Health Care in America
Recently as described in a previous blog I had to go to the hospital for a kidney stone. I was pretty sure what it was but the attack came at 4 am and the ER was the only option. In retrospect I could have stayed home and just risked not knowing the cause. It might have turned out okay or I might have died. Funny thing is, next time, maybe I will take the chance.
Everyone in America knows the realities of health care in this country. The maze of paperwork and policy details and fine print. Even if you have insurance there is no guarantee it will pay for anything.
Since I just went through a real world example of this I thought I would share my billing experience with Lexington Medical in beautiful South Carolina. Two days after the visit they sent me a survey. I guess they wanted to make sure I got it in before the bills started to arrive.
So, this is my recent experience with going to the ER for two hours with my kidney stone. They did one CT scan and gave me two shots of pain killer. That was the sum total. I was in and out in under two hours.
This is what it will cost total and cost me. Keep in mind I have one of the best insurance polices available for US Government Employees. We are ridiculed by the nation for our excess. Despite my "good fortune," I have to pay 15% of the cost up to 5,000 dollars. After that the plan pays everything.
In the US if the medical facility accepts your insurance carrier they have to accept what the carrier will pay them vs. what they would charge a person off the street with no coverage. If they don't and you have to be treated, it will cost you much much more.
The hospital has charged the insurance company twice for $779.00 of which the Insurance paid $248. and I have to pay 30 dollars. One of these charges is a complete mistake as I wasn't even there on the day they charged it. When I told the insurance company this they told me to tell the hospital when they bill me. Wouldn't you think they would be more concerned over their money?
Now the big stuff:
They did a CT scan. The price to read the scan was $429.00. They will pay $248.00. Because of my deductible of $300 I have to pay $239.50
So now comes the big part:
Drugs:$100.00
Injections: $230.00
Use of the space for the CT scan: $3,722.00
Medical care: $1,300.00
In all the hospital is billing $5,238.40 in reality the insurance will pay $3,567.40 and I have to pay $538.00.
So the total cost of my less then two hour adventure to the ER in America.
Hospital Charge: $6000+ Insurance Paid $3,567 I have to pay $800.00
If I was uninsured, I would have had to pay the $6,000+.
Just to be clear, this was for less then two hours at the ER, one CT scan and two shots of pain killer.
Every year just to have health insurance for myself and family I and my employer pay approximately $12,000 half from me, half from them.
This is America...
I was told by the insurance company that when the hospital bills me if I call them and negotiate to pay the whole thing at once instead of installments they might give me a discount. How could I be so lucky?
Oh but ask anyone with an "R" next to their political affiliation and they will happily tell you we have the finest medical care in the world. We should fund our healthcare out of private "health savings accounts." It must be nice to have so much money a trip hospital is like going to the movies. For the other 98% of us we must ask the question, do we go and not pay our other bills this month or do we just take the chance that this will be the time we die?
Everyone in America knows the realities of health care in this country. The maze of paperwork and policy details and fine print. Even if you have insurance there is no guarantee it will pay for anything.
Since I just went through a real world example of this I thought I would share my billing experience with Lexington Medical in beautiful South Carolina. Two days after the visit they sent me a survey. I guess they wanted to make sure I got it in before the bills started to arrive.
So, this is my recent experience with going to the ER for two hours with my kidney stone. They did one CT scan and gave me two shots of pain killer. That was the sum total. I was in and out in under two hours.
This is what it will cost total and cost me. Keep in mind I have one of the best insurance polices available for US Government Employees. We are ridiculed by the nation for our excess. Despite my "good fortune," I have to pay 15% of the cost up to 5,000 dollars. After that the plan pays everything.
In the US if the medical facility accepts your insurance carrier they have to accept what the carrier will pay them vs. what they would charge a person off the street with no coverage. If they don't and you have to be treated, it will cost you much much more.
The hospital has charged the insurance company twice for $779.00 of which the Insurance paid $248. and I have to pay 30 dollars. One of these charges is a complete mistake as I wasn't even there on the day they charged it. When I told the insurance company this they told me to tell the hospital when they bill me. Wouldn't you think they would be more concerned over their money?
Now the big stuff:
They did a CT scan. The price to read the scan was $429.00. They will pay $248.00. Because of my deductible of $300 I have to pay $239.50
So now comes the big part:
Drugs:$100.00
Injections: $230.00
Use of the space for the CT scan: $3,722.00
Medical care: $1,300.00
In all the hospital is billing $5,238.40 in reality the insurance will pay $3,567.40 and I have to pay $538.00.
So the total cost of my less then two hour adventure to the ER in America.
Hospital Charge: $6000+ Insurance Paid $3,567 I have to pay $800.00
If I was uninsured, I would have had to pay the $6,000+.
Just to be clear, this was for less then two hours at the ER, one CT scan and two shots of pain killer.
Every year just to have health insurance for myself and family I and my employer pay approximately $12,000 half from me, half from them.
This is America...
I was told by the insurance company that when the hospital bills me if I call them and negotiate to pay the whole thing at once instead of installments they might give me a discount. How could I be so lucky?
Oh but ask anyone with an "R" next to their political affiliation and they will happily tell you we have the finest medical care in the world. We should fund our healthcare out of private "health savings accounts." It must be nice to have so much money a trip hospital is like going to the movies. For the other 98% of us we must ask the question, do we go and not pay our other bills this month or do we just take the chance that this will be the time we die?
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