Sticker shock

[JDTM]

So I had an MRI (or MRE, if you want to get technical) a few weeks back, after getting permission from my insurance company to have it done. Everything went fine, but I got a surprise bill for over $10K in the mail over the weekend!!! I called the hospital yesterday and it sounds like it was a clerical error, and I was told to disregard the bill, but man, did that ever throw me for a loop! I'll wait to see if I get a bill from the insurance company now and see what's what, but for the moment, I'm at least somewhat reassured that the crisis has been handled.

This got me thinking about our little community here, and about the importance of health insurance here in the U.S. -- I know it's a thorny issue, but I'm very thankful that I have health insurance and I worry about those who do not have it, especially now as the health care issue is certainly hitting close to home. (And even with decent co-pays, I'm still shelling out a considerable amount for frequent office visits and medication.) For those of you in the U.S. who do have health insurance, have any of you ever ended up with any crazy surprise bills from hospitals or GI visits? Not sure how common of an occurrence this is.

 

[CLynn]

I have been well versed in insurance issues, since getting Crohn's in my 20's. My husband also became a type 1 diabetic at age 35, so between us, we can rack up the bills. So I've dealt with things being coded wrong at the doc's office, etc. But never, ever, have I had what we just experienced. His insurance wants us to buy all long term meds thru the mail at 90 day supplies, pretty common. They made him switch insulin, they no longer want to cover the brand he has been on for 11 years. Ok, he got his doc to prescribe a new one. But then, when he called to see how much the 90 day supply would be, was told it was $648.94. The insurance company applied the cost to our DEDUCTIBLE!!!!!! Never have I had any insurance company do that with prescriptions. Who can pay that?

 

[David]

I have a $7,000 deductible. EVERYTHING goes through it first, including medicines. I'm not on any medicines despite me knowing I should probably be on something for my eye. But what works is $150.00 a month.

The year prior to my diagnosis was a VERY expensive one for me. My "favorite" bill was for the ER visit where they did an abdominal/pelvic CT scan and charged it as if it was two separate scans. At $4,000 each.

 

[CLynn]

Our deductible is the same, David. On up to 4 of us, I think. It's ridiculous. I love it when the doc's office codes the bill for a scope as "diagnostic" instead of "screening"....then I get hit with more of the bill than I should.

 

[Cat-a-Tonic]

When I first got sick, I had a $4000 deductible on our health insurance, which I get through my work. I had always been fairly healthy so went cheap with health insurance which of course didn't end up so great. I got sick in October 2009 and had to decide which insurance to get for the 2010 year in November of 09. I had only had one flare-up at the time and I thought it was gastroenteritis so I didn't figure on being chronically ill and having so many tests in 2010. So I stuck with the $4000 deductible plan for 2010 which royally screwed me of course and I had a couple more flares in late Nov and Dec 09. I had a bunch of scopes, scans, blood work, etc in 2010 and ended up with about $6,000 total in medical debt from the tail end of 2009 and all of 2010. Fortunately I applied for financial aid through my hospital and I was approved, and they wiped out my debt so I had a zero balance again. In 2011 I switched my deductible and went with the lowest one I could afford, which was a $500 deductible! Much better. Good thing too as my hubby was the one to get really sick that year - he had kidney stones. An ER visit and 2 minor surgeries for him still cost us a bit out of pocket but nothing like what it had been when we had the $4000 deductible.

Does anyone get those "This is not a bill" notices from your insurance, showing what you'll likely be billed after all the insurance stuff goes through? I get them in the mail. If we didn't have insurance, hubby's ER visit would have been something like $5000 and one of his two surgeries to remove the stones would have been $10,000. We paid a lot less than that! But it's still scary to see those numbers written down and associated with our names.

We have separate prescription insurance too (also through my work, but from a separate provider from our health insurance itself) which is also pretty good. We pay $10 for most generics. I paid $75 per month when I was on Entocort (normally over $1000 per month without insurance) and I now pay $75 per month for Asacol (something like $500 per month without insurance). If I didn't have insurance, there's no way I'd be able to pay for doctor visits nor tests nor meds. I'd be sick and miserable with no help. I'd probably emigrate to Canada or something like that if I lost my insurance and couldn't get insurance. Sad but true, the healthcare system in this country can stink on ice sometimes.