$130,000 in Medical Bills..so far!!!

[OldAgePensioner]

Anyone considering trying to avoid health insurance should be wary. I know we all tend to think it won't happen to us but consider this. When I retired at 55, I had:

1. Complete physical every other year for last 20 years at company expense.
2. Worst "known" health issue was 136/80 blood pressure.
3. Fitness was excellent. Jogged, swam, played full court basketball, boxing/sparring.
4. BMI was fine 5'10"/165 lbs and cholesterol was 150 ish and high HDL levels.
5. Diet of tuna, salmon, swordfish, turkey, veggies, etc. No junk food whatsoever.

I thought my retirement health should be fine. It wasn't. I have 9 years to go before Medicare. At $130,00 a year, my savings would have been wiped out.

It cost $80,447 for an 11 day stay to clear up issues with my initial operation. You would think BlueCrossBlueShield would ask some questions before paying.

I'm not selling insurance but I rest a lot easier with it.

How much of that did the insurance pay?

[cute fuzzy bunny]

Dang OAP. You make a great case against 'rolling the dice' even when you're feeling healthy. I'm glad you were covered, the last thing someone who is facing an illness needs is worrying about money.

I had read an article recently on "healthy living". The tough part is a lot of healthy stuff might not be as good as we think. In particular, a lot of people eat a lot of fish. Unless the fish comes from deep, cold water it has a good shot at carrying pollutants and heavy metals. Even at that, the nutritional profile of fish isnt as good as you'd think. Many fish have high fat and cholesterol counts. Excepting bland stuff like cod, schrod and orange roughy and white meat chicken without skin, you're almost as well off eating lean beef.

Veggies and fruits can be loaded with pesticides and fertilizers.

We've been eating more organic vegetables and have flirted with 100% meat free diets. We felt so good a couple of years ago when we were completely meat free my wife ended up pregnant!

However, I wouldnt count on that happening to you...

[SteveR]

OAP,

You got that one right for sure! If you try to go naked without medical insurance you better be very very well off to cover the expenses on your own. I am so very sorry about your health issues but I respect your drive and will to go on.

When my wife had her fatal illness we spent 16 hours in the hospital...Emergency Room to Medical Intensive Care unit...to morgue. The cost was over $110,000. My medical insurance picked up 90% of it and her life insurance paid off the rest along with her funeral.

You never know when you might need health insurance. My son nearly got himself killed in a car wreck a week ago. He was very very lucky but it could have gone the other way and he could be creating huge medical care debts.

The major reason we are not already ERd is the medical insurance issue. Sure we could afford to pay our own way but we choose to work another few months so DW can get her retirement medical benefit. We do not want to go naked with our current health issues so we choose to work longer to get that major benefit.

OAP, Hang in there man. We are thinking about you and sending you positive thoughts for a speedy recovery.

[justin]

I'm curious to find out how much BCBS actually paid on that $130,000 bill. In my limited experience with health issues, I've only seen what the insurance paid for pregnancy and delivery care. The "retail" price that us consumers would pay was $9000. The insurance company only ended up paying around $3600 for all the serivces rendered (we paid zero). Some labwork only cost BCBS 5% of the "retail" price.

Just curious what BCBS ended up paying for all your medical expenses. I'm leaning more towards a high deductible plan and self-insuring for the most part. The insurance company lets you pay using their much lower negotiated rates than the "retail" rates you would otherwise be charged.

[cute fuzzy bunny]

Justin...pretty much jibes with what we had when my wife delivered...the total bill was around 10k, blue cross paid about 4k and we paid our $500 deductible.

Muddying the water slightly is the part where my wife works for the hospital, so any hospital related items (like the room, inhouse tests, etc but not doctor fees) are half price.

[Outtahere]

OAP I would have to agree with CFB, thankfully you have insurance to cover those costs and don't have to worry on that. *I'm wishing you a speedy recovery so you can get back to enjoying your retirement.

This is the kind of thing that keeps me working just a little longer, I'm not a gambler, at least not with my retirement money.

[OldAgePensioner]

Al,
All but $5000 was covered. 80% coverage up to a max of $5000 per year.

CFB, yeah, I was eating swordfish 2-3 times a week. I love it. Doctor said cut it down to 1 time per week. If I end up pregnant, that does it, I quit.

SteveR, I feel the positive thoughts, I really do. Not sharing my misfortune with friends and family has been tough at times. Sorry to hear about your wife's illness, but I know that the ERoom can run up bills quick.


Justin, I'll get a few examples of what BCBS paid. The bills read:

Charges: $4,000
Paid by BCBS: $3,000
Amt you owe: $0

So BCBS is paying some preferred rate.

Outtahere, I hear ya. Had I known what would happen to me, I would have worked till 80. But I'm just that much of a worry wart. Somehow having the company to help me out was comforting.


BOTTOM LINE: I pay:
$500 deductible
80% after that but no more than $5000 per year.

Please, no one roll the dice. I had NEVER, NEVER, EVER filed a medical claim during 40 years of employment. I did wonder if paying $338/month was worth it. I now know the answer.

[cute fuzzy bunny]

If you end up pregnant, call me. You'll need a manager...

Hell, you've gotta look better than that 62 year old lady that just gave birth...

[Cool Dood]

Quote:

Originally Posted by OldAgePensioner BOTTOM LINE: I pay: $500 deductible 80% after that but no more than $5000 per year. Please, no one roll the dice. I had NEVER, NEVER, EVER filed a medical claim during 40 years of employment. I did wonder if paying $338/month was worth it. I now know the answer.

Um, if you'd invested that $338/month instead of buying health insurance, it might be worth over $800,000 today, out of which your medical bill would be a small chunk and you could blow the rest on hookers, coke, and any medical procedures ensuing from the hookers and coke.

Yes, it's a risk, and I wouldn't necessarily recommend it, but my point is that it's not so clear-cut that you shouldn't take that risk, and there's a 100% risk of losing a helluva lot of money by buying health insurance........

[Cool Dood]

Oh, and I should definitely add, congratulations on being able to cover it, and I hope you recover fully!

[cute fuzzy bunny]

The only hole in that postulation is that the payments wouldnt have been $338 years ago. Modelling average annual costs of health care over 40 years at an 8% return rate and a 3% inflation rate would probably throw up a nice low six figure amount.

Trust that if you end up making a six figure claim on your health insurance, they didnt make a lot of money off of you, if not a wholesale loss. Investing it yourself might have brought you a few dollars, but a lot of anxiety until you saw the final bills.

[OldAgePensioner]

cool dood,
for 40 years I paid nothing for health insurance. *The company supplied. *So far I have paid 10 payments for a total of $3,380 and $5000 out-of-pocket for my $130,000 surgery.


It would take a brave 55 year old to bet that they will have no health issues during their remaining 30-40 years of life. *And yeah, if you don't have a health issue till your 95 years old, then you've wasted a lot of money on payments. *But, if something major comes along at 56 years old. *BINGO. You're a winner.

[cute fuzzy bunny]

This is like avoiding the umbrella liability as its pretty unlikely you'll need it if you're careful.

There isnt any recovery from a major event.

You can skimp on car coverage, you can skimp on homeowners a little, you can say no to 'extended warranties' on tv sets.

A one-time six or seven figure event is the end of the story.

[Cool Dood]

CFB, you make a good point which I had neglected. (As I said, it's not that I'd recommend skipping out on health insurance, just bringing up the risks/benefits on both sides -- but you knew that.)

OAP, it sounds like you got a rockin' deal out of it. Congratulations on screwing the insurance company!

I also can say that with a house that burned down and a wife who had a brain tumor and five brain surgeries (all turned out OK), that our payments will never come close to what we received.

Insurance paid for everything (about $650,000 for house and contents, and 100% of medical bills). Over a million at least.

[farmerEd]

Quote:

Originally Posted by TromboneAl I also can say that with a house that burned down and a wife who had a brain tumor and five brain surgeries (all turned out OK), that our payments will never come close to what we received.* Insurance paid for everything (about $650,000 for house and contents, and 100% of medical bills).* Over a million at least.

Guess thats why I had to make just over $48,000 in health insurance premium payments in the last 5 years and had just under $5000 in claims...but with 4 kids you really can't afford not to have it..too bad Mass doesn't allow hi-deductible policies.

[OldAgePensioner]

cool dood,
I actually feel sorry for BCBS. *This Northwestern Medical is giving them a ROYAL screwing over. *I actually doubt most of the charges are legitimate.

One $2,400 charge was for a cardiologist who spent 10 minutes with me. *5 of those was her asking me how long it would take a spacecraft to reach Mars. She and her 11 year old disagreed on the answer.

[justin]

Quote:

Originally Posted by OldAgePensioner I actually feel sorry for BCBS. This Northwestern Medical is giving them a ROYAL screwing over. I actually doubt most of the charges are legitimate. One $2,400 charge was for a cardiologist who spent 10 minutes with me. 5 of those was her asking me how long it would take a spacecraft to reach Mars. She and her 11 year old disagreed on the answer.

I think medical providers and insurance companies play games all the time. They probably call it "Highball-lowball". We'll see a $200 claim for some lab test for my wife's pregnancy. BCBS will pay something like $5.28 on the claim and make the lab company eat the other $194.72 in charges.

Then they do crazy stuff like pay for 4 out of 5 lab tests that only pregnant women would have. The 5th test was denied on the grounds that BCBS doesn't cover lab tests for in vitro fertilization!?! In vitro? She's already pregnant! She's the last woman that would need in vitro!!!

Insurance companies. :

[Martha]

JG, UncleMick, are you reading this?

My best friend survived cancer. We are celibrating her five year anniversary shortly. She was a vegetarian, skinny as a rail, and as fit as can be.

Now she is on the paleo diet. She no longer thinks a vegetarian diet is healthy. She is quit religious about it.

I think that we cannot control everything that happens to us by leading "perfect" lives.