I'm 51, so I'm older than most you BBSers; I'm sure most of you still think your bullet proof. But I got a rude reminder this week that you just can't afford to be without health insurance coverage. I had a very minor outpatient surgery for sinus polyps two weeks ago (sorry for the image). You get them from allergies and they give you headaches. The bills are starting to roll in and so far are running about $35,000. This was for a two hour outpatient treatment. I have an individual Blue Cross Plan with a $2500 deductable but of course the first letters say that the surgery was for a pre-existing condition and won't be covered. I assume though this will be settled between the doctors and the insuance company. It seems that you have to wait until at least the third 'payment over due' letter before you ever make a payment to a hospital. In these hard times I know health insurance seems awfully expensive and possibly the first thing to be cut out of a tight budget. But, even the most minor medical proceedure can wipe a young family's entire nest egg. There are going to be some tough choices made as employers reduce benefits, but keeping your medical coverage is more important than say buying a new car. Carry on.
Yikes. Yet another reason to move to Canada. Not that the Canadian health care system is perfect, mind you, but $35,000 for a routine op is insane in the membrane.
Thanks, GP. Hell of an outpatient bill. I sell health insurance (not in Texas though). I think you can see FattyFatBastard about that, perhaps. We now have Health Savings Accounts in NC. This has been nicknamed the Medial IRA. Does anybody there have any experience with this kind of individual health plan? Just curious.
This has got to be the exception rather than the norm. I had herniated disc surgery which lasted a couple of hours and I was out the same day. My entire stay was probably about 10-12 hours. My total bills for that would've been about $16,000 (if I recall correctly). I don't think I paid more than $2000 thanks to insurance.
This is just scary. I know a lot of young people, including some friends of mine, who have no insurance. Their jobs don't come with it, and they don't feel like buying it. If this is you, please buy some. I know you don't feel like the bite out of your paycheck, but what if something happened to you? (It even scares me, since I don't have much savings or make much money... and I have a good insurance plan.)
I talked to hospital administrator once and they told why everything was so expensive. The reason is that 2 out of 3 people don't have insurance and don't have the means to pay. So, they charge the people that do have insurance and can afford to pay 3 times as much to make up the difference. I don't know how accurate that number is but, that was the jist of the conversation.
Not to defame many of the good health professionals and institutions out there, but there's also a LOT of unethical and/or illegal practices in the healthcare industry as a whole. There's a number of reasons for rising costs, and some of them aren't valid ones. Thanks for the reminder, Gene. By the way, what hospital did you go to?
Kirby Surgical Center, just north of Reliant Stadium. It looks like a Randall's or something in a shopping center, they just do outpatient surgery. Their bill is currently $30,236. The anesthesiologist billed $1235 and I paid the Otolaryngologist the full $2500 of my deductable before the proceedure so I don't know if there is more to come from her. Come on Blue Cross, save my ass!
Great post , Gene, with a reminder everyone should take to heart. There are 10's of millions of Americans today without insurance and large numbers of them are decidedly middle class... not the stereotype that a lot of folks imagine. The other day a good friend of mine who changed jobs after he was laid off told me that his new job didn't have a plan for his family. He was covered, but not his wife and kids. He needed the job too badly to just keep looking, although he has his eye out for another. I was surprised when I heard his predicament, but not shocked. I've seen similar things happen before to friends and relatives. This is a very responsible "family man". He's shopped around for coverage and he's looking at several hundred dollars a month that he doen't have right now. Sounds like we're in the same age bracket, Gene. Ain't it a bummer??
I assumed the Docs and the surgical center pre-approved the proceedure, however the first claim has been rejected as a pre-existing condition. I had an allergy rider when I first got the insurance but that was over year ago. Anybody aware of what their preapproval responsibility is? I think it is just the SOP for medical insurance. The hospitals charge some outrageous number and the insurance company rejects the claim. Then they negotiate a figure to settle on. At least I hope Blue Cross settles. If for some reason they maintain their position and I am held responsible for the full amount, are their medical attorneys that negotiate settlements for individuals? It's not like I had any choices or competive bids prior to the surgery.
I think that riders don't just go away. You can request that they be removed, but you have to formally request it after the minimum stipulated time.
That's screwed up, man. I hope you can slog through that mess OK. Thanks for the reminder about health insurance, though: I definitely take it for granted.
Did you have the polyps before you got the insurance? Having allergies already seems like nothing to be concerned about. If the allergies caused the polyps... isn't that just an opinion? It sounds like two different issues. Did I say I hate insurance companies?
