Sunday, November 09, 2008

Picking up the Tab :-(

One of the things that came in the mail last Thursday was from the hospital where K had his appendectomy. The moment I saw it I knew it was a bill... and I also got curious to find out how much it had cost. The funny thing is that this summer there was an article on the Philly Mag about health insurance and it featured precisely an appendectomy (the author's daughter's), so I am aware that the total there is NOT what the insurance company (IC) paid because the hospitals actually have contracts with each IC and they pay only what has been previously stipulated. Very complicated, that was the whole point of that article.

Well, take a look:

Now... the "co-pay" or whatever what we need to pay is called did surprise me (although we haven't yet called the insurance company or the hospital or K's former employer to make sure that we really have to be 1K poorer because of this)... I thought that a fancy-schmanzy plan like the one K had at Big Pharma wouldn't charge us that much and I feel terrified at the thought of how much would the tab be on another less comprehensive insurance.

I also felt a bit disappointed that his appendicitis happened while he was still under his old insurance because I suspect that his insurance plan at the university might now have had such a co-pay (we paid nothing when he had the surgery in his wrist, but then, he also didn't stay two nights in the hospital... or maybe I'm wrong, maybe we paid a couple hundred dollars... I can't remember). Well, we never had co-pays when we had the student insurance at our old universty, but then, again our grad student union was AWESOME and made sure we had free and comprehensive health and dental insurance. Oh... I miss that and no-copays...

Anyway, I have a question for you... what was the costliest and scariest copay or hospital bill tab you ever had to face?

6 comments:

pithydithy said...

So, you probably know this, but the payments/adjustments includes what your insurance actually paid plus the discount that they've negotiated with the hospital. When you get your EOB (explanation of benefits) from your insurance company, it will break that amount apart and you can see what they actually paid and then how they billed you based on that.

Anyway, our insurance pays 80% of charges after a $300 deductible, up to a $1100 out of pocket cap per person. For both pregnancies I'll probably end up paying $1100...which feels like a lot, especially given that we already pay over $400 per month for the insurance to begin with. (This is through my employer, btw.) But all of that pales compared to our infertility expenses. At the time, my old insurance covered about 50% of the drugs costs and 50% of the costs of IUIs (but none of IVF), but our bills were still very high. (Although, compared to how many women have no infertility coverage, they were amazingly cheap.) I still can't think about that time without remembering the dread I felt at every envelope in the mail.

pithydithy said...

PS-- I thought Annie Fox's survey sounded interesting too, but there's no way I'll ever find an hour to take it. Sigh.

Unknown said...

My total out of pocket costs for my last pregnancy and delivery (via C-section) were close to $2,500. I kid you not. And I supposedly have "good" health insurance.

zabrina said...

Geez...you don't wanna see our bills!!! We did not go to Brazil because kiddo went to hospital last January and we own 15 times more! Helicopter ride, ambulance, hospital care, doctor's visit and we also have a few more bills from my mammos last year...they suspected I had cancer. Fortunately I am ok.
Missed you. i hope all will be fine. Hugs,

Renata said...

I don't have as much to add, but I would recommend anybody request an itemized bill. Sometimes it doesn't affect your copay, but otherwise it is still overcharging insurance companies (which in turn raises healthcare costs). I also discovered that they charged something like $10 for a 2oz tube of Nivea cream. Ridiculous. The insurance company picked up the tab, but no wonder healthcare costs so much!
Also, I have had my OB owe me money after the births of my first two. We paid the global fee by 7 months gestation and because the deliveries required little intervention, the charges ended up being less. Nonetheless, they were already sending us confusing bills soon after the birth and before the insurance had processed the payment. I wonder how many people overlook this kind of stuff and pay them twice.

Unknown said...

My first kid--completely natural delivery, with a few minor issues for me post delivery cost us a couple of thousand out of pocket at least. I remember we made our final payment on the first kid when the second one came along.

The second kid, c-section for breech position cost us nothing. That was on a different insurance plan. We're on still another and I've never had to pay more than $20 or $30 even for ER visits (and we've had a few unfortunately).