There's so much chicanery going on with the whole US healthcare system, but pharma and insurance are the worst culprits.
Maninacan
(296 posts)Girlfriend got food poisoning out of state . 11000.0$ for one night. Insurance might not cover it. Half a years net salary.
LuckyCharms
(22,648 posts)
Celerity
(54,407 posts)(from the broad base up to the top of the pyramid) scheme in human history. The US will spend (at all levels, in toto, at current rates of increase) closing in on 90 to 100 trillion USD over the next 10, 12 or so years and will get, on balance, only middling care (compared to MANY other nation states) for the majority of people, despite massive outlays for much of it.
People here in Sweden are losing their minds that they now have to pay (max, there is no mandatory monthy government insurance charge) around 265 USD for ALL meds per year and 135 USD per year for ALL healthcare over a rolling 12 month period.
That 400 USD 12 month total used to be around 275 USD (or so) total up until 4 or 5 years ago, when it started to rapidly go up.
My wife and I have never come remotely close to paying the max for either of us, as we are young (we both are 28yo females) and in (knock on wood) in very good health and are in very good shape (fitness-wise, as we are both extremely active).
markodochartaigh
(5,545 posts)The US does not have a health care system. The US has a profit making system which produces as much profit as possible while producing as little health care as possible as a byproduct.
Phoenix61
(18,828 posts)LuckyCharms
(22,648 posts)Please pay $50 online.
For what? Some detail maybe? Or should I just wait a month for the EOB to arrive from the insurance company?
It's infuriating.
And this literally happens every day.
Luciferous
(6,586 posts)bill. A lot of times they send those out for amounts that are pending insurance. Do you use the patient portal for your provider? You can also look up your billing that way to see what is pending and what is actually owed.
H2O Man
(79,051 posts)My older daughter & family lives in Europe. Health care and education are valued in that country. They recognize advantages in having a healthy, educated, and happy population. I think my younger daughter is moving there for a teaching position. It's like the opposite of when my father's aunts and great aunts moved here from Ireland in the 1800s.
Yet it is a potential for this country, too -- though not under the current political circumstance.
dalton99a
(94,115 posts)
leftstreet
(40,680 posts)
joanbarnes
(2,119 posts)I never pay when they order me to, have to get details. Much of the time they are WRONG.
OldBaldy1701E
(11,142 posts)I tell them that any charge that is not on the bill is not going to get paid. If anything is on the bill that I do not recognize as something that is sensible, it is not going to get paid. (A 'handling fee' for meals? They were hired to deliver meals, why are you charging me double for that? I already pay my part of their salary as a paying patient! And, they don't even get this fee, that goes elsewhere!)
I agree. A double FU to the predatory insurance industry.
Skittles
(171,710 posts)I mean, come on, that is ridiculous.
not that "medical insurance" overall isn't a bad joke
BigmanPigman
(55,137 posts)Who the hell has the energy, time and brain matter to do all the health insur BS while you feel like crap. It's like adding insult to injury.
I have had more BS dealing with health insur crap a lot more than usual since Dec and a new "health insur year" and the companies lie, tell you incorrect info, tell you to call back in 5-10 business days, and they contradict each other. In a 15 minute period Blue Shield told me I was suspended and had NO insur unless I paid $1,100 a month. A few minutes later I was cut off, called again and a different person said I was NOT suspended. WTF!!!!!
They are creating more stress for already ill people and anxiety harms them even more on top of it.
JoseBalow
(9,488 posts)
dcmfox
(581 posts)I'll keep it short: Retired here in 2022.
I had some stomach issues, no appetite.
Went to emergency care which has no "added expense"
I have no regular doctor
Fully battery of test, blood, sexual diseases which made me laugh, Cat scan which scared me because of cost
No insurance
I had 3 credit cards waiting to pay the bill..450 bucks out the door. Just an irritated stomach lining.
hunter
(40,690 posts)When my wife and I were young we turned down several opportunities to move to truly civilized nations with good health care systems. I sometimes wonder what our lives would have been like had we emigrated.
At our lowest point we were both uninsurable, my wife's COBRA had come to the end in the midst of her chemotherapy, and we were a week away from losing our house to foreclosure.
At the last minute the State of California picked up the cost of my wife's medical care, including some horrifically expensive pharmaceuticals ($400 a week billed to us in addition to whatever her COBRA had paid) and we squeaked through the crisis by the skin of our teeth.
I'm quite certain there are people who simply give up and die, or else they fall through the cracks and die because they don't have any strong advocates to guide them through the system when they are in the worst possible health and in no condition to fight.
BaronChocula
(4,555 posts)by Cedars-Sinai for an MRI last year. They told me to create a user account through their online accounts receivable link and when I did, the AR site didn't recognize me as having been a patient. So I waited for the eventual bill which I paid. Figgin' monkey business.
Godot51
(781 posts)In December of 1979 I came to Japan. After my and I got our official "marriage" license I joined the Japanese national health system in February of 1980.
It has been a pleasing, informative, and mostly pain-free experience.
We pay a set amount according to family size and our ages. Since our children are adults who pay their own national health there are just the two of us.
As we age the payments have decreased. This may change as Japan in general ages but, we'll see. Our yearly payments in are much, much less than described above. All medical treatments, procedures, medications, care, and so on are price controlled.
In 2010 I had a complete left knee replacement and paid ¥56,000. This was my 30% share. The national health paid another 70%. My rehab was about ¥450 or $5 per 45 minute session, again a 30/70% sharing. At the same time my American relative said her rehab was $125 per session and her state job insurance paid 80% of her charges. The actual operation, treatments, medications, and hospitalization was an unbelievable amount.
Right now I'm under treatment for chronic, but not too chonic, heart disease. When I see the doctor and pay for my prescriptions it's under $200 for two months.
All in all Japan's system works and hopefully will continue to work.
I have great sympathy for those who must live under the "best health care system in the world". I'll take what I have very happily.
Evolve Dammit
(21,777 posts)
Johnny2X2X
(24,207 posts)Where there are several care providers at one location for one procedure. So each of them can get their co-pays after they've each billed your insurer. There are people whose whole careers are medical billing who don't even understand how parts of it work.
And there are no market forces at play because people really aren't equiped to understand what's needed and not needed. It's a racket with a legion of companies with their hands out when someone gets so much as stitches for a minor cut.
Mike 03
(18,690 posts)figured out it went to the nurse (or someone) who checked in on me for about one minute to ask me how I was doing. Never seen her before or since. Her job had some fancy title like "physician liaison" but all she did was peek into the room to make sure I was still alive. I swear that's true.
Hekate
(100,133 posts)I am so sorry. If I didn’t have my husband dealing with this, I think they’d make me lose my mind.