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PlanetaryOrbit

(155 posts)
Sun Feb 16, 2014, 06:42 AM Feb 2014

My first time going to the ER in a very long time. I'm terrified of the cost.

Without disclosing my medical condition...........I had to go to the ER. Got blood drawn and a blood test for electrolytes. Had two doctor consultations. That was the extent of the treatment. Then I went home.


I have employer-provided health insurance that might cover the majority of the cost....along with some other out-of-pocket maximum rules that I'm not sure I understand.........and I'm not sure I'm even located in the correct state to qualify for the insurance coverage in this situation (I'm in Texas right now.)


I'm terrified of getting some giant ER bill and the insurance company not paying for it - or, if they do, that they'd pay so little of it that I'd still be stuck with $1,500 or $2,000 to pay. I realize that many not seem like much compared to some unfortunate people's massive hospital bills, but right now, even a $900 bill would be an enormous financial burden. I'm VERY tight on money at the moment - have quite a bit of debt, in fact - and I don't want this to push me into a big financial pit.


It says a lot about the terrible state of America's health care system that a patient like me - who dislikes needles, injections or scalpels - is far more afraid of the financial cost of health care than the physical sensation of needles, etc.


I'm not sure why I'm writing this post, except to just find comfort in the helpful community of DU - it's nice not to feel alone. I'm in my 20s, single, living on my own, my parents are thousands of miles away, and things like unpredictable hospital bills ($600??? or $10,000???) are one of the things that worry me the most.





22 replies = new reply since forum marked as read
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My first time going to the ER in a very long time. I'm terrified of the cost. (Original Post) PlanetaryOrbit Feb 2014 OP
I should add that I didn't take an ambulance. PlanetaryOrbit Feb 2014 #1
I don't blame you for worrying. Laelth Feb 2014 #2
Mandated barbarism, you gotta love it n/t Fumesucker Feb 2014 #5
Don't freak out just yet. My Good Babushka Feb 2014 #3
I know several people who have done this Major Nikon Feb 2014 #4
Agree with this, as others below have said... Phentex Feb 2014 #16
I understand... been there handmade34 Feb 2014 #6
I know it's demeaning, but if you get a bill you will have trouble paying, Vinca Feb 2014 #7
it is a strange system - you must purchase something without any price or competition rurallib Feb 2014 #8
So sorry you had to go through all that and I hope you're feeling better. Laffy Kat Feb 2014 #9
you are a perfect example of why we should have medicare for all. madrchsod Feb 2014 #10
Two pieces of advice. FSogol Feb 2014 #11
in december barbtries Feb 2014 #12
Wait, how much did you think your insurance was going to pay? PlanetaryOrbit Feb 2014 #17
no, no, no, that's not what i meant at all. barbtries Feb 2014 #19
Ah, I see PlanetaryOrbit Feb 2014 #20
now you get it! barbtries Feb 2014 #21
i was in for 3 days and two nights. no surgery or any thing, just hooked up to heart monitors and an dionysus Feb 2014 #13
With my insurance there is a copay for ER treatment that is waived if you are admitted. alarimer Feb 2014 #14
That's how I learned not to worry about money or credit ratings. hunter Feb 2014 #15
NOBODY should have to worry about financial ruin to get health care. riderinthestorm Feb 2014 #18
Thanks, all of you! PlanetaryOrbit Feb 2014 #22

Laelth

(32,017 posts)
2. I don't blame you for worrying.
Sun Feb 16, 2014, 06:51 AM
Feb 2014

I hope you're doing well. Personally, I think sick people ought to be worrying about getting better, not about their doctors' bills. Our system is barbaric.

-Laelth

My Good Babushka

(2,710 posts)
3. Don't freak out just yet.
Sun Feb 16, 2014, 06:54 AM
Feb 2014

You didn't have any imaging, so that's one of the more expensive things to have done. If you've got an 80/20 plan, there's a good chance your bill could be under $500. Some hospitals will cut you a deal if you pay quickly, and if you can't, just pay something, $10 or $20 dollars a month. I have paid off bills this way. I send a payment, ask them to re-calculate my bill and send my balance, repeat every month. As long as you are paying something, it won't go into collections.

Major Nikon

(36,906 posts)
4. I know several people who have done this
Sun Feb 16, 2014, 06:58 AM
Feb 2014

From what I understand they can't charge you interest or penalties so long as you're making regular payments.

Phentex

(16,516 posts)
16. Agree with this, as others below have said...
Sun Feb 16, 2014, 11:34 AM
Feb 2014

Once they bill you something, call them and find out about a payment plan - a REASONABLE payment plan, not something that would cause you to not be able to pay them. Then pay it. You may find they'd be willing to accept less if you do this.

Feel better and try not to worry. I know, easier said than done.

handmade34

(22,928 posts)
6. I understand... been there
Sun Feb 16, 2014, 07:12 AM
Feb 2014

just know that you can always just make minimum ($5-10) payments... still not right or fair but you need to worry about getting healthy not about money right now


Vinca

(51,094 posts)
7. I know it's demeaning, but if you get a bill you will have trouble paying,
Sun Feb 16, 2014, 07:39 AM
Feb 2014

beg to get it lowered. It doesn't hurt to try. (Only in American must you lose your self respect to avoid financial calamity.) Hope you're feeling better.

rurallib

(63,225 posts)
8. it is a strange system - you must purchase something without any price or competition
Sun Feb 16, 2014, 08:45 AM
Feb 2014

then if the bill is too high you have little recourse.
Given those circumstances I say we band together in mutual aid - into say a single paying group......


I think we would all love to hear how you come out. Please be sure to follow this up. Thanks - most of us have probably never been through this.

And welcome to DU

madrchsod

(58,162 posts)
10. you are a perfect example of why we should have medicare for all.
Sun Feb 16, 2014, 09:13 AM
Feb 2014

first thing you would always have access to a doctor. second the price you pay would be negotiated by medicare. my doctor visits are around 10 dollars. i have my own social security-medicare website. if i`m a thousand miles from home a hospital can find out everything about my medical condition.

i've been in your boat several times in my life and i know how you feel. pay as much as you can and do it every month. that way they can`t do much about it. oh ya..i've declared bankruptcy 3 times in my life due to large medical bills that were covered by insurance.

FSogol

(46,548 posts)
11. Two pieces of advice.
Sun Feb 16, 2014, 09:20 AM
Feb 2014

1. Never pay the first version of any medical bill. They always bill you first, before the insurance company, hoping you will pay them extra. They know what they can get from insurance companies, they are hoping to get more. It is often quite comical how the amount changes after the insurance pays. Sometime the insurance company will disallow certain billing items in your favor (believe it or not).

2. Pay what you can. You owe some emergency room doctor 2 grand after the insurance pays? Send him what you can monthly. Send them $20 or $50 every month and don't accept them adding interest. You never signed an agreement to pay interest.

One more piece of advice. No good comes from worrying. Good luck.

barbtries

(29,856 posts)
12. in december
Sun Feb 16, 2014, 09:24 AM
Feb 2014

i ended up in an ER in TX too (living in NC). i never even saw a dr, just a nurse practitioner. had a cat scan, an IV, got some prescriptions and a diagnosis (kidney stones).
i have high deductible blue cross through my employer and the best thing is i have an HSA, which my employer contributes a hefty amount of money to every year. with that and my regular payroll deductions i was able to pay the bill in its entirety. actually leaving me somewhat short for my share of the surgery i just had, but that's a different story altogether.
my share of the bill was over $2,000 but that was primarily due to my deductible. the total the hospital billed blue cross was around $15,000 but here's the thing: blue cross doesn't pay anywhere NEAR that amount. what blue cross pays of that is a tiny fraction, i think it was less than 1/3.
the hospital cannot make you pay more than blue cross would have paid had you already satisfied your deductible. remember that!
also, though you may end up on the hook for more than you can afford right now, understand that you can make arrangements with the hospital and pay them a little every month and they won't go after you. ask them to work with you and they may even lower your share of the bill, i don't know.
find out as much as you can about how your insurance handles your situation. i don't blame you for being terrified, but try not to be. you can get through it just fine. don't let the bastards scare you. you may find yourself looking at bills that stop your heart, but you will not be responsible for all that, i am 99% certain that i am correct in this.
best to you, and i hope your health is improving all the time.

PlanetaryOrbit

(155 posts)
17. Wait, how much did you think your insurance was going to pay?
Sun Feb 16, 2014, 01:36 PM
Feb 2014

Did you think it was going to pay a lot more than 1/3 of the cost?

Because I think (or thought) my insurance would cover the majority of an ER visit - at least, that's what my policy says - but now I'm concerned (after reading your comment) that maybe mine won't pay more than 1/3 either........

barbtries

(29,856 posts)
19. no, no, no, that's not what i meant at all.
Sun Feb 16, 2014, 02:09 PM
Feb 2014

the insurance companies make a deal with providers. they "settle" for an amount that is way, way less than the bill the provider sends.
i expect that your insurance co will pay most of your ER visit - but that is not what i mean. say the ER bills for $10,000. the insurance company's settlement amount is $3,000. ALL the ER can get for your visit to the ER is $3,000, regardless of whether you have a deductible, a co-pay, whatever. YOUR share of the amount will be your share of the $3,000.
another way to put it is that the ER will send out a bill that is inflated, then the ins co will say, here's how much your bill can be.
it's crazy. another person in this thread said never pay on the first bill you get. this is why.
i don't know how much your insurance company will pay for your visit, all i know is that when the ER bills for it, they do so knowing that they will not be paid the full amount of that bill. why it has to be this way i have no idea, maybe for tax purposes? but it causes consumers such as you and me an undue amount of stress.
i get an EOB(explanation of benefits) from blue cross. the bottom line on that piece of paper is a column that says "amount provider may bill you."
Okay, i have my statement from the ER in front of me. out of $15,173 the hospital originally billed, $11,499.85 was subtracted for a "contractual adjustment." Of the balance, blue cross paid a little over $1400 and i paid the balance, but again that was because i have a high deductible plan with a health savings account.
so that was over $11k that just went away because it's part of their contract with blue cross. i would be surprised if your insurance co does not also have a similar contract with your provider.
i hope this makes it clearer for you.

PlanetaryOrbit

(155 posts)
20. Ah, I see
Sun Feb 16, 2014, 02:13 PM
Feb 2014

So, if I understand you correctly, an ER will often issue a frightfully large bill at first (say, $10,000) but this will quickly get knocked down by the insurance company to a figure that's much closer to Earth? So then one might be looking at, say, $2,500 instead of $10,000 after a few weeks.



Sometimes it seems that the amount of heart fright or heart jolt that comes with seeing a high ER bill negates any heart/cardiovascular benefit of health care in the ER..............


Thanks for the advice!

barbtries

(29,856 posts)
21. now you get it!
Sun Feb 16, 2014, 02:33 PM
Feb 2014

let us know how it works out for you, and skip the terror: they can't hurt you, just know that. your health is worth a few months of making payments if that's what has to happen.

dionysus

(26,467 posts)
13. i was in for 3 days and two nights. no surgery or any thing, just hooked up to heart monitors and an
Sun Feb 16, 2014, 10:51 AM
Feb 2014

IV.

we had just been bought out by a different company, so my insurance had changed from BCBS to Cigna

total cost: $10,000 (wtf, that's criminal)

I got hit with the $200 emergency copay, and burned through my $500 deductible. insurance "negotiated" the rest of the price down, and covered 80% of that.

I was stuck with a bill for $1700. Thankfully, the hospital allowed me to make monthly payments of $70 (the payment you get depends of the size of the bill). if you end up walking out of there owing $2000, you might be looking at a really low monthly payment, if that's any consolation.

Had this incident occured a month prior, under my old insurance, all I would have had to pay was the $200 emergency room copay, and my insurance would have covered the rest.

The insurance system sucks, but it is truly a godsend to have coverage. otherwise, that 10k would have bankrupted my ass.

and people without coverage are just fucked.

the system needs to change, and I think eventually, the insurance companies will be their own undoing.

especially if single payer takes hold in Vermont or California, it will start a trend, and private insurers will have to stop gouging, or go out of business..

alarimer

(16,596 posts)
14. With my insurance there is a copay for ER treatment that is waived if you are admitted.
Sun Feb 16, 2014, 11:01 AM
Feb 2014

It is something like $230. Plus the co-insurance payment for the actual treatment, whatever it was.

I guess they get the $230 upfront, with the rest of the bill to arrive later.

I think one of the real problems with our health care system is that you never know exactly what it's going to cost when you use it. I think there definitely needs to be price controls, so that a procedure will never cost more than X dollars, no matter where you go in the country.

hunter

(38,969 posts)
15. That's how I learned not to worry about money or credit ratings.
Sun Feb 16, 2014, 11:18 AM
Feb 2014

Don't be afraid to negotiate afterwards. It's a lot like buying a car, but with more players: Doctors, the Hospital, Labs, your insurance company... Of course your insurance company may try to disallow as much as possible, but that's worth negotiating too.

Be nice to medical debt collectors, they have one of the crappier jobs there is. Most of them know it, and will appreciate the courtesy, maybe even be helpful. Being nice to those who actually like harassing ill and injured people is great fun. It hurts them to be nice.

I hope you get a small bill, but don't be terrified. Your health is what matters.


 

riderinthestorm

(23,272 posts)
18. NOBODY should have to worry about financial ruin to get health care.
Sun Feb 16, 2014, 01:44 PM
Feb 2014

NOBODY.

I am so, so sorry.

I have no advice. Just a sympathy rant.

PlanetaryOrbit

(155 posts)
22. Thanks, all of you!
Mon Feb 17, 2014, 05:03 AM
Feb 2014

I've learned more in this thread than in three hours of talking to hospital staff, most of whom were less than helpful.

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