Is it any wonder the uninsured do not go to doctors?

[Mothernature]

Originally Posted by foggierbard9 I know that our insurance company emails us to notify of a new claim. We can then get out the website and view all the claim summaries as they are paid by them. Then they also send us an indepth claim report every quarter. If we didn't get them through email/on the website then I wouldn't have any clue as to what is being charged/paid.

Thank you for the information. I went to the website and registered for access. The insurance company has to mail a pin number. The site did state that access to features is determined by which plan the insurer is covered.

Originally Posted by XUfan ...I have arthritis, bursitis and sciatica, but have not been to see a doctor in over 4 years. We just can't afford it. The office visit isn't the problem. It's the tests and meds that we can't afford. My husband sees our doctor twice a year...which is what he requires in order to write a prescription for high blood pressure meds. Kroger and Target carry both of his prescriptions for $4. Also, my husband is finally working again and after he was on the job for 90 days, was offered health insurance. For the basic coverage for the 3 of us, the cost was 1/3 of his take-home pay. We are still uninsured. Who can afford that????

Do you have a pharmacy that offers the 90 day prescription for $9.99 plan? I know CVS offers this. You have to pay $10/year for the plan. We save quite a bit more than the $10 so it makes sense. Check CVS's Formulary (if in your area). Remember, prescriptions must be written for 90 days increments.

I went three years without health insurance. It was scary. I would avoid things like ice skating. I secured new employment at the time. For a healthy 20 something female sans maternity, the monthly cost was $250. My previous employer paid half.

Incidentally two months after securing the insurance plan, I slipped down a flight of stairs and my left knee took the blunt force at the Century Theater in Chicago. I limped to the stairs near the concession stand. I went into shock. Every employee ignored me. Their insurance company only agreed to pay the difference of my insurance or half of the bills had I no insurance. I really hated those days.

[Liz]

Originally Posted by Mothernature No wonder the uninsured end up so sick! With the 1 out of 4 in poverty and swine flu abound, this is a disaster waiting to happen.

Really bad statistic and not even close. Here's an article for you America's Most Impoverished Cities - Forbes.com , but we're really looking at roughly 1 in 10 to 1 in 8.

[cbms]

Tell me about it! The breakdown for my daughter's cardiology visits are like this:

158 for OFFICE CALLS OFFICE/OUTPATIENT VISIT, EST
121 for EKG
549 for X-RAY DOPPLER COLOR FLOW ADD-ON
1162 for X-RAY ECHO TRANSTHORACIC
422 for X-RAY DOPPLER ECHO EXAM, HEART


Even after the breaks for participating in the insurance group, the total the insurance paid was 1047.00. The discounts they offer for uninsured are 50%, so it would be more than 1,000 dollars! And we make this visit 3-4 times a year! eeeeeeep! This doesn't include the annual lung perfusion scan (nuclear medicine is NOT cheap), annual cardiac catheterization, and regular visits.

*edited because I missed the regular office visit part*

[Mothernature]

Originally Posted by Liz Really bad statistic and not even close. Here's an article for you America's Most Impoverished Cities - Forbes.com , but we're really looking at roughly 1 in 10 to 1 in 8.

I stand corrected. I thought it was 1:4, it is 1:6.

[Mothernature]

I've received the pin for my online health insurance account. These totals do not include my out of pocket co-pays nor pharmacy claims. These amounts cover the calendar year 2009 thus far.

Total billed to insurance: $12719.52

Total insurance allowed: $5115.36

Secondary insurance paid : $1667.37

The difference between what the providers billed v what insurance allowed is ~60%.

I can not fathom paying a 60% difference due to lack of insurance.

In reviewing these claims, I've noticed a few providers tried to charge for items (like lab handling) that insurance claims are no longer a justified universal charge. I feel for the people who are socked for charges like these.

[tdgirl]

I once had a doctor charge $600 for coming into the room and having a 3 minute conversation with me about why I was there. She did NOTHING else, just asked why I was there and left the room. Total bill for me was over $3000 for sitting in a room for a few hours. Think of the vacation I could have taken for that....

[erica007jr]

I do work in the healthcare field and see this everyday. However, do you realize that for every one person who is treated with insurance, there are several more behind him/her that are treated and have medicaid or uninsured? The insured folk/insurance companies are charged the outrageous prices to make up for the loss of revenue that the hospital/dr office loses on uninsured (who many times can't pay and the bill is written off) or public aid. I work for a non-for-profit hospital that has a program for those that are unable to pay...most is written off)

Say, for example, we are both charged $1000 for an MRI. I have public aid who pays $50 for this MRI. You have insurance that pays the entire bill. Eventually the price of an MRI is going to go WAY up to make up the part that public aid and uninsured can't pay (and yet public aid will continue to only pay $50.)

The reimbursement rate for medicaid in my area in pennies on the dollar. Where do you think those dollars are going to be made up? Answer: the insured! While public aid has its appropriate uses...I can say from experience that it is widely abused in the healthcare system and we all pay the price! I, by the way, pay >40% of my paycheck for insurance for my family....I know the cost!

[MamaBird06]

i went without insurance from 2006-2008, because we couldn't afford it from dh's work. dh had to pay 150$ for himself and it would have been an additional 400$ for me and 350$ for ds. Ds was covered on medicaid until 7/07, then i got him an individual plan for 100$ a month, he's been on about 3 plans so far, i've switched him b/c the first plan didn't pay office visits, then the next one there was a billing error and his plan somehow got cancelled and now he is on his current plan which is the best we've found so far, he get 6 visits a year for a 30$ copay and anything else comes out of the deductible of 4500$. I took him to the doctor a couple times so far on the plan so far and it's pretty reasonable. In 9/08 dh switched jobs so in april i got on his healthplan at the new job as it is only 350$/month for the two of us. Then dh was in a wreck and we were struggling financially and put off going to the obgyn, it's been 3 years since i've been, i'm not too worried, but a part of me has this nagging feeling inside but not having a pap this long makes me think of my own mom, she went many many years w/o an exam, probably 7 or so, until she finally landed a job with insurance. She knew she was sick, but couldn't afford to go to the doctor. She got the highest amount of life insurance the company offered w/o having a physical, and once her insurance kicked in, she went to the doctor to find out she had cervical cancer. She went threw treatment and thought everything was fine until months later she was having heartburn problems of all things, she practically forced the oncologist to open her up and when he did, he found the cancer had spread to her intestines, she had to have a colostemy. She ended up dying 7 months later. Had she had insurance 7 or so years earlier, they could have caught her cancer before it developed into something life threatening. My mom died from one of the most preventable cancers around. So couple months ago when we were better financially, i took on the task of getting a pap appt. Most the obgyns weren't accepting new patients or i couldn't get in until the new year. I finally got an appt. for the middle of november in the mean time, i got pregnant and had a misscarriage. i called the office where i had an appt scheduled and they wanted to see me, so i went in for blood tests and then the next week i talked to the nurse and she said they wanted to test my blood again to make sure my levels were going back to normal. Well 2 weeks later and still no call from the office. I mean, if they are going to get me in there and waste money on tests, shouldn't they at least have the decency to give me the results? I always feel like if there is a problem, they always find some excuse to have you come in again to make $$.

A side note about the ambulances, my grandma's find was having pains, not sure what kind, but anyway, my grandma drove her find to the hospital and when they got there, the nurse or someone yelled at my grandma for driving her friend to the hospital and said she should have called 911 and had an ambulance come. Um, why? Ambulances cost tons of money and in this case taxpayers(friend is on medicare), so if she had another way to the hospital, what is wrong with that?

[M_Lexx]

My one visit to the ER last year cost me $3,500. I went there myself, saw a triage, an MRI tech and a janitor, got charged for an ambulance ride (took a cab), three doctors (never saw one, so those names in the bill were a surprise to me), $100 for taking temperature and blood pressure (never happened), $75 for a toothbrush (did not see one at all) and, the crowning jewel, they billed me for suturing up 10-inch laceration, the problem was that the laceration was on my chin and I really would like to see a person with an 10-inch chin. When I called the billing companies I got bills from I got 'You are uninsured and should expect to pay for those who do not pay'. Well, when they applied MY payment installments to someone else's account, they actually blamed me for it, 'you probably bought these money orders at some dark alley' and slammed a past due on my butt. Sloppy sutures, an allergic reaction to antibiotics ('you have to take them, so what your throat is closing up fast, it is a course and should be taken in full' - $50 charge for a phone 'consultation'), and an untreated fracture in the jaw, all this fun for mere $3,500. I hope they (whoever they are) will get an awesome case of diarrhea and get charged $10,000 for one roll of single-ply toilet paper.

[erica007jr]

M_Lexx,

If I were you, I'd be contacting the "patient relations" dept from the hospital immediately! Request an itemized bill from the hospital. Go over it in detail with your representitive from the hospital. You should be able to get this resolved!

I once got bumped around by my PCP (primary care physician) all day, was told that "prompt care" couldn't see me, and ended up in the ER for a minor infection. After contacting patient relations and explaining the situation, my ER copay was reduced to an office visit co-pay.

Do document "who, what, when, why, and where" when you talk to anyone relating to an invoice though. The more "proof" you have, the better. Good luck!