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User Topic: No medical insurance...what happens if...
wifehad5
♂ Moderator
Member # 15162
Default  Posted: 4:36 PM, November 8th (Friday), 2013View ProfileEdit MessagePrivate MessageHomepage

The bill said that my insurance wasn't valid. Of course I called the hospital and told them that I did indeed have valid insurance. Turns out they had billed my OLD insurance company in error, and the old company denied the claim, of course.

I don't think this is anything new. When I was a kid, I had to have quite a few surgeries. I was covered under my Dad's insurance, but my Mom had BCBS that was secondary coverage. The hospital continually ignored my Dad's insurance and always billed BCBS first, which would be denied

It took well over a year to get straightened out.


FBH - 42
FWW - 43 (BrokenRoad)
2 kids 7&12

The people you do your life with shape the life you live


Posts: 36970 | Registered: Jun 2007 | From: Michigan
StrongerOne
♀ Member
Member # 36915
Default  Posted: 4:50 PM, November 8th (Friday), 2013View ProfileEdit MessagePrivate MessageHomepage

Yes, insurance and hospital billing screw ups have been around since the dinosaurs

When I was in grad school (when dinosaurs roamed the earth), i had insurance provided through the university. U has a med school and hospital. So this is all right in the neighborhood, literally and financially.

Go in for minor health issue. I get EOBs, but no bill. I call. No bill -- don't worry, don't pay until you get the bill. Nice idea, until it went to collections...

One hospital and associated lab near us screwed up insurance claims with so many errors on our son's claims that we had to laugh about it (we also stopped going there): wrong name. Wrong policy number. Wrong date of birth several times -- once he was apparently a newborn (in fourth grade!) and once he was 58 years old. Wrong procedure billed for (in general, 8 year old boys do not need obstetric care).

[This message edited by StrongerOne at 4:52 PM, November 8th (Friday)]


DDay Feb 2011.
In R.

Posts: 855 | Registered: Sep 2012
karmahappens
♀ Member
Member # 35846
Default  Posted: 5:33 PM, November 8th (Friday), 2013View ProfileEdit MessagePrivate MessageHomepage

My MIL worked at a dry cleaners for many years. They employeed a woman under the table who was not a legal immigrant. Her sister had mass health and the entire family of women ( six that we knew of) all shared her card and took on her identity when making hospital trips.

Both my kids, DD 23 and DS 25 are on our insurance....like the others said, until 26

[This message edited by karmahappens at 5:34 PM, November 8th (Friday)]


“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anaïs Nin
Me: 45
Him: 47
Dday 8/2007
We have R'd

Posts: 3793 | Registered: Jun 2012 | From: Massachusetts
karmahappens
♀ Member
Member # 35846
Default  Posted: 5:48 PM, November 8th (Friday), 2013View ProfileEdit MessagePrivate MessageHomepage

sorry for t/j

rachel go here

http://www.aphis.usda.gov/mrpbs/hr/benefits/downloads/faq_health_reform.pdf


“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anaïs Nin
Me: 45
Him: 47
Dday 8/2007
We have R'd

Posts: 3793 | Registered: Jun 2012 | From: Massachusetts
scaredyKat
♀ Member
Member # 25560
Default  Posted: 5:50 PM, November 8th (Friday), 2013View ProfileEdit MessagePrivate MessageHomepage

T/j NP... I'm enjoying the conversation. I have some stories of my own along the same lines...


Me-BS-60
HIM-SAFWH-63
Damn autocorrect is responsible for the silly errors, sorry!

Posts: 3459 | Registered: Sep 2009 | From: In my head
karmahappens
♀ Member
Member # 35846
Default  Posted: 6:42 PM, November 8th (Friday), 2013View ProfileEdit MessagePrivate MessageHomepage

I have some stories of my own along the same lines...

It makes me


“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anaïs Nin
Me: 45
Him: 47
Dday 8/2007
We have R'd

Posts: 3793 | Registered: Jun 2012 | From: Massachusetts
sisoon
♂ Member
Member # 31240
Default  Posted: 1:19 PM, November 9th (Saturday), 2013View ProfileEdit MessagePrivate MessageHomepage

The link posted originally is to a copy of the Time magazine article from a couple of years ago.

Most of us know hospital billing only from our own experience. The article is an overview of the problems and the causes.

I urge everyone to gird up their loins and read it. And, if you find the article disturbing, pass it on to people who can make a difference.


fBH (me) - 70 (22 in my head), fWW (plainsong) - 65+, Married 45+, together since 1965
DDay - 12/2010
Recovered, not yet fully R'ed
I share my own experience because it's the only experience I know, not because I'm a good model.

Posts: 9991 | Registered: Feb 2011 | From: Chicago area
StillGoing
♂ Member
Member # 28571
Default  Posted: 7:54 PM, November 10th (Sunday), 2013View ProfileEdit MessagePrivate MessageHomepage

Our son was considered a pre-existing condition the insurance didn't want to cover.. the hospital bills for his birth. That was a lawl.

If you do not have insurance, you do not get basic or preventative care. You do not get access to medication unless you are covered under a government plan or they have a generic you can afford (one of mine does not have a generic and a 1 month supply at a 1/3 dose costs $500, so without insurance I do not have those meds). Without insurance some doctors offices, if they are kind, will cut a deal for direct pay when it comes to basic and preventative care, but those bills mount quickly and if you are in a position where insurance is a problem, then a hundred bucks here, fifty there, three hundred for something else is probably going to be a major issue.

If you are seriously injured and do not leave the hospital AMA before the costs get into the 5 digits you are still responsible for those bills unless the hospital elects to voluntarily cut some deal. They're likely to sell or farm out delinquent payments to collections or finance departments, who can and likely will bring you to court, for which you will have to pay as well. If you happen to have a job that pays crap and offers no insurance they can take a % from your wages, which you probably couldn't afford before anyway. So the best thing to do is declare bankruptcy and fuck over everyone else involved so you don't get fucked over for life. As an anecdote, the worst I heard was a woman who was shot during a home invasion and was subsequently terminated because she couldn't perform her job function, and losing her job meant losing her insurance, which meant all those bills that piled up because things like shattered bones thanks to bullets don't get all healed up with a single Cure Light Wounds and tend to require weeks and months of treatment, but when your insurance runs out a week in, that sucks. She declared bankruptcy from what I heard.


The insurance my company uses has a magic deductible. By magic I mean they turn a profit.

A family deductible is $3500. That, however, has to be cumulative for a single member before it is cleared for the entire family. We have the 4 of us here and that means one of us has to hit the 3500 ceiling before the deductible is cleared for everyone. A few years ago during a particularly bad year we paid out of pocket more than ten grand before that was met. On top of that they take more than five grand a year out of my pay; ultimately I worked out that of the 15,000 in medical bills we paid, they covered less than what they took out of my paycheck for the year, which meant at the end, we quite literally paid an insurance company for the privilege of being sick.

That's not even looking at the horse shit where they intentionally refuse coverage on things they blatantly should cover just to see what they can get away with not paying.

The problem is not the hospitals, doctors or healthcare industry, it is 100% with the insurance industry, which does not have to adhere to the same regulations healthcare does, but gets most of the exemptions and benefits.


“Fate is a fickle bitch who dotes on irony.”

Posts: 7431 | Registered: May 2010 | From: USA
Pentup
♀ Member
Member # 20563
Default  Posted: 9:02 AM, November 11th (Monday), 2013View ProfileEdit MessagePrivate MessageHomepage

I beg to differ. It is not solely on the insurance companies. There needs to be torte reform on malpractice and serious consequences for bad/dangerous healthcare staff. Kansas has/had? A good model for this. Until GOOD physicians can practice to the best of their ability without being sued or under threat of suit, then unnecessary testing, etc will continue to occur. Until those who are scamming insurance and disability for injuries that really do not prevent them from working at some level are held accountable, then everyone who works within the systems are going to pay.

There does need to be reform, but it needs to be in many areas, not just one. Personally, I think it starts with realistic expectations, self care, personal responsibility and knowledge by the consumer. (I do not work for an insurance company. ).

I know I am in a minority, but I do not think full service healthcare is a right. Nor do I think basic healthcare is a privilege.


Me- BS
Him- FWS (I hope- F)

Posts: 6545 | Registered: Aug 2008 | From: Not Oz
sisoon
♂ Member
Member # 31240
Default  Posted: 2:30 PM, November 11th (Monday), 2013View ProfileEdit MessagePrivate MessageHomepage

Sorry, the last I heard, the Congressional Budget Office and other economists who look at medical costs estimate malpractice at 1%-2% of the total medical costs. It's a trivial part of the equation, and protecting docs against malpractice claims will result in only a trivial cost savings, if any.

Health insurance for large groups can be quite good. The health insurance market for individuals can be treacherous. For example, individuals whose policies are cancelled because they don't comply with the ACA are being enrolled automatically in the insurer's high cost plans, even though much cheaper and often better policies are available through the exchanges, although that doesn't help right now if you have to use the Federal exchange.

Not only are individual consumers terribly disadvantaged in the health insurance market, small medical practices and sole practitioners are also terribly disadvantaged, with insurers squeezing them with low reimbursements and hospitals trying to swallow up their practices.

Health care finance and delivery in the US is a system run amok.


fBH (me) - 70 (22 in my head), fWW (plainsong) - 65+, Married 45+, together since 1965
DDay - 12/2010
Recovered, not yet fully R'ed
I share my own experience because it's the only experience I know, not because I'm a good model.

Posts: 9991 | Registered: Feb 2011 | From: Chicago area
Pentup
♀ Member
Member # 20563
Default  Posted: 2:36 PM, November 11th (Monday), 2013View ProfileEdit MessagePrivate MessageHomepage

Sisoon, I would like to compare how economists got those numbers to what I know to be related to quality of care across the nation. Under reporting, not coding medical errors, and families who opt to not pursue I think would dramatically change any numbers if there were reforms I place to challenge bad medicine without a malpractice suit.

I agree with your other comments, but do not believe that the issues I pointed out are trivial to the economic equation.

Going to back out because I am veering off the original question and I do not want to t/j.


Me- BS
Him- FWS (I hope- F)

Posts: 6545 | Registered: Aug 2008 | From: Not Oz
Snapdragon
♀ Member
Member # 4286
Default  Posted: 2:47 PM, November 11th (Monday), 2013View ProfileEdit MessagePrivate MessageHomepage

When I was 21 yrs old I had to have emergency laparoscopy for an ovarian cyst.

It took me FIVE YEARS to pay it off. Each area of the procedure had their own bill. I had to pay $10/mo on each one. I was barely making over minimum wage as a medical assistant. My employer did not offer health insurance. I did not get paid for my time off.

Anesthesia
Surgeon
Hospital
Pathology
Radiology

That's $50/mo. I was only bringing home $600.

No one wrote off a damn dime or gave me any discount. I was charged full price. Those with insurance got charged a fraction due to negotiations with the insurance companies. If I didn't pay it would have gone to collection and impacted my credit score.

Never, ever got without health insurance!


Divorced - recovered and hoping to help.

"We're not broken, just bent, and we can learn to love again" ~Pink


Posts: 3077 | Registered: May 2004 | From: Midwest
itainteasy
♀ Member
Member # 31094
Default  Posted: 8:30 AM, November 12th (Tuesday), 2013View ProfileEdit MessagePrivate MessageHomepage

Every hospital is different with their Charity care programs.

My fiance had to apply for charity care. First requirement was applying for Medicaid. He was denied. Charity care was then approved. His six figure hospital stay was reduced to almost free.

He also negotiated a self pay rate with his physicians for the after care he needed.

But yes, insurance is a must.
2 more months and I can include him on mine under the Domestic Partership clause my company offers. Thank God.


Posts: 3355 | Registered: Feb 2011 | From: NWPA
NaiveAgain
♀ Member
Member # 20849
Default  Posted: 12:30 PM, November 12th (Tuesday), 2013View ProfileEdit MessagePrivate MessageHomepage

When I was still with my WS, he got bit by a brown recluse. He was working down south, so I flew down to be with him in the hospital. His leg had swelled and was turning colors.

The hospital decided they needed to check his heart along with treating his leg. They ran him thru about 4 different tests, including an overnight stay because they needed to do one of the tests in the morning. We kept telling them we did not have insurance, how much was all this going to cost, and why did they keep checking his heart when all the reports came back normal.

After they did finally treat him with IV antibiotics for the spider bite, we got a bill for $12K. I called them, I wrote them, I wrote the BBB, and I wrote a letter to the governor of the state. I wrote the hospital that we did not ask for the heart tests, and after the first one came back fine, there was no need to keep going. I told them I felt they were doing unnecessary tests and we were not going to pay them. In the end, they wrote off the entire bill, because I finally got to the point where I was looking into lawyers.


Original WS D-Day July 10, 2008. Kept lying, he is gone.
New WS (2 EA's, no PA) 12-3-13
If you don't like where you are, then change it. You are not a tree.

Posts: 15194 | Registered: Aug 2008 | From: Ohio
Topic Posts: 34
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