@Nrdsb4 - I looked again and actually got the info in an email from a colleague (I sent the content to you). There will be more coming out in the next few days.
Then your son got lucky and you have nothing to complain about.
The point of buying health insurance is not to get your money back - it’s to protect against the risk of high-end bills you can’t pay, or the risk that the person gets sick but can’t afford the cost of needed care.
Insurance wouldn’t work unless the vast majority of insureds were paying more in premiums than they were receiving. That’s the whole point of having insurance.
I understand the problem of being on a tight budget --I’m self-employed and before I was old enough for Medicare the only thing I could afford was a high deductible plan - with a $5000 deductible – so I know what it’s like to debate whether or not to go to the doctor because of worries about the cost. But the point is – the staff at a medical facility have jobs to do, and their job is to provide the best care they can manage. And right now many of them are literally putting their lives on the line.
That made me cry, @garland. There was a request for people to line the funeral procession route with hands over their hearts on 5/14 at 12:50 ET. I’ll be doing that from across the country. I’ll also be wearing Mets colors, as requested by his wife, in his honor.
BS to this. He called and asked about what was supposed to be a free test - and never got the test because when he arrived where they told him to go they said the test was reserved for those who were older or who had high fevers or those in a higher risk category. Then he ended up with a 4 digit bill because they did other things instead.
I think we have plenty to complain about.
If you’re ok going somewhere that’s supposed to be free and getting a high bill instead plus not even getting what you thought you went there for, well, that’s you, not us.
A good lesson to always get everything in writing.
@hrh19 I’ll be in my Mets gear today. It truly is a heartbreaker. Like I said, I didn’t know the gentleman, and even though I don’t live in his town, the entire area has been in grief over his loss. Truly seemed like an exceptional man.
He could have said no to the other services if he didn’t think he needed them. As soon as he was not eligible for the free test, he could have left.
I’m sorry you are angry that someone cared enough about your son to do a medical evaluation when he showed up at an emergency room with a cough in the middle of a pandemic. Because if he didn’t look particularly sick to them, they could also have simply refused to treat him because he didn’t have insurance. And if he did look sick, then wouldn’t you want him to have appropriate care?
When they took him in for this all important medical examination (vs test) they weren’t even suited up. He wasn’t presenting a fever at the time. I’m not convinced they were worried about his life nearly as much as their bottom line. I assume they thought he had insurance. He wasn’t asked about that until later.
After his chest x-ray everyone was suited up (fancy that!) and he was told he definitely had a lower respiratory infection and that it was likely Covid. Other than that they merely sent him home with instructions of when to come back if it reached X level. They told him it would get worse over the next few days, then should get better. They gave him a letter allowing him to stay home from work (which he didn’t need since he works from his house even without Covid).
You take from it what you want. I see them as wanting money from any source they can get it from. They certainly didn’t act like they thought he was dying.
Another of my lads is in med school. We hear a lot about what’s going on. I have sympathy for the medical profession. It’s part of why I’m not really protesting the bill, but just paying what it came down to. It doesn’t mean the profession is perfect. (We also hear a lot of behind the scenes stories that drop our jaws.) When someone or some entity needs money, a lot of things can cross the line with what happens. It’s human nature.
@calmom It also might help to remember that he called to get tested to help his state/area out with numbers and tracking. If he had it, tests were supposed to be free and we all thought folks wanted to know. He didn’t show up at the hospital thinking he was dying, nor did they seem to think so when they saw him. All he wanted was a test to know.
In hindsight, he should have declined any treatment, but going in, it’s very typical to just do what you’re told to do and not make waves. He’s young with no health issues or experience with hospitals going back to his youth when he broke his collar bone in gym in 8th grade. He had no clue what costs would be. Sometimes it takes laps around the sun to learn things like that. He’ll know in the future - and now could take chances with his life that he shouldn’t knowing the high costs (even if he were to get insurance).
I’m not posting this to belabor the point but for clarification for others who may be reading this thread. I totally agree with @Creekland about her son being young with no health experience and having no clue on costs. Heck, even adults with experience still don’t understand the process.
US insurance and medical billing is very, very complicated. Almost no two policies are the same, even from the same insurer or employer, because there are so many variables. This is why hospitals and most doctor’s offices have billing departments. No one in an ER setting is going to be able to tell a patient what the bill is going to be. They simply don’t know. Even if they did a prescreen, they still wouldn’t know for certain until the bill was submitted and then either rejected, partially paid, or paid. Even if the person ordering the tests knew someone was uninsured, their goal is to make sure they don’t miss something medically, not how the patient is going to pay. $ in an ER setting is not even a consideration.
Unfortunately, the onus is on the patient to know their own situation and make decisions accordingly. For a young person never going through the experience, they don’t have a way to really understand this.
The good news is that if you approach the hospital billing department as if they were like any other person trying to do their job and treat them with kindness, they usually have policies in place to work out a payment plan to pay the bill slowly over time. They truly are not in the business of screwing anyone or making a money grab.
And I will belabor this point for any young people reading - buy health insurance. Start an HSA (health savings account). You can’t legally drive without car insurance and health insurance should be thought of in the same way. You never know when you’ll need it and something truly catastrophic can bankrupt a family. It’s not worth the risk of being uninsured. Save your money elsewhere.
My daughters were also naive about medical treatments. They grew up blindly trusting their doctors and medical facilities. In the last few years they have learned to ask and question any treatments before it’s performed on them. I still get calls from them when they are in the doctor’s office about, “They want to do XYZ, what do you think?”
One time D2 gave my credit card to a doctor’s office as she signed in and they charged whatever the insurance didn’t pay on my card. It turned out the doctor’s office used a wrong code, so the insurance company refused to pay. Since the doctor’s office already got paid they had no incentive in correcting it. It took me months to get it straighten out. I told her she was never to do that again. I said let them file and then bill us.
These are all life lessons.
Our insurer has a contract with providers that patients are NOT to be charged until after insurer has paid its portion. Some providers do ask for copays up front anyway and it’s up to us patients to decide whether or not to agree. It honestly depends on my mood. If I don’t want to, I just politely decline and wait for my statement and charge by phone or via the app for my portion.
I agree that our young adults can be pressured to just go did the path of least resistance. My S allowed his auto insurance to lapse and was involved in an accident. I was very upset with him but fortunately the damage was minimal and he learned a very important lesson.
While we have any say in the matter, we have never allowed any of us to be without medical insurance — just too much risk.
@creekland, I sure hope you and your S can get this resolved. I’m sorry your S was unable to get the free test He was expecting and got imaging that didn’t really change his care. The US medical system sure does have some shortcomings.
@HImom We’ve paid the bill - well, he did with my cc. His matter is resolved aside from future bills from the doctor and the person reading the xrays that I expect are still to come.
The US medical system definitely has shortcomings. It’s terrific if one is rich or has great insurance through other means. It’s also decent if one is a kid on CHIP. Otherwise, we live in typical America with a median income slightly below the national average and I hear way too many horror stories from folks who have to choose medical care or other things like paying the mortgage/rent. Most folks will not seek out care unless they feel it is really critical. They know paying will be a struggle.
I’ve found billing departments to be pretty flexible. I’m paying off a PT bill from late 2018 at $57/ month, zero interest. Another time the hospital discounted our portion 25% if we would pay immediately. It’s always worth calling and asking what they can do for you.
In other words, he really was sick enough to warrant that x-ray.
I could see you being upset and feeling taken advantage of if your son’s symptoms were very mild and the x-ray came back clear — but the x-rays told that your son was in fact sick with pneumonia or at least something close to that. The x-ray is a diagnostic tool that gives the doctors the information needed to make a judgment call as to whether to send a patient home or admit them. (My guess is that before the x-ray was ordered, a doctor probably used a stethoscope – which is pretty routine and wouldn’t show up in your bill.).
Right now there are parents of young adults who are grieving because their sons or daughters happened to be the rare youngster who ended up dead – some who died in hospitals, some who died at home either because their symptoms weren’t taken seriously enough or because early on the risks of Covid for younger people (like stroke risk) weren’t fully understood. And there are others who are frantic with worry because their kids are sicker than they’ve ever been, whether hospitalized or not – with no one knowing what long-term impact this will have on their health.
And some of us are parents of kids whose jobs put them on the front lines, being exposed to Covid patients on a daily basis – and we worry day and night both about their potential exposure and the risks that they may bring the virus home to their families.
I wish we Americans had the Canadian health system, where we could all go into any doctor or hospital and get needed treatment without worrying about the cost — but we don’t. We are in a country where health care has to be paid for through private insurance, and responsible citizens protect themselves by paying premiums, either directly or with their employer’s assistance. (And I’d note that the Canadians pay for their health care system through their taxes – they don’t have the option of foregoing their cost-sharing obligations in the way that young Americans who choose not to buy health insurance can).
So I’m sorry. I am glad that your son seems to be on the mend from his bout with probable Covid. Even though I don’t know your or your son, I do care about your son’s physical health. That’s why I think it’s a good thing that he got an X-ray when he went to the emergency room, which seems to me to be basic standard of care.
But the financial issue is your son’s choice (and yours as well – there are many parents on CC who have taken on all or part of the cost of the premiums to cover their adult kids when their kids legitimately could not afford it on their own). And I while I understand that young people don’t always know or understand how health care billing works, that’s not an excuse either. That is one of those things that we parents can anticipate and tell our kids, as part of the “why you need health insurance” talk. And honestly, I can’t see the angst over a $1200 hospital bill when I’m currently paying 4 times that much in annual premiums now that I’m on Medicare (and very happy to have that privilege), and that would be roughly the cost of a single month’s premium for me if I weren’t old enough for Medicare and made too much money to qualify for ACA subsidies.
I think this discussion underscores the brokenness of our health care system. Those of us fortunate enough to have affordable insurance, or fortunate enough to be able to afford our insurance premiums & associated costs (copays, deductibles, etc) are the very lucky ones. More and more, the system works for fewer and fewer. My hope is that from the ashes of this current crisis, a new appreciation for the importance of a system that works for all might arise. I am waxing a bit poetic, but this has really been on my mind (and heart) a lot lately.
The x-ray didn’t tell them anything that the test wouldn’t have, but the cost was different and not doing the test allowed NC to have one less (potentially) positive result.
As we learned in a recent press conference - no tests, no disease (paraphrasing).
I get that you’d be content going somewhere thinking you were doing something for free that was for the public good and then getting a 2K bill that you bargained down to $1200 without ever getting a result or doing any public good for your time.
That’s ok. You can be content when/if that ever happens in your family.
Our views differ. That’s ok too.
Some on here talk about getting tests “because we’re supposed to.” They might want to check to see that they truly are free. I know in our area ¶ they are and when you call they’ll tell you whether to come in or not (back in the day my lad went - now they are free for all if I recall what I heard correctly). I foolishly thought that was the case everywhere. It’s not. NC plays a different game.
Just so you know-- EMTLA requires every hospital to treat anyone who presents themselves to the ER without regard to whether they have health insurance or whether the patient is able to pay.
ER physicians are not allowed to ask about a patient’s insurance status. So the physicians treating your son gave him the same standard of care they would have given anyone who presented with similar symptoms/illness–insured or not.
The physicians who treated your son acted in good faith. They are not responsible for the political decision made way above their pay grade.
That’s simply not true. A Covid-19 test doesn’t tell anything about whether or how far the disease has progressed. Plenty of people test positive with no symptoms or minimal symptoms. But the damage that Covid 19 can do to lungs presents with a very distinct pattern on an X-ray (the “ground glass opacity”), and the extent to which that is seen could be the difference between being rushed to an ICU vs. sent home. Your son could also have had a secondary infection of a different type of pneumonia, and the X-ray would have given insight into that as well.
Also, both then and now there is a significant false-negative level of tests – and back when your son was seen there were no fast test results. There were many patients, young and old, who were tested and sent home who ended up dying before the test results came back. (Here’s an article about testing from mid-April about the false negative problem - https://www.bloomberg.com/news/articles/2020-04-11/false-negative-coronavirus-test-results-raise-doctors-doubts )
Let me ask you this:
What would you have said if your son had called you from the ED, and told you that he did not meet the criteria for testing, but the doctor was recommending a chest x-ray based on the symptoms he presented with? Would you have told your son to go ahead with the X-ray? Or would you have told him it would cost too much and advised him to go home?
You wrote: "You can be content when/if that ever happens in your family.
Our views differ. "
You are right. I’d never begrudge anyone from providing medical care to one of my kids or to my grandson.
My daughter went to the ER last year in Florida. She didn’t have her insurance card with her so received a bill for the full amount (well 3 bills for hospital, lab, and doc bill). She/they thought appendicitis so did an MRI, a bag of fluids, and that was about it. Total bill? $18,000. Yes, EIGHTEEN THOUSAND DOLLARS for a little over 2 hours in the ER. Turned out to be a bladder infection and they gave her a prescription for an antibiotic (which she had to pay $5 for at CVS). Now they did reduce the bill immediately by $8000 because even they knew that $18000 was too high, and insurance did pay the rest, but $18000 for an MRI and a bag of fluids.