FYI: Health Insurance Edition

Aug 18 2012 Published by under Medical Paperwork

Faithful Whizbangers will remember when I tried to amputate my finger in June. I have just now received the Explanation of Benefits from my insurer. The bill includes $233.27 for drugs, $205 for supplies, and $666 for service. The latter was divided into two separate categories; I have no idea if that occurred solely to avoid the sign of the beast.

The grand total for sewing me up came to $1104.27. If I had no insurance, this would be my bill. Oh sure, the hospital might be willing to negotiate it down some if I could show financial need.

Of course, I have employer-provided insurance. Thanks to the company's power, $651.71 is "not covered." This brings the final bill down to $452.56. I will end up paying this amount toward my annual deductible, essentially covering the entire final bill out of my pocket.

So let's review that: even though my insurer is not paying a cent for this ER visit, I get a $651.71 discount simply because of their power. No insurer and I owe the entire amount.

I am not complaining about my bill. The final amount seems fair, and I clearly had to have the wound cleaned and closed.

I wonder about the pricing and discounts and other negotiated sorcery.

 

5 responses so far

  • WHY DO YOU HATE AMERICA!?!?!?! SOCIALIST FASCIST HATER!!!11!!!!!!11!!1!!

  • Jim Thomerson says:

    I had 11 stitches on my hand in an emergency room. I was the only patient there, and the total bill was $3000, paid by medicare and my State of Illinois funded secondary. I don't recall what was actually paid. So I have state managed socialized medicine at both the federal and state level.

  • Nico (@nfanget) says:

    Interesting. As a UK resident, had such mishap happened to me, I would have been presented with a bill for £0. Or if that had happened in my home country of France, €0.

    Similarly when our little one (3 years old) went down with a bad pneumonia and had to be hospitalized for a few days, followed by daily visits to the hospital for i.v. antibiotics for 2 weeks, all I had to pay was the car park or tube fare.

    Why some feel the need to introduce US-style healthcare to Europe is beyond my understanding, our systems are far from perfect but at least poor people do not dodge the doctor until they are death's door.

  • jbmohler says:

    Its not hard to find quotes for current medical cost totals for the US (e.g. http://www.kaiseredu.org/Issue-Modules/US-Health-Care-Costs/Background-Brief.aspx), but in light of this post what are they counting? The billed cost and the paid cost differ by a factor of two (or more). Now it's true that the alarming rise is more than a factor of two, but seriously I don't even know how to read most stuff about medical care costs given this ridiculous disparity.

    Having tracked these costs for the birth of my children, I found that the going rate in those cases was that insurance paid about 33% and the rest was written off.

    For various reasons, I'm now a happily (yes, happily -- http://www.samaritanministries.org/) uninsured member of the US and we routinely get bills cut in half with-out any negotiation whatsoever. I somewhat agonize over whether this is "responsible" and paying my bills and all that, but the fact is that the doctors my family and I frequent get their money from me the day of the event which is *much* quicker than they would from the insurance company. On top of that I'm saving money over the usual insurance companies.

  • Samantha says:

    I think first of all people need to keep in mind that we may need insurance plan at any time, so first thing we need to look out is for our basic needs for the Medicare plan and then we need to look at the monthly premium for the plan as we should feel comfortable paying the Premium every month !

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