Medical Bills. They suck.
And because I rarely go to the doctor’s office, I am always surprised at how much things cost.
Remember a few weeks ago when I was so sick I stayed in bed with a fever, unable to blog, and practically sweating to death?
I had started feeling a little ill on Sunday and didn’t drag myself into the Dr.’s office until Saturday morning. Had I of known I’d start to feel better later that day, and that the diagnosis was “Food Poisoning, sorry, there’s nothing we can really do for you, it just needs to run it’s course,” I would have stayed home.
Well today I opened the mailbox and found the medical bills.
Co-Pay $35
Nausea Meds $15 {which I didn’t end of taking because the side effects scared me}
Dr. Visit & Lab Work $213.96
Total $263.96 {after discounts and insurance}
If we had not had medical insurance we would have had to pay a whopping $958.50 out of pocket instead of $263.96.
I don’t understand. Wouldn’t it be less work for the medical billing people to bill someone who had to pay out of pocket LESS, then have to bill an insurance company and wait around to get paid?
How do people without insurance do this?
What am I missing here?
~Mavis
diane says
Wow! Very glad I live in a country with universal health care!!!
That’s a crazy amount of money…
Mrs. Chow says
1. There aren’t supposed to be people without insurance any more.
2. I used to pay out of pocket, and still do if my insurance refuses a test. Those prices are insurance prices. For example, my doctor wanted me to get an MRI for my knee, and insurance said no. Cost of the MRI if billed to the insurance company? $1600. What the MRI place would have received, based in apricot agreement with the insurance company? About $900, and I would have had a co-pay. What the MRI place charged me when I said I would pay out of pocket? $418.
Mrs. Chow says
“prior,” not “apricot”! Autocorrect strikes again!
Mavis Butterfield says
HOLY APRICOTS!!! $418 for a MRI out of pocket? I don’t think that is too bad.
Edie says
The key is you have to negotiate self pay at the time of service. (Which is hard if you feel terrible!)
Mrs. Chow says
I didn’t either.
nancy from mass says
That’s nothing! My husband has out of state BCBS and his MRI cost him….$1,800. Yes, 1, 8, 0, 0. My insurance cost for an MRI on my shoulder: $108.14. (I unfortunately cannot have him on my insurance or it will cost me 400 extra per month since he has insurance with his employer.)
What do people without insurance do? They call the hospital/doctor and ask for payment plans or for them to discount the bill. My husband has so many medical bills, we have 38 more payments until they are paid off. 🙁
bobbi dougherty says
yes, I didn’t have insurance for a while and that is what I did too. Our health care system is SO screwed up. I can’t with this subject…I just got OFF my BP meds and don’t want to have to get back on them…I have taken my health care in to my own hands!
Kat says
Are you getting the out of pocket amount from the statement you received? That’s the total they bill insurance. The out of pocket for patients paying cash (or setting up a payment plan) is probably less, for the reason you state – it costs the clinic less in terms of staff time.
People without insurance in Washington are hopefully on medicaid, since WA was a state that expanded under the affordable care act. People in states that did not expand their medicaid eligibility rules are totally screwed and probably visiting sliding scale clinics where they can, or going into debt where they can’t.
Erika says
I’m sure your insurance company has prenegotiated rates for the services you had. They didn’t pay that balance but the lower preset prices. Then they payed there part of the coinsurance, leaving you with your coinsurance balance. Still, always crazy expensive for a 15 minute visit.
Alice says
My husband recently had a MRI. (2 weeks ago) Even though he had already met his $1000 deductible for the year, we had to pay 20% of the cost of the MRI. Our 20% was still $400. ( sounds like insurance didn’t help us much, compared to what Mrs. Chow paid out of pocket) 🙁
Mavis Butterfield says
I don’t think so either. 🙁
Stacie says
As someone who spent years gambling her life and well-being without insurance, I would say that I “did it” by just not going in to the doctor. Ever. I didn’t participate in anything even close to high-risk (Example: I went skiing and skied uber slow and kept falling on my butt to keep from breaking an appendage so that I wouldn’t lose my job waiting tables which paid for my college tuition and all other bills). It was a scary, scary time. If I had been in an accident during that time, I would never have been able to finish college or get a salaried job. I would have been working 3-4 jobs trying to pay medical bills and I still would have fallen behind on payments. It’s very sad.
Danielle says
My husband and I specifically chose to pay the tax penalty rather then pay the ridiculously high premium we were offered each month ($500 for very poor coverage.). We did our research, called our pharmacy and PC. When we planned to get pregnant we called the hospital. In total, we probably save a couple thousand each year by not having insurance. (Then that pregnancy ended up in an early delivery and my baby spent 3 months in NICU… So, Who knows if health insurance would have saved us. Somehow we miraculously qualified for Medicaid… So, thank you, taxpayers, for covering our million dollar health care bills…).
Cheryl says
Well we pay over $500.00 a month and I am glad the rest of us covered your child. That is why everyone should pay something in healthcare. Glad your child is o.k., not real happy you decided to pay a penalty and the tax payers have footed the bill. By the way, everyone in Canada and Britian who gets free healthcare, it isn’t free, your taxes are very high. Cheryl
Edie says
I understand what you mean about paying a high premium for basically catastrophic coverage, which used to and should be cheap! As you say, limited coverage plus the insane deductible would probably not have helped (I am thinking you are thanking the taxpayers bc of bankruptcy?) The difference between the medical bk average for those insured (18k or so) and the max Allowed family deductible (13k+ for 2015) is not really enough to eliminate medical bankruptcies in the future. What is worse, with deductibles this high, a family can slowly be financially ruined with a few medical events each year. (Not to mention higher premiums.) I am glad your baby is well, though!
lynne says
Insurance stinks. And I think it’s ridiculous that we are “forced” to have it. I remember when I was young (I’m 47), my dad paid the Dr. in monthly payments, just like you would a car payment. Insurance companies are a legal Ponzi scheme, but what do you do? I criticize, but I am thankful for the insurance my husband’s job provides. I just don’t see it getting any better as far as costs go. Lynne in MN
Rosaleen says
Medical costs are whacked out, with or without insurance. Yes, if you can use an “in-network” provider, the fees are negotiated. If one qualifies for help, then the cost is reduced, but if not, too bad. We recently were on vacation and hubby was ridiculously sick with what MAY have been extreme food poisoning. We found a walk-in clinic, thankfully, and got some heavy-duty anti-diarrhea meds. Even then, he was sick for 8 or 9 days out of a 10 day vacation and pretty much glued to the bathroom. Yeah, ruined vacation, but at least he was OK Lost 10 pounds, but OK. No lab tests but it was SO worth having insurance. We paid $45 out of a nearly $300 clinic bill. Without the narcotic med, I think he would have ended up in the hospital. When we were between jobs, we relied on walk-in clinics for free care. They help fill in gaps, but are not the answer.
Crystal says
Yeah… how come we can’t just get rid of the insurance companies, and pay the doctor a retainer or something? Seems like more administration is what drives up prices.
Stacey says
My thinking is along that line, too, Crystal. I would rather let the doctor keep more for his/her work. A friend of mine is a nurse practitioner, and she told me the average turn-around for insurance payments is 8-9 months. That’s too long to wait to be paid for services. I have no problem with the people doing the work getting paid for it. Medical providers worked hard to learn their profession and work hours that I wouldn’t want to. They deserve a good paycheck.
Karen says
That’s why I wait until I feel like I’m going to die and then wait 1 more day before going to the Dr. Usually by then I’m starting to feel better.
Lisa Millar says
The cost of health care in the US has always seemed amazing to me. (Obviously from what I have read and not experienced.)
I did read from a recent study that medical bills were the biggest reason of personal bankruptcy in the US.
I grew up in a different system and have always been looked after medically. I did my research into insurances here, (Australia) and it just wasn’t worth it. We pay a little more in personal tax now because we don’t choose to have private health cover.
Up until the last five years or so I haven’t had to go to the doctors so often, but recently I have managed to have 3 major surgeries and I estimate my out of pocket expenses were around $300?? (Mostly visits to the specialists)
Sure nothing is ‘free’ and tax pays for health here… however keeping the community at large healthy and therefore productive keeps the world going around.
Sandra says
1. Food poisoning can kill you., depending on what kind you have, how hydrated you can remain, and if you are older or have other health conditions. If you are young and healthy, you can usually ride it out. Very unpleasant; I have had it three times (from restaurants) and only ended up in the ER once.
2. Anti-nausea meds saved my life when I had weekly IV chemo for 6 months. Most people don’t get the side effects. Usually the docs prescribe Zofran or its generic for nausea. That’s what I had, with no bad effects. It did give my daughter headaches.
3. My daughter had an MRI. The insurance covered most of it, except for the $1,400 “facility fee.” That hurt.
nancy from mass says
Food Poisoning CAN kill you is right. I lost my cousin last year to a bad case. It’s always better to err on the side of caution and see a dr…you never know.
pamela sheppard says
Well I am one of those people that you don’t know how we do it without insurance. I simply cannot afford it. No matter what the government thinks I should be able to afford for the lowest tier policies. The last time I saw any type of Dr was at an urgent care place because I had a cold so bad I couldn’t breath. It set me back a couple a hundred dollars between the fee and the meds. The time prior to that I saw a Dr it set me back nearly $1000 dollars between office visit, an in office test and blood work. It’s terrible.
beth says
I live in Canada and when I am sick I go to the doctor. We do pay more in taxes but probably no more than you do with the costs of your insurance and copays.
I work in health care and the thought that someone would delay seeking medical health because they couldn’t afford it is very sad. Early treatment is so important in many cases and delaying a visit to a health care provider could be catastrophic.
I am happy to pay more for our social service safety net and not to have to worry about personal bankruptcy if I suffer a serious illness. Not providing health insurance to everyone seems inhumane.
Caroline says
Thank you, Mavis. Healthcare should be a basic human right. It is a MORAL issue. But instead in our country- insurance companies make a profit off of NOT providing healthcare – that’s how they make their money – they fight you to so they do not have to pay out, and they will always pay the least amount possible, even though you are forking out hundreds every month. Doctors are another problem -in racking up test after test and unnecessary drugs and treatments, etc. Did you know that our healthcare system is the third leading cause of death in the US? Check it out: http://www.health-care-reform.net/causedeath.htm
EVERY SINGLE foreign person I’ve ever talked to about this already knows way more than the average American because they are literally terrified of our healthcare system, and they always tell me it’s one of the main reasons they would never move here. To think that they could get billed thousands if they broke a bone or simply rode in an ambulance or got a virus… We are the only 1st world country that still does this. And politicians are paid big bucks to demonize foreign countries’ systems in the news, as you often falsely hear.
Still millions of people are without access to basic health care here in the US, one of the richest countries in the world for goodness sake. And millions of people are bankrupt exactly BECAUSE of our current healthcare system – I bet you also didn’t know that medical bills are the number one cause of bankruptcy in the US: http://www.cnbc.com/id/100840148
So it’s high time for the US to join the rest of the civilized world…sometime in the 21st century would be nice. I hope you will please check out this link I’m pasting below about Not For Profit Healthcare. Vermont already has a version of it. And we also already provide Single Payer to a huge segment of the population that includes children, the elderly, the disabled, the poor, the military, etc. So it definitely can be done, it’s only a matter of moral priorities.
The money is always there, so that is not the issue. – For instance, consider the cost of one military jet program, the F-35—the money for that jet alone could house EVERY homeless person in America with a $600,000 home. Yet we cannot provide simple healthcare for all citizens. Pathetic if you ask me. We have to start waking up and questioning these things, because the vested interests certainly will not (and will fight tooth and nail), and because so many people still slip through the cracks who cannot afford $400, $500, $600+ a month.
Anyway, here is the link I was talking about if you would like more info. It is Physicians for a National Health Program–a non-profit research and education organization of 19,000 physicians, medical students and health care professionals who support single-payer national health insurance. Thank you again, and I really hope you’ll join the fight: http://www.pnhp.org/facts/single-payer-faq
Blair says
Just a side bar here, when my husband and I were on our honeymoon, we met a nice Canadian lady who said that her husband had been diagnosed with cancer. Although his healthcare was free, guess where they brought him for the best care in the world? The good ole’ USA. They used to fly him to Johns Hopkins for cancer treatments. Just a testament to how great our healthcare services really are. Sure, it has its’ flaws, but what doesn’t?
Monika says
Yes, my good friend’s Canadian’s father was scheduled 8 months out for heart surgery. He came to the U.S the next week instead!
Kim says
Caroline,
I think you may be confusing health care (medical care) and insurance coverage (money).
In the US, you are legally entitled to be seen and cared for in an emergency room during a life threatening illness. However, someone has to pay for it. Doctors don’t go to school for free and those hospitals don’t keep the lights on by providing free care. The cost of the care needs to be YOUR responsibility, not other people’s.
That being said, I’m more dissatisfied with my insurance coverage (not my healthcare) than ever before. Health insurance from your employer used to be a perk but no longer is. “Affordable” health care is a misnomer. Unless you’re dead broke and getting subsidized by other taxpayers, health insurance premiums are not affordable. Even with health insurance, your deductibles are higher than ever before and the out of pocket maximums are outrageous.
Prices for medical services are increasing rather than decreasing due to the law of supply (no growth) and demand (increased with ACA).
We may have helped some folks but it was likely at the expense of many others.
Monika says
I completely agree that something needs to change but I am not sold on single payer for a few reasons. First, the Oregon study of people with Medicaid concluded there was no better outcome than those who were uninsured! Secondly, my parents grew up with socialized medicine. My father was a foreigner in two different countries and it wasn’t until he came to the US that a degenerative issue was diagnosed. By then treatment was not an option.
Doctors request unneeded test to cover every remotely possible issue in order to avoid being sued! This is a huge factor in medical costs here.
I am no fan of insurance but the ppaca has limited their profits and will reimburse losses. They have a guarantee and if certain small plans aren’t profitable they are just canceling them. It leaves high risk people with the short end of the stick as before.
What to do? Let consumers pick the plans they want, bare bones cheap ones or full coverage, let companies sell across state lines and well. Insurance has little motivation to fight for customers. As always, everyone should read their contracts to understand what is covered. Premiums should not be tied to income. Bring back tax free health spending accounts for everyone, that can be rolled over.
Big programs are always full of fraud and waste and a burden on the middle class. I am no fan of war funding but realistically that money isn’t going to be transferred to social services, it’s going to have to come from higher taxes.
Monika says
One last thing – people are denied services under VA and Medicaid. Single payer will do nothing to help this issue.
Lisa Millar says
Great thoughts Caroline.
We in other countries are also terrified when the current governments try moving towards the US model of healthcare.
I feel quite sad reading a lot of these posts. You just don’t hear of that where we are.
And Blair… absolutely you have great standards of care, but it seems more available to those that can afford it than those who desperately need it.
Someone up above sounded a little sarcastic about “Our tax money paying for your sick child.”
I read that kind of comment a lot when I have read this and that about the US health system.
That is so sad.
Health is where I WANT my tax dollars going. I truly want our government putting those dollars into the health system for anyone who needs it.
(And education despite us not having children)
If people are on the whole, healthy and educated (and NOT bankrupt) they have a better chance contribute to our society, enhance it without becoming a burden on it.
Renee says
I just got the bill for the birth of my daughter. For My hospital Stay and Hers it’s 37,362$. Her first 4 pediatrician visits due to complications total $837 and all of my visits to the OBGYN total $4376.
My total OOP is $5200. the rest is covered by my insurance. I don’t have co-pays or anything like that. I have met my deductible so the rest of the year we are set at least!
Medical bills are Ridiculous!
Ali says
This is why we in the UK are fighting so hard to keep our NHS where medical care is free for everyone at the point of access. We pay for it through National Insurance and everyone who works pays the same percentage. In Scotland our prescription medications and eye tests are free (not the case elsewhere in the UK)
The NHS (National Health Service) is a large organisation full of bureaucracy and layers of administration and far from perfect but no one need ever think twice about calling the doctor for a minor or major illness through fear of not being able to afford it.
Rachel says
Wow. I never truly realized how amazing my insurance coverage was until I read some of these posts. My 2nd child cost us $50 total. That includes all prenatal care & testing, delivery with epidural and 3 nights in the hospital. The emergency appendectomy I had this year was a bit more at $100, but that was for the emergency room facility fee. And yes, I live in the US.
Blair says
Yep! Some of us, myself included, have excellent insurance. For my OB care and daughter’s birth, it cost me literally nothing. Now, for routine care I have a $20 co-pay and for specialty care I have a $30 co-pay, but it sure beats what it could be.
Heather says
The office I work at gives self pay patients at 25% discount if they pay at the time of service. It is not fair to charge a self pay patient 100%. We never receive 100% from insurance. There are discounted fees and insurance allowance that always brings the amount down.
Scott says
Last year I was hospitalized with diabetic ketoacidosis. Basically, my blood sugar was over 900 and I should have been dead. Final hospital bill was over $67,000. If I hadn’t had insurance, I’d be in bankruptcy proceedings. So happy that I had insurance and that I’m actually forced to have it. I’ve gone without when I was younger and payed everything out of pocket. Can no longer afford to do that.
Mavis.com says
$67,000. WOW! So glad you are okay. That’s scary stuff!
Kelly says
Mavis,
I hear you LOUD & CLEAR ~ and I don’t know how people without insurance do it.
I work for a small business and we pay about $400/mo for individual (not family) healthcare (and do not qualify for the cheaper stuff). I have a $6000.00 deductible (on top of premium and copay).
I have history of blood clot, so when I had similar symptoms I went to the doctor to be safe. It cost me about $700.00 just to see the doctor and have a leg scan done & read. They charge $350.00 for someone to read the scan because no one in the doctors office is capable of reading it?
It’s crazy how much they charge for things!
Mavis says
I’ve heard you can call and argue high charges and sometimes they will reduce them. I’ve tried this with my dentist but not with the doctor’s office. Maybe we should!
karen says
We do not have “healthcare” in this country. We have “sick care”. Doctors unfortunately receive more training in how to manage a disease and which drugs to prescribe than training in how to prevent the disease in the first place, and in the event that disease happens, how to help the patient recover their health.
The health insurance companies charge high premiums to the potential patients, and low payments to medical providers. Their job is to make a profit for the shareholders, not to protect patients from catastrophic medical expenses.
Medical providers do not provide price sheets for costs of services because their charges to the patients depend on what insurance you have and how much you can pay. I would never purchase a car from a dealer who calculated how much he thinks I can afford. Why on earth should I be forced to pay on a sliding scale?
The system is broken. Universal health insurance isn’t fixing it.
Monika says
Right on! Very few doctors have training in nutrition. What has official government nutritional advice done for us? Made us sicker! This alone should be a reason to get the government OUT of health CARE.
Mariana Cisowska says
I had a surgery 3 years ago (I stayed in the hospital during the day only and was released).
With insurance I paid $3,500 for all and after all the bills (and they were coming for 6 months or so), it would have been 46,000 out of pocket. Debt for life.
I was happy for the insurance but even $3,500 seemed crazy.
Alexis says
There is an alternate option to conventional insurance ( though I don’t have any personal experience with it because we have decent insurance through my husband’s job) which are health sharing co-ops. Basically you still pay a monthly amount, but it goes directly to people who need it. And it can be much cheaper than what a lot of people have to pay, between $399-449 for a family of 4+ a month, and much less for a single person or couple. You pay the monthly amount, and then everything up to $500 is paid for out of pocket, then the rest is covered by the group, up to a million bucks depending on the plan you choose. I’m not clear on whether that means $500 per incident or per year or what. The one I’ve looked into the most is http://www.libertyhealthshare.org/ This particular one is Christian based, but I believe some aren’t, and you don’t need to be a member of that church, just agree to live a healthy lifestyle (not smoke,exercise) and what not. So like I said, I haven’t looked into it extensively or participated personally, but I think it’s a great alternative, and acceptable under Obamacare as insurance.
Edwin says
I am a diabetic survivor of Hodgkin’s Lymphoma and a triple By-pass, just for starters. One (of many) of my hospital stay bills first line charge was $500,000. That was just the first line item. I had one bottle of 40 pills with a cost of $839.00 per pill. I consider my self extremely fortunate to have had great insurance thanks to my Union.
That $40 co-pay with everything else covered is a small price to pay. My question is why the richest, most productive nation in history can’t provide for all it’s people?
Joan Blurton says
We don’t have universal healthcare in the U.S. What we have is a for profit system. From the universities that charge hundreds of thousands for people to become doctors, to doctors wanting to become wealthy due to their sacrifice and occupation, to the so called”non-profit” hospitals that seem to have endless plans of market share.consolodation and the money todo it
Joan Blurton says
Ooops…to the Forune 500 pharm companies, to the insurance companies that serve no purpose other than to make a profit. What do you do if you don’t have insurance? In this country you suffer, don’t get needed meds or rehab etc., and sometimes you die. 30,000 people a year in this country dying due to lack of health care/insurance.
Lora says
I guess I disagree. I don’t think that is too much to pay. You were able to consult a qualified doctor on demand. You received good care and the diagnostic tests were run quickly and correctly. If you were a person with a low income, a disability or a senior I would say those fees are too high for you and you should receive some assistance in paying them. But your not.
Lora says
Sorry for the 2nd comment, I hit “post” by accident. In addition to the above, you found out that in general, you are completely healthy! That is good news! How many people left their doctor with bad news that day? Aside from that you have a lovely home, a lovely 2nd home, 2 healthy children, a loving husband and are living a life of your choosing. Be grateful, pay your bill and life life in good health.
Lisa Millar says
I think the main point and question of Mavis’s post was how do people with low incomes and inadequate insurance manage?
And reading through a lot of the replies here there are some really hefty bills.
Which would put so much strain on peoples lives.
Reading Mavis’s blog I have never thought she has come across as a whinger and ungrateful for what she has.
But her question is valid. The stats on people in the US putting off treatment because of high costs, and personal bankruptcy due to medical bills is incredible for a first world country.
Mavis says
You got my point exactly, Lisa!
Lisa Millar says
🙂
Jen Y says
Now, people WITH insurance can’t afford to go to the dr.
A good friend used to have great insurance before Obamacare. After, they dropped her policy & all she can afford gives her a $!000 deductible per person in her family. She has 4 children, three had to go to the dr this summer within weeks of each other so she was out almost $400 just with a dr visit per child, plus medications & any lab tests. They literally cannot afford to get sick WITH insurance.
My family is blessed in that my husband works for a large corporation that loves their employees. Before Obamacare we had amazing insurance. But thankfully, they saw what was coming & tried to make changes that would ease the burden on their employees. Our deductible is $2000 per person to keep our premiums down but we have a health savings account that is not taxed so we can pay for all medical expenses out of it giving us a break. We can earn ‘free’ money for our accounts as well by turning in our well-check reports from our dr, exercising, ect. So the company gives us $100s a yr when we take advantage of their incentives, which we do.
My husband is a Type I diabetic & we spend a lot on his medical supplies/meds.
But most people work can’t work for large corporations that can afford to carry the load. It’s crazy & I only see it getting worse. 🙁