Health Insurance for me and the kids

[PrincessFiona]

Isn't that the secret now, though? Those with more money will always be able to pay for access. That is already happening.

Those with more money will always have more of everything.

Zoe has a friend whose parents are a pharmacist and successful real estate agent. They live in a million dollar home, take their 5 kids on 2-week European vacations, have an I ground pool with fountains and hot tub and the best health care money can buy. What do we do? Insist on a national income that is the same for all professions? Declare that everyone gets low paying health insurance so that no one has more?


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[rufflesanddots]

A living wage that allows people to actually afford insurance would be a great place to start. Maybe non-prof hospital C-level compensation packages could also be overhauled so there was more $ for charity care programs. I can't solve this problem on a message board, but adequate health care for all will always be more important to me than a salary for DH that allows us to buy a ton of extra stuff. He feels the same. There is a middle ground , even if you are I haven't seen it yet.

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[MDPhDWife]

Well we gambled and lost. As I mentioned we went with the employer sponsored deductible plan because I was having a tough time finding a PCP on the HMO plans. Last night DD14 knocked on our door at midnight screaming and sobbing complaining of severe abdominal pain. DH examined her and her symptoms aligned with appendicitis. We decided to take her into the ER. The ER ended up admitting her. In the end it was determined that she has an ovarian cyst. Apparently since the employer sponsored plan is an old grandfathered non ACA plan, the $1500 deductible doesn't apply towards the $2K Max out of pocket. The admission office said we'll owe the full $3500 for just the 16 hour hospital stay alone. This means that the stay would have cost at least $11500. I have a hard time buying that. I'm waiting to see a detailed bill before paying anything. F*%k!!! I cannot believe the rotten string of bad luck we've had the last two months. It feels
like we're gonna be in debt forever. Attendinghood sucks major balls so far. 😖

[SoonerTexan]

Aw crap


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[TulipsAndSunscreen]

Wait it this your dhs hospital? They don't have coverage of care within his hospital? That's insane. Attendings at DHs hospital are 100% covered at their home institution.

[Deebs]

T&S - that's almost unheard of now. The federal government really clamped down on it, so only hospitals really committed to that kind of professional courtesy make it work (DH's is one of them, though and that's part of why we're here). I'd call and ask for a payment plan. Guessing the cost is so high because it was under observation, not inpatient.

[Windsurfer]

Insurance is the devil. Medicare for all. We need national health.

Makes me glad I live in Canada.

[MDPhDWife]

T&S - that's almost unheard of now. The federal government really clamped down on it, so only hospitals really committed to that kind of professional courtesy make it work (DH's is one of them, though and that's part of why we're here). I'd call and ask for a payment plan. Guessing the cost is so high because it was under observation, not inpatient.

Will a payment plan have interest? Are these things negotiable? Is there a strategy to paying the hospital vs. the other bills we'll get like labs and for the sonogram she had? This is all completely new territory for me since I've always had HMO's and EPO's.

[Deebs]

This is what you do ( anyone, especially those who have done billing, feel free to jump in)
- call everyone you get a bill from. Don't miss any
- tell them you simply can't afford the bill and ask if there's any room to negotiate it down
- even if they negotiate it down, ask to be put on a payment plan. We've never been charged interest (I paid for DD1's delivery over a two year timeframe, interest free)
- we've never been asked to show proof of income
- I have had every scenario from the bill being completely written off (in attending hood for an ER bill that was very unexpected and I really was just looking for a payment plan) to paying every cent, but over a long time.


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[TulipsAndSunscreen]

Another option if you have some cash on hand is to pay a big chunk upfront in exchange for forgiveness on the rest. This is typically approached by the "this is what I can afford to pay" conversation. Remember, if your insurance covered it, they wouldn't be paying the sticker price either. They negotiate rates waaaaay down so the price on the bill is never what is paid.

Bill for my first delivery: $27K
What my insurer paid: $11K
What I would have seen on a bill if I were cash pay: $27K

So make sure you are only paying for what the hospital would actually realize if you'd met your deductible and insurance was paying.

[MDPhDWife]

Another option if you have some cash on hand is to pay a big chunk upfront in exchange for forgiveness on the rest. This is typically approached by the "this is what I can afford to pay" conversation. Remember, if your insurance covered it, they wouldn't be paying the sticker price either. They negotiate rates waaaaay down so the price on the bill is never what is paid.

Bill for my first delivery: $27K
What my insurer paid: $11K
What I would have seen on a bill if I were cash pay: $27K

So make sure you are only paying for what the hospital would actually realize if you'd met your deductible and insurance was paying.

So you're saying that since my deductible wasn't met yet, I'm being charged non insured self pay rate? I thought the amount I paid to reach my deductible was the already discounted insurance rate. Is that not the case?

[TulipsAndSunscreen]

Not always the case. It pays to check.

[HouseofWool]

It should be the discounted rate.

And, yes, talk to the hospital.

In some cases, the facility is in network, but individual providers are not (think locums). Call to ensure that the services were at the in net rate.

This is a frequent issue if you have out of net benefits.

[MDPhDWife]

Should I expect to receive additional bills from the providers or are those included in the hospital bill?

[MDPhDWife]

This is what you do ( anyone, especially those who have done billing, feel free to jump in)
- call everyone you get a bill from. Don't miss any
- tell them you simply can't afford the bill and ask if there's any room to negotiate it down
- even if they negotiate it down, ask to be put on a payment plan. We've never been charged interest (I paid for DD1's delivery over a two year timeframe, interest free)
- we've never been asked to show proof of income
- I have had every scenario from the bill being completely written off (in attending hood for an ER bill that was very unexpected and I really was just looking for a payment plan) to paying every cent, but over a long time.


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Wow Deebs, how did you manage to get the bill completely written off?!