So I had surgery last year and surprise surprise, my insurance ended up not paying the entire bill for whatever reasons. So the Hospital and everyone else is coming after me with a ton of bills which I'm not sure it's even fair to ask me to pay. Why didn't someone tell me beforehand that I would have thousands of dollars of out of pocket costs? Had I known I would have gotten more insurance coverage. Anyone have any experience in dealing with this sort of stuff?
They do that crap on purpose to steal as much money as they can from you, I'd think you would need a lawyer for that kind of ripoff.
It's always good to talk to people and do the research before having the surgery. When I had mine a few weeks ago, I knew I'd have to pay the first $1,000 and the insurance would pay 80% after that. Thing is that the doctor, hospital, and anesthesiologist all wanted to bill me as if I hadn't met my deductible. I just let them know I had already met it and it was cool after that. The whole thing cost $6,000 with the insurance paying $3,800 and me paying $2,200.
Always check your level of coverage. Always. I used to have the minimum health insurance at my work. Then, when I had my seizure last year and spent two days in the hospital, I owed $3K out of a total of 30K. I've upped my coverage since. I might pay more, but insurance is for piece of mind, and I know now that if I ever have a serious medical issue, I'll pay next to nothing.
I got billed for a surgery I never even had. Idiots at the insurance company paid whatever they could and I got billed the rest. I filed a police report and haven't heard from the doctor since.
Did you check before the surgery what your insurance would cover? Did they agree to cover it all at any point? What reason did they give you for not paying the bill (coinsurance, not eligible, deductible, etc)?
Insurance companies SUCK, they try like Hell to not pay.....they will find any excuse in the book to avoid paying. Man, I want national healthcare in this country....... Why are we the only westernized country without a national healthcare program? Boggles the mind. DD
You had a deductible; how high? You had co-insurance; what percentage? You had stop-loss limits; what were they? Did your policy have "internal limits" on procedures? Find out what the Usual & Customary Rates were for each element of the surgery (anaesthesia, OR charge, surgeon fees etc.). Subtract the UCR from the actual charges... now add everything together. What number do you get? Was anything actually "denied?" Those are some starting questions...
I did check and I had "100% coverage" but the insurance company later on said that I had a deductible and that the hospital also over charged what they considered typical for the prodecure. The second part is what hit me hardest.
I'm bickering with my insurance company over some BS charges right now -- it isn't a whole lot of money, but it's the principal more anything. I've found that just b****ing and b****ing and b****ing to the insurance company has got quite a bit knocked off -- my doctor has been cool about letting the payment slide because he understands it's nonsense.
THey said I had a deductible of $1,700 but the bills I received totalled $4,500, so it doesn't add up. The worst part is that I have like 10 different bills so it's a mess to communicate with all of these guys. When I called the insurance company to address it, they said I need to come back with a ridiculous amount of information regarding the exact date and time of service for each bill and what the service was. It doesn't even list that on the bills! I'll tell you guys something - I had Guardian year back - that was the best insurance ever. No deductibles, no issues. I had a surgery done with them and never saw a single bill. These guys (Primera - Blue Cross Blue Sheid) is the one I'm getting a tough time with. And I don't trust Oxford which is my current insurance provider much either. Make sure you get good insurance.
Hospitals are always going to charge what they charge... part of it is because of the headache that insurance companies cause for them (insurance companies screw over doctors/hospitals just as much as they screw over patients). Sounds like your headache is with the insurance company... they said you had 100% coverage (or you assumed that) when you really didn't. If you put the research/leg work into all medical procedures (just like you'd do if you were buying a car, buying a house, or planning a vacation), you'll get all the information before hand... and won't ever be blind-sided like you seem to be. Doctors/hospitals will tell you UP FRONT what they charge... and if you told them you couldn't pay that before your case, most doctors/hospitals would negotiate (or would refer you to another place where you could afford the surgery).
Might this play out.... Three phases: 1. Deductible (you pay all) 2. Co-insurance (you pay share -- say 20% and Insurance pays 80%) 3. Stop-Loss: 100% of excess paid by Insurance Company Is this approximately your experience? You paid $1,700 Deductible You paid 20% of next $10,000 of charges ($2,000) Insurance pays 100% of other charges except what the Insurance Company considers to exceed the Usual and Customary Rate (say $800) $1,700 + $2,000 + $800 = $4,500 OR You paid $1,700 Deductible No co-insurance Insurance Company paid 100% of all charges except what the Insurance Company considers to exceed the Usual and Customary rate (say ($2,800) $1,700 + $2,800 = $4,500
I've heard if you don't pay your medical bills it doesn't hurt your credit too much. Just don't pay it. **** Doctors and they're over billing.
Social medicine sounds like a good idea.............however, can you imagine the lines and the waiting rooms? People would go to the doctor if they even "suspected" something was wrong with them...i.e. hypochondriacs. There are too many people with too good of a job/health benefits....it'll never happen. I hope it does, but I don't think it will.
There was no co-insurance so it was the second option. I'm going to try to call of my creditors on this medical stuff and offer them $.25 on the dollar. So that way I only pay $1,500. I'll basically say you can take it or leave it, and I'll just deal with a lower credit rating if you want to go that route. I don't think it's fair that I should have to pay more then the deductible since I never agreed to pay whatever someone deems I should pay. I think a law should be passed that patients get to know how much they will have to pay out of pocket prior to any charges. I also think that there should be some ways for hospitals and doctors to be held in check regarding costs. I'm not against hospitals being in a business to make a profit - but this is ridiculous. Had I known i would have taken out additional insurance and then had the procedure. Shouldn't they give me a clue about what's coming???
