Large emergency room bill

[lost*in*cyberspace]

This happened to me with Tricare too. Did you talk to one of their "collections specialists"? She was the one who finally got the hospital to drop it and the bill was pulled from collections. It was a real pain with biweekly calls first from the hospital billing office and then from the collections agency. When we got the letter from the collections agency I responded with a letter asking for proof that we owed the debt. A few weeks later we got a letter saying the hospital had withdrawn the bill from the agency.

Thanks for the suggestion. I've been dealing with medical insurance for over 30 years, and seems as if there is always a hassle dealing with billing issues. Everything has been documented and the collections action has been put on "hold." It will be resolved eventually; I just don't understand why so many people working in medical billing don't have a clue.

 

[lauradis]

Don't let a hospital take you under observation until you find out how much of that your insurance will cover.

Instead insist on a full admission.

(from Bottom Line Books)

This will not work for our insurance we still have a $4k dec., before they will pay one red cent. Unless its for woman care or physical.

 

[mj70148]

That's normal for ER. Set up a payment plan; usually they will be interest free for 2 years if you agree to a monthly payment.

Next time you have open enrollment, consider what will happen if you encounter another emergency, and maybe opt for a lower deductible (or lower OOP max - which is the ultimate thing to consider). My OOP max for oct 1-oct 1 was $5500. I met that in 3 months with ER visits, specialists, many many office visits. We wish we had upped the premium and had a better plan with a lower OOP max. Even if we never have this situation in the future, it's just better to be safe and choose a better plan up front and sacrifice the $ somewhere else in our lifestyle. Having to pay up to the OOP max is REALLY tough when you arent ready for it.

 

[queenbetsey]

a few years back I had to get back surgery. it was not optional and was told I would need a back brace to wear for a few months. they wanted me to call and order it so it could be delivered to the hospital. I ordered the brace and gave my insurance info. figured that was it. I was in a huge amount of pain and when the lady called back and said we have a problem I was shocked. she asked what I was having done and I told her. she asked if I was sure I wasn't having breast augmentation. I told her "uh no I am ordering a back brace for my back surgery" she said " I am so embarrassed to say this but your brace is not covered for that but is covered for breast augmentation....." all I could do was laugh albeit a crazy person laugh. but we had to pay for the 250.00 back brace for my back surgery. jeesh. I felt bad for the poor lady she was shocked but it wasn't her fault. and also told her it was ok to laugh at this one it was a whole lot of stupid

 

[Mary2e]

Don't most high deductible plans also come with a matching flexible health care spending account that you make tax-free deposits to cover the high deductible each year as well as your portion of the medical expense that isn't covered?

Too many people take out those plans because they cost less yet never put nearly enough into the savings plan for the uncovered costs.

 

[lanejudy]

We have a high deductible insurance plan, so I was expecting a large bill, but I was still a bit surprised when I got a bill in the mail today for $1866 for "Emergency Services". Insurance paid $258 of that, leaving me with $1608 (which is kind of odd too because my insurance is supposed to cover 20%, but what they paid is actually just under 14%. I'll call the insurance company too to figure out what's up there).

OP -- you'll get the best information about the amounts by talking to your insurance company. They should provide you with an Explanation of Benefits (EOB) which details the original charge, any discounted amount to be written-off, how much of your deductible is applied, any co-insurance and the amount the insurance company pays. The hospital may have some of this detail but not necessarily all. The amount doesn't really sound unusual in today's medical environment, especially with a high deductible plan. You likely had not fully satisfied your deductible prior to this claim -- so of the $1608 owed by you, part is deductible then the 20% co-insurance only applies to the amount due after your deductible is satisfied. That's why it seems to be 14% covered.

If it's more than you can pay at once, as others suggested, call the hospital billing department and request a payment plan. I've found them to be very reasonable when I've needed to do just that.

Good luck!

 

[Arielle22]

Don't most high deductible plans also come with a matching flexible health care spending account that you make tax-free deposits to cover the high deductible each year as well as your portion of the medical expense that isn't covered?

Too many people take out those plans because they cost less yet never put nearly enough into the savings plan for the uncovered costs.

Not all companies off flexible spending accounts. Due to the laws relating to those accounts, the money is available prior to the employee funding it. So for a company with high turnover, you could be left paying out thousands for employees who used it then left.

 

[Mary2e]

That doesn't make sense. The employee entirely funds the FSA with their own money. I have heard of some companies matching or even giving some money each year, and that may be what you're talking about.

I think of these accounts like IRAs for medical benefits only.

But the real point of my post is that people should be funding these accounts at least for the amount of the deductible each year.

 

[kymom99]

I don't fund that much because my son and I never reach our deductible. And we only roll over $500.

And what the PP is saying is true. I had access to my full amount elected before I paid a cent. If someone quit their job, they could conceivably have used up all their money before they contributed the full amount to the account. Mine is front loaded.

 

[Mary2e]

But that money rolls over, it never expires. This account is different than the flexible spending account that is capped and covers other expenses. I'm talking about the high deductible plans that have a completely different spending account that can accummulate over your lifetime to cover medical expenses and the larger deductibles. Those of use with regular medical plans (PPOs & HMOs, etc) cannot open one of those accounts but can open a flexible spending account - this is the account that is use every year or lose.

 

[JanaDee]

I don't fund that much because my son and I never reach our deductible. And we only roll over $500.

And what the PP is saying is true. I had access to my full amount elected before I paid a cent. If someone quit their job, they could conceivably have used up all their money before they contributed the full amount to the account. Mine is front loaded.

You are talking about a flex spending account, which is different. A health savings account (HSA) is typically funded 100% by the employee. It is like a regular savings account, but you use it for medical expenses.

 

[saraschoening]

OK, so it's been a long time since I've posted here and this really isn't Disney related, but it is budget related and I know that you guys are all super smart, so I'm hoping someone can give m some advice

A bit more than a month ago I was installing a new water heater at home and I managed to cut my thumb pretty badly with a box cutter as I was attempting to strip a wire. I went to the emergency room and wound up with 5 stitches and a tetanus shot. I would have gone to urgent care if I had the option, but unfortunately it happened at about 6:30PM on a Sunday night and the ER was the only place that was open.

We have a high deductible insurance plan, so I was expecting a large bill, but I was still a bit surprised when I got a bill in the mail today for $1866 for "Emergency Services". Insurance paid $258 of that, leaving me with $1608 (which is kind of odd too because my insurance is supposed to cover 20%, but what they paid is actually just under 14%. I'll call the insurance company too to figure out what's up there). Unfortunately the bill isn't itemized at all, but to me it certainly seems outrageously high for maybe 20 or 30 minutes of a doctor's time to stitch my thumb and 5 minutes for a nurse to give me a tetanus shot. I'll try to request an itemized bill so that at least I can see how they came up with that number.

I suppose the good news is that I've seen news reports of people getting stuck owing hundreds of thousands or millions of dollars to hospitals, so we're certainly better off than we could be. However, I've also seen reports of people being able to negotiate outrageous hospital bills too and I certainly don't want to pay any more than I need to.

So, all that said, do you guys think that $1866 is reasonable for 5 stitches and a tetanus shot? Do I have any options to try to negotiate this bill down? If so, where do I start?

Thanks much,
Brett

Hi Brett.. I am sorry to hear about your accident!! Thats awful! But I am also glad that you are going to be ok. I personally think that having to pay anything is ridiculous but then again I am Canadian. I have had to take my daughter to the ER 4 times this year (severe ear infections) not only do we have great doctors here (in and out of the emerg in 40 mins) but I didn't get a bill. So I really feel for you. In my experience everything is negotiable. I would start with your insurance company, then move on to the hospital and ask them to itemize everything. After all that I would contact AR at the hospital and let them know what you can pay that day. It NEVER hurts to ask.. the only thing that they can say is no and then your in the situation that you are in now.. no difference right?

 

[Mary2e]

Yikes... when I was responding I called the 2 different types of accounts by the same name. My apologies. JanaDee got it correct - I was talking about the Health Savings Account that is available only to those with high deductible plans. I went totally blank on the name. A flexible spending account is available to everyone and this is the account that can be emptied before it's actually funded and may cost the employer money.

 

[kymom99]

You are talking about a flex spending account, which is different. A health savings account (HSA) is typically funded 100% by the employee. It is like a regular savings account, but you use it for medical expenses.

I have both. The HSA is $500 per year. It rolls over if I don't use it, but I always use it. With the FSA, I put in the money but it will only roll over $500. Someone was saying people should put in enough to cover the deductible, but if I did that I would lose the money. I can't add to my HSA.

 

[JanaDee]

I have both. The HSA is $500 per year. It rolls over if I don't use it, but I always use it. With the FSA, I put in the money but it will only roll over $500. Someone was saying people should put in enough to cover the deductible, but if I did that I would lose the money. I can't add to my HSA.

We add to our HSA every single pay period.

 

[kymom99]

We add to our HSA every single pay period.

Every plan is different. If we want to put money aside it is through a FSA, not the HSA. That is why I have both, but they are managed by the same company. Wageworks.

 

[Mary2e]

You can only have an HSA if you have a high deductible plan. I check into it every year since I have a regular PPO. I use the FSA to fund my deductible and other non-reimbusible expenses, such as the copays and eye glass costs.

The amount you put into an HSA is entirely up to you. For an FSA there is an annual limit.

JanaDee, you should look into that $500 limit - I suspect you can put more in if you would like to. The entire point of an HSA to to accummulate a tidy sum of money for future medial expenses when they arise. The FSA is only to cover current year expenses.

 

[JanaDee]

You can only have an HSA if you have a high deductible plan. I check into it every year since I have a regular PPO. I use the FSA to fund my deductible and other non-reimbusible expenses, such as the copays and eye glass costs.

The amount you put into an HSA is entirely up to you. For an FSA there is an annual limit.

JanaDee, you should look into that $500 limit - I suspect you can put more in if you would like to. The entire point of an HSA to to accummulate a tidy sum of money for future medial expenses when they arise. The FSA is only to cover current year expenses.

We put way more than $500 a year in our HSA. That's how much we put in over approx 2 months. I think you have me confused with the other poster.

 

[Mary2e]

I do... I'm having brain freeze today, and unfortunately, it's not associated with ice cream

 

[crispychicky]

You can only have an HSA if you have a high deductible plan. I check into it every year since I have a regular PPO. I use the FSA to fund my deductible and other non-reimbusible expenses, such as the copays and eye glass costs.

The amount you put into an HSA is entirely up to you. For an FSA there is an annual limit.

JanaDee, you should look into that $500 limit - I suspect you can put more in if you would like to. The entire point of an HSA to to accummulate a tidy sum of money for future medial expenses when they arise. The FSA is only to cover current year expenses.

There actually are annual IRS limits for HSAs. For 2015, it's $3350 for an individual and $6650 for a family (if you're over 55 you can contribute an extra $1000). http://www.irs.gov/pub/irs-drop/rp-14-30.pdf Any seed money an employer contributes towards your HSA counts towards the IRS max.

To the PP who can "only" put $500 in their HSA each year, you really, REALLY need to look at your plan details. That doesn't sound correct at all. No insurance company is going to limit you from investing your money with them in an HSA. It just doesn't make any sense.