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re: Let Me Get This Straight

Posted on 6/14/23 at 8:32 pm to
Posted by Jim Rockford
Member since May 2011
98591 posts
Posted on 6/14/23 at 8:32 pm to
I'm really sorry this happened to your family. My point was this happens here too. And when the ambulance finally does show up they bill you $1500 for the ride.
Posted by mrcoon
Louisiana
Member since Jul 2019
537 posts
Posted on 6/15/23 at 7:19 am to
Just file for legal separation. Baby will be free to your wife. That is called the Allen Parish Special. The baby will get medicade and WIC. Work the system like the rest of em.

My wife was still in college for our first child so it was pretty much free. Our second hit our out of pocket max, $3,750. She also required a heart surgery that same year which was all covered. We had none of the perks the protected classed get though like meals and a place to stay. We payed out the wazoo to stay in NOLA for a couple weeks.
Posted by Hopeful Doc
Member since Sep 2010
15054 posts
Posted on 6/15/23 at 7:35 am to
quote:

pay $4,200 cash to have a child,



On top of your correct observation, let’s say you have a HDHP that covers your family. The max out of pocket per individual is up to $9,100/18,200 (individual/family). The max HSA contributions are $3850/7750. So if you had a kid go to the NICU, you’ll meet their max out of pocket in a few hours. It would take you 3 years of maxed out savings to have an adequate amount in your HSA because the contribution limits have significantly lagged behind the max out of pocket costs. And then it would take you another 3 years to be prepared for your next family disaster.
Posted by Hopeful Doc
Member since Sep 2010
15054 posts
Posted on 6/15/23 at 7:39 am to
quote:

I'm really sorry this happened to your family. My point was this happens here too. And when the ambulance finally does show up they bill you $1500 for the ride.



Maybe this isn’t the time to share the story of a patient of mine that smokes crack most days of the week and visits the ER by ambulance 1-3 times a week, all by ambulance, usually for complaints of a runny nose, toe pain, and other various non-emergencies. They usually go home after asking for a sandwich.

Fortunately, the patient has Medicaid, so we as a society pick up the chauffeur and catering bills.
Posted by The Torch
DFW The Dub
Member since Aug 2014
19527 posts
Posted on 6/15/23 at 7:52 am to
quote:

You need new insurance.


It's a large group company plan from BC/BS Texas

Company pays 2/3 and me 1/3 but it has a 5K ded and we had just rolled over the new year
Posted by Hopeful Doc
Member since Sep 2010
15054 posts
Posted on 6/15/23 at 7:59 am to
quote:

Medicaid dictate what they will pay hospitals. For example an ER visit pays the hospital around $80 per patient. That’s why it’s so expensive for people with insurance.



Their reimbursement to clinics is pretty low, too. I’ll get about half of what I get for most private insurance for Medicaid. And then they decide they just don’t cover some things. Example: there’s a code you use to bill when someone goes home from the hospital. Medicaid won’t pay it. They’ll pay for follow up care codes on the day of discharge (again at about half of what private insurance would pay ), but they won’t pay for discharge services.


It’s why you see so few clinics accept Medicaid or in such limited numbers.
Posted by AwgustaDawg
CSRA
Member since Jan 2023
7438 posts
Posted on 6/15/23 at 8:08 am to
quote:

Yep. We paid about that for our most recent (7 years ago). A family member from Maryland, same job (teacher), paid maybe $500. Ever person here who gets something "free" is paid for by those with insurance.




This is what is so infuriating about the whole socialized medicine issue...we already have it. No one who is willing to put in the effort in this country is going without medical care...it may be inconvenient if you don't have the money but it is available. All of those costs can only be recouped from PAYING customers. The providers and hospitals only source of revenue is paying customers...every expense must be recovered by billing and being paid by paying customers...revenues must meet and hopefully exceed expenses and there is only one source of revenue. Given that paying customers are already footing the bill why not simply let paying customers foot the bill and cut the lawyers and collections agencies out of the equation? When someone steals a pair of jeans at WalMart every customer who pays for jeans pays for the stolen pair...WalMart only has one source of revenue just like a doctor. Those of us who do pay are already paying...providers are going to treat, for the most part, because they are human, and society expects it...but for some reason we insist on also paying lawyers and paying for collection efforts because doing otherwise is a "slippery slope"...one that we slid to the bottom of many decades ago....
Posted by MyRockstarComplex
The airport
Member since Nov 2009
3442 posts
Posted on 6/15/23 at 8:12 am to
Brace yourself now for college tuition.
Posted by AwgustaDawg
CSRA
Member since Jan 2023
7438 posts
Posted on 6/15/23 at 8:14 am to
quote:

Get a detailed bill break down, and start sending snail mail letters complaining.

Memorial Hermann attempted to charge me $654.50 for one gram of IV acetaminophen (Tylenol) THREE YEARS after my daughter got tubes put in. The price for the same amount of the same drug was $35.05, and I offered to pay them $60. It took about 18 months, but I sent a letter about every 60-90 days, with copies of all the previous letters, and they wrote it off.

They also "reversed" a "managed care discount" of $238.29 six weeks after surgery, which they never explained, and I never paid.

All in all, it was a little over four years from initial payment at the date of service to them giving up on trying to collect after I repeatedly disputed.

There's gonna be stuff on your bill that can be questioned.


No doubt...and it all goes back to the paying customer paying a portion of the unpaying customers costs...along with the effort to collect and the effort you put forth to pay what was still over priced. Paying customers in every market cover the costs of goods and services provided to those who will not or can not pay...it doesn't matter if it is healthcare or a convenience store...there is only one source of revenue and it is paying customers. Providers are going to provide, for the most part, and as a society we demand it of them, mostly (let a hospital turn away a patient who proceeds to die and watch the outcry). Why we don't cut our losses and simply provide basic health care, which we are doing already, without also paying for the costs of collections and litigation, is beyond me....
Posted by KWL85
Member since Mar 2023
1229 posts
Posted on 6/15/23 at 8:24 am to
He has private insurance, so his max is way higher than $4200. Mine is 7k for individual, and 14k family.

Blame Obama if you want, but name a president that did a good job helping with health costs? The answer is none.
Posted by Lithium
Member since Dec 2004
62283 posts
Posted on 6/15/23 at 8:38 am to
Ask for a cash discount. seriously
Posted by LaLadyinTx
Cypress, TX
Member since Nov 2018
6123 posts
Posted on 6/15/23 at 9:10 am to
quote:


This is what is so infuriating about the whole socialized medicine issue...we already have it. No one who is willing to put in the effort in this country is going without medical care...it may be inconvenient if you don't have the money but it is available. All of those costs can only be recouped from PAYING customers. The providers and hospitals only source of revenue is paying customers...every expense must be recovered by billing and being paid by paying customers


Truth! I think if they did it as a tax like the Medicare tax, there would be more people paying in. Everybody pays that no matter how little they earn, if they get a W-2. We already have socialized medicine. It's just a broken and disjointed system paid for by the few.
Posted by SaintsTiger
1,000,000 Posts
Member since Oct 2014
1127 posts
Posted on 6/15/23 at 9:12 am to
Has there been a blood test to confirm paternity? If not, that could help you get out of the bill.
Posted by Topwater Trout
Red Stick
Member since Oct 2010
67601 posts
Posted on 6/15/23 at 9:24 am to
quote:

Hospital just called to tell us our bill to have our first child will be $4,200 out of pocket after insurance.


but you don't have to pay any over your yearly maximum out of pocket right?
Posted by AwgustaDawg
CSRA
Member since Jan 2023
7438 posts
Posted on 6/15/23 at 9:27 am to
quote:

Brace yourself now for college tuition.


Gonna be a fiasco. Loan forgiveness is one thing...the system was allowed to run amok and we ignored it, that is on us....the money is gone. Most of it is not going to be paid back but by dam we insist on going through the effort and paying a helluva price in the process all to try to collect a debt that is never going to be collected. I am all for paying for college for those who are college candidates who can't pay but it is an idiotic idea to ask the poor and middle class to pay for the education of kids from wealthy families.
Posted by AwgustaDawg
CSRA
Member since Jan 2023
7438 posts
Posted on 6/15/23 at 9:30 am to
quote:

Truth! I think if they did it as a tax like the Medicare tax, there would be more people paying in. Everybody pays that no matter how little they earn, if they get a W-2. We already have socialized medicine. It's just a broken and disjointed system paid for by the few.


You are absolutely correct. Neither side will say it...they either talking about "free" health care when everyone knows even lunch ain't free or the slippery slope of socialism...meanwhile every paying customer in a providers office today is paying some portion of an unpaying or underpaying customer...plus the collections efforts.
Posted by Screaming Viking
Member since Jul 2013
4528 posts
Posted on 6/15/23 at 11:15 am to
quote:

Small price to pay to bust in them guts baw.


spraying them tits sounds real good right about now.

i kid. kids are truly a blessing. and this big brother's way of checking your privilege.
Posted by Ten Bears
Florida
Member since Oct 2018
3353 posts
Posted on 6/15/23 at 11:40 am to
quote:

So I have private insurance, get hammered by federal tax income, work over 40 hours a week to provide for my family, and have to pay $4,200 cash to have a child, but someone with Medicaid pays $0 and has the government front the bill?



Think of all the uninsured that now have insurance. Think of all the women who couldn't afford birth control, but now they can. Think positively.

But seriously, as a business owner, it frustrates me to no end. I pay my people well, and I pay 80% of an employee's premium, but I often wonder how people afford these high deductibles and max OOP expenses.

In 2008, the Cadillac plan from United HC total premium for an employee + spouse & kids was $800.00/month. It carried a $500 deductible and a $1,000 OOP max. Being that United had the contract for most teachers in the country, the network of DRs was vast.

Now, that same Cadillac plan is 3,000/month, with a $5,000 deductible and a $8,500 max OOP. And the network sucks.

At some point, it is unsustainable.
Posted by Hateradedrink
Member since May 2023
1359 posts
Posted on 6/15/23 at 11:41 am to
Yeah but don’t vote for single payer, then you’d be paying for the poors!!!!!
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