Surprise medical bills

One of the premises of Obamacare was that if patients were expected to pay more towards their health care—have more “skin in the game”—they would shop around for the best prices and spend less.

If only.

I posted about how difficult, if not impossible, it is for patients to shop for health care. Prices are not as transparent as some policy makers would like to think.

Related post: Researching health care costs

A recent article in Kaiser Health News confirms this:

Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them into smart shoppers. So he shopped.

He called around for price quotes on the CT scan his doctor ordered. After all, his plan’s $2,000 deductible meant paying the full cost out of pocket. Using information from his insurer, he found a good deal — $473.53 at Coolidge Corner Imaging in Boston, a half hour from his house.

But the bill he got later was for $1,273.02 — more than twice as much — from a hospital he had no idea was connected to the imaging center.

“I was shocked,” said White, a doctor of physical therapy who thought he knew his way around the medical system. “If I get tripped up, the average consumer doesn’t have the slightest chance of effectively managing their health expenses.”

So even savvy patients can be left with surprise medical bills.

And with the ongoing trend to increase cost sharing through high deductibles, co-pays and narrow networks of providers, more patients will see these unexpectedly high medical bills despite how hard they try to be smart consumers.

Related post: Obamacare—America’s “Bitter Pill”

What else can patients do?

The Kaiser Health News article contained a link to a good online tool from Consumers Union, a division of Consumers Reports: 

Stand Up to Surprise Medical Bills

These days it’s not enough to have health insurance, pay your monthly premiums, and understand your co-pays and deductibles. Even the savviest consumers can get hit with surprise bills from out-of-network doctors.

Often your hospital is in-network, but after the fact you get the“surprise” – the anesthesiologist was out-of-network. But many people don’t know where to turn with complaints about these surprise bills. Use our new tool to find out where to complain in your state.

Consumers Union also offers an informational page about surprise medical bills, and an invitation to share your own surprise medical bill story.

I have many stories I could share! I’m a nurse and I’ve been navigating the system for many years. But all I know for sure about medical bills is that they will always be higher than I expect.


Frugal Nurse

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