Health insurance stuff is stupid (1 Viewer)

[RUSF18]

Thank you for an honest answer.  This sums up why I feel HDHPs (high deductible health plans) lower the overall cost of care, and why I think any "Medicare for all" with zero out of pocket costs will greatly outgrow all of our current estimates of costs.  People make different decisions, even on their health care, when they're doing so with their own money than when they do so with someone else's money. 

I don't disagree that this is how it would play out in reality if instituted today, but don't you think things could be different if this approach was taken 10-15 years ago before costs spiraled out of control, everyone's premiums went up, coverage went down, etc.

I was lucky growing up as my mother was a teacher and had great coverage and she paid nothing, and we never willfully choose to go to the doctor for minor things. That extended into my 20s when I worked for the government and had very cheap, very good insurance. I remember hurting my shoulder a bit working out and it wasn't until weeks later that I got it checked out and that was only because I couldn't even move my arm enough to type on a keyboard. That led to a couple visits, an MRI, and rehab and the whole thing didn't cost me more than a few $30 copays.

But now I absolutely treat things differently. We hit our family deductible by January this year after my wife was having some problems that eventually led to an ER visit, multiple scans, multiple doctors, etc. Thankfully everything ended up fine but after all we've spent on HC over the last few years I was definitely planning on getting things taken care of that wasn't a priority.

(A job change a few months ago through that plan out the window, of course)

 

[matttyl]

So my son's tongue wasn't billed as an emergency? Is that the secret to this? Just call the doctor's office and have them change the billing? If that's true, between the numerous calls to the hospital/insurance, no one has brought that up.

It's complicated, but generally it will be billed as in network.  That means you wouldn't have to fulfill your our of network deductible and such (which I believe is what you said earlier).  That said, the carrier will only then pay the in network rate - and if the doctor charged more than that amount (which I also believe is your case), you'd be "balance billed." 

So if the in network rate for this was $4k, it would at least go towards your in network stuff; but if the doctor charged $10k you'd still be billed the additional $6k directly. 

It's also difficult to get stuff billed as emergency after the fact. 

 

[ghostguy123]

So I had a routine wellness check, then went back for the follow up.

A couple weeks later I get a bill for $125 (150 minus my 25 dollar copay).  I should not have been billed.  

Anyway, I called the number on the actual bill, waited on hold several different times before I was actually able to sit for 20 minutes once to get through to someone.  They tell me it looks like a mistake (gee, I wonder how many times they do this on purpose just to see who pays), so they tell me to call my insurance.  So, I call my insurance, and they tell me to call the doctors office directly to have them correctly submit the claim. So, I call the doctors office directly, and they tell me they don't do their billing, so they give me the number to their billing department.  

So, after all that, the doctor's office has just transferred me to the original number I called from the bill I received.  

How's everyone else's morning going?

I almost never go to the doctor or hospital or anything, yet every time I do I have stupid issues like this.

 

[russinfortworth]

Wife went to an IN NETWORK ER back in February. 

Still arguing with the Insurance company, the hospital, and the attending Dr about a charge from the Dr, since the doctor WAS OUT OF NETWORK.

 

[Da Guru]

A friend`s wife was in a bad car accident 10 years ago. Was in a coma for weeks and has seen multiple doctors for numerous injuries and follow ups.

Anyway he said he was so tired of fighting insurance over unpaid doctors bills he just stopped paying what the doctors were billing him. Said he was contacted by collections and after awhile they  stopped billing him.  All this time he was checking his credit score to make sure everything was OK.  Last month he bought a new condo and went over his credit with the bank and it was right where it always has been even though he said he has over 30K in unpaid medical bills over the last couple of years..the bank employee said that medical disputes in billing do not go against your credit score.  Is this true?

 

[IMAX 3D]

A friend`s wife was in a bad car accident 10 years ago. Was in a coma for weeks and has seen multiple doctors for numerous injuries and follow ups.

Anyway he said he was so tired of fighting insurance over unpaid doctors bills he just stopped paying what the doctors were billing him. Said he was contacted by collections and after awhile they just stopped billing him.  All this time he was checking his credit score to make sure everything was OK.  Last month he bought a new condo and went over his credit with the back and it was right where it always has been even though he said he has over 30K in unpaid medical bills over the last couple of years..the bank employee said that medical disputes in billing do not go against your credit score.  Is this true?

It’s possible.  I got sent to collections because they were billing the wrong address for a year, nothing was reported