Astonishing medical bills

[easysurfer]

NBC News had a story on this very topic. In this situation, the patient tried her best to dot the I's and T's ahead of time but still got socked with a hefty bill:

How to Protect Yourself From Surprise Medical Bills - NBC News

 

[audreyh1]

No. They cannot recognize revenue that has not been collected, and only the actual cost of services in kind can be deducted, not the price or value.

Well I wondered, as it seems like every business would use this technique to become "non-profit".

 

[Sarah in SC]

I had a pharmacist the other day launch into a rant with me, unbidden. He said that they order hydrocortisone suppositories (and no, that is DEFINITELY NOT what I was picking up, lol) and the cost had jumped in the last month or so to over $200 a blister pack. For the same hydrocortisone that you could buy off the shelf. I had to ask if he was advising customers to "roll their own" to save money.

The whole system is simply broken.

 

[Dawg52]

For the folks on Medicare, doesn't getting a supplemental plan F (plan type) pretty much cover everything hospital and doctor related that Medicare doesn't? I'm still years away from Medicare but made several mental notes about the supplemental plan.

Yes.

My mother must have had a plan F supplement. I knew she had one, just wasn't sure what. When she died 3 years ago, she was in intensive care for 10 days before passing. I never received one statement from the hospital or any kind of medicare/insurance EOB statement. I thought that was odd.

 

[Amethyst]

So, given all this, might "large number of nearby doctors and specialists willing to accept Medicare" a necessary criterion for "Where shall I retire?"

Amethyst

 

[MRG]

I had a pretty terrible experience.

When I was in my early 20s... I started to get what felt like heart attacks... multiple times a week.

I'd go to the emergency room... nothing was wrong but they told me (obviously) to come back.

My empathy!

In 92 I had the same kind of issue but only a one time hit. Checked into ER for chest pain and a numb left arm and was treated as if I was having a heart attack. Then told it's nothing but a panic attack, which is not nothing. Since my insurance had no mental benefits I was stuck. Luckily it was not what you got tagged for, but it hurt. I acted as though it was a car payment every month.

People tell me they have no need for mental coverage, they are clueless.

 

[audreyh1]

So, given all this, might "large number of nearby doctors and specialists willing to accept Medicare" a necessary criterion for "Where shall I retire?"

Amethyst

That doesn't mean it won't change as soon as you move.

 

[REWahoo]

For the folks on Medicare, doesn't getting a supplemental plan F (plan type) pretty much cover everything hospital and doctor related that Medicare doesn't? I'm still years away from Medicare but made several mental notes about the supplemental plan.

Be aware that the 2015 "Doc Fix" legislation states no new Plan F policies will be sold after Jan 1, 2020 - although existing policy holders will be grandfathered. Also, there is a high deductible Plan F that may continue to be available (no ruling on that yet).

Consider Plan G as a close alternative.

 

[meierlde]

So, given all this, might "large number of nearby doctors and specialists willing to accept Medicare" a necessary criterion for "Where shall I retire?"

Amethyst

Look for areas that have a large percentage of population over 65 Physicians in those areas have little choice but to take medicare because that is a large part of their business.

 

[imoldernu]

Practical advice from my (even older) neighbor re health costs and medicare:

"Things aren't going to change. Best advice is to not pay any of the bills you receive for at least three months, while the doctor, Medicare, and your supplement straighten out the details."

The "You may be billed..." part of the invoice is meaningless, and any payment made based on that statement, has a fair chance of being lost along the way.

But then, you already knew that, didn't you.

 

[rbmrtn]

I had looked into this a few years ago and learned about something called "chargemaster"
https://en.wikipedia.org/wiki/Chargemaster, it's where the inflated charges start

The Times reporter Steven Brill did an article that hit on it, http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

 

[Sue J]

RonBoyd,

That restaurant video was excellent. Thanks for posting it.

 

[easysurfer]

Be aware that the 2015 "Doc Fix" legislation states no new Plan F policies will be sold after Jan 1, 2020 - although existing policy holders will be grandfathered. Also, there is a high deductible Plan F that may continue to be available (no ruling on that yet).

Consider Plan G as a close alternative.

I'm still awhile away before medicare. But mental note made.

 

[easysurfer]

My mother must have had a plan F supplement. I knew she had one, just wasn't sure what. When she died 3 years ago, she was in intensive care for 10 days before passing. I never received one statement from the hospital or any kind of medicare/insurance EOB statement. I thought that was odd.

I had a friend who a few years before passing away, seemed like she went to the ER several times a year for various tests and treatments. I had the same "I thought that was odd" thought too. Even more odd I thought was when she switched from one F supplement plan from one insurance company to another, save coverage (as dictated by law) but different premium costs.

 

[FUEGO]

I had a pharmacist the other day launch into a rant with me, unbidden. He said that they order hydrocortisone suppositories (and no, that is DEFINITELY NOT what I was picking up, lol) and the cost had jumped in the last month or so to over $200 a blister pack. For the same hydrocortisone that you could buy off the shelf. I had to ask if he was advising customers to "roll their own" to save money.

Sounds like a pain in the butt.

 

[audreyh1]

Be aware that the 2015 "Doc Fix" legislation states no new Plan F policies will be sold after Jan 1, 2020 - although existing policy holders will be grandfathered. Also, there is a high deductible Plan F that may continue to be available (no ruling on that yet).

Consider Plan G as a close alternative.

I notice that plan G is not yet offered by several companies in TX. I assume that will replace Plan F when time comes closer? Just surprised that it is not already available.

 

[FUEGO]

This is beyond outrageous and well into immoral if you ask me.

At first I was shocked when I realized the previous bills I had seen weren't THE big bill. Then just shrugged it off, laughed and acknowledged that this is how our broken medical system works - there is no way he would ever be able to pay it (at age 68 on $950 of SS per month and at the time disabled and barely hanging on to life). The upside is that the care he received seemed pretty good and he would almost certainly have died without medical intervention.

My MIL was uninsured at that time (too poor to hit the 100% of FPL to qualify for ACA subsidies in our non-medicaid extension state of NC). Her healthcare plan for anything over a thousand dollars was to seek emergency treatment and not pay the bills (or die). Fortunately she's on the same type of gold plated silver UHC plan that my family is on with $0 deductible so she can actually get care at a primary care doc before it becomes acute and an emergency (and costs many tens or hundreds of thousands).

 

[REWahoo]

I notice that plan G is not yet offered by several companies in TX. I assume that will replace Plan F when time comes closer? Just surprised that it is not already available.

Not sure why either. A lot of agents appear to be trying to convince people to switch from F to G for fear F rates will increase more in the future with no new, healthy people entering into the pool. They suggest making the move now, while healthy enough to pass underwriting requirements. I suspect the motivation is actually based more on drumming up new sales commissions than watching out for their customer's best interests, but what do I know.

Another unknown is the fate of the High Deductible Plan F. The govt has made no determination on whether it will also be excluded from new sales starting in 2020. I've seen speculation both ways but nothing official yet.

 

[audreyh1]

Not sure why either. A lot of agents appear to be trying to convince people to switch from F to G for fear F rates will increase more in the future with no new, healthy people entering into the pool. They suggest making the move now, while healthy enough to pass underwriting requirements. I suspect the motivation is actually based more on drumming up new sales commissions than watching out for their customer's best interests, but what do I know.

Another unknown is the fate of the High Deductible Plan F. The govt has made no determination on whether it will also be excluded from new sales starting in 2020. I've seen speculation both ways but nothing official yet.

I've already decided I'm not going on any high deductible plan once I'm eligible for Medicare. The reason - it really complicates things at the doctor's office. They're always asking "have you met your deductible?" or calling the insurer about it. With a very low deductible you can take care of that in one or two visits, and the rest of the year no more hassle.

Plan G will be fine. But I looked at pricing recently for TX (for future cost estimation/modeling purposes) and no one in my area was offering it.

 

[REWahoo]

I've already decided I'm not going on any high deductible plan once I'm eligible for Medicare. The reason - it really complicates things at the doctor's office. They're always asking "have you met your deductible?" or calling the insurer about it. With a very low deductible you can take care of that in one or two visits, and the rest of the year no more hassle.

Interesting. DW and I both have had HD Plan F for the past 3+ years and neither of us has ever been asked that question by any of the several doctors we've seen. And by my calculation we've saved almost [-]$8K[/-] $5K so far through lower premiums.

 

[MBSC]

Plan G will be fine. But I looked at pricing recently for TX (for future cost estimation/modeling purposes) and no one in my area was offering it.

The following are Plan G rates for age 65 female in McAllen, TX area.

TransAmerica Premier Life: $92.62
Individual Assurance Company (IAC Group): $93.96
State Mutual Insurance Company: $94.42
Sentinel Security Life: $95.57
Equitable: $95.75

As for why more companies are not yet offering Plan G, why sell plans at these rates when you can sell the regular 'F' at $125+ for a few more years.

 

[audreyh1]

The following are Plan G rates for age 65 female in McAllen, TX area.

TransAmerica Premier Life: $92.62
Individual Assurance Company (IAC Group): $93.96
State Mutual Insurance Company: $94.42
Sentinel Security Life: $95.57
Equitable: $95.75

As for why more companies are not yet offering Plan G, why sell plans at these rates when you can sell the regular 'F' at $125+ for a few more years.

I guess the quote I ran didn't show those. The "big" insurance companies like Humana weren't offering it. I also noticed that BCBS offers plan G in TX, but not here?

 

[audreyh1]

Interesting. DW and I both have had HD Plan F for the past 3+ years and neither of us has ever been asked that question by any of the several doctors we've seen. And by my calculation we've saved almost [-]$8K[/-] $5K so far through lower premiums.

It's a real hassle with regular insurance. Maybe they don't bother with Medicare? There is often a discrepancy, usually minor, between what the insurance allows them to charge me and what they actually do. It would be easier to reconcile after the fact, but most of them want it up front of course.

 

[MichaelB]

Interesting. DW and I both have had HD Plan F for the past 3+ years and neither of us has ever been asked that question by any of the several doctors we've seen. And by my calculation we've saved almost [-]$8K[/-] $5K so far through lower premiums.

I like that option, and would take, except it's not offered by any insurer in my zip code. The closest we can get is Plan G, which I'll sign DW up for when she becomes eligible later this year.

 

[REWahoo]

It's a real hassle with regular insurance. Maybe they don't bother with Medicare? There is often a discrepancy, usually minor, between what the insurance allows them to charge me and what they actually do. It would be easier to reconcile after the fact, but most of them want it up front of course.

I think you are correct that Medicare is a bit different.

We pay nothing up front. The medical providers run all charges through both Medicare and our BCBS medigap plan. We then get a bill from the medical provider showing what Medicare allowed, what was paid by Medicare and BCBS, followed within a few weeks by an EOB from Medicare. Only once over the past three years have the provider's bill and the EOB not both agreed to the penny, and in that case the Medicare Explanation of Benefits specified we did not owe one of the items we were billed for and instructed us not to pay it.

Pretty simple and straightforward, even with the deductible(s).