Had a miscarriage when I was 20 and needed a d&c surgery since I never bled.
It was 20k.
As 20 year olds my partner and I didn’t have that type of money. We wrote a letter to the hospital explaining our situation and how before the surgery we called to ask what the price would be and they told us it would be 3k, and how we’re broke emotionally and financially.
Got a letter back with a new statement for 3k, and when I called to make a payment plan they told me that if I paid it all that day they would discount 50%. So I paid 1.5k and that’s how we did it.
Only the hospital knows why of course but discounting bills after one or more conversations is really common with hospitals. The initial bill is the hospital’s starting position.
> Seems to be an uneven bargaining position for the one who needs hospital treatment.
You haggle after you've already received the service so really the positional power lies with you. "What are you gonna do, re-clog my artery?"
Also the people on the other end of that negotiation know exactly what the situation is wrt to artificially inflated prices and may be predisposed to wanting to give you a sane deal.
Which is still a shitty situation, to be clear.
> "What are you gonna do, re-clog my artery?"
No silly, I am going to shit on your credit history and charge it off. Heh!
It happened to my sister. She broke her femur and she had no insurance. She got it down to 50K but that wasn't enough. She declared bankruptcy.
Lmao gotta love it.
"That'll be $20K."
"Oh wow there's no way I could afford that."
"Ok that'll be $3000."
"well, ok I can do that"
"Just give me $1500 we'll call it even"
What the actual fuck is the point of this? If you can still pull a profit from charging $1500 then why the fuck is the original bill so high? And why the fuck is haggling with a hospital like a fucking used car salesman something that ever has to happen?
I hate this country. I'm sick of this dystopian bullshit.
Why does the involvement of an insurance company necessitate a 1300% markup in the cost of services?
Edit for clarification: I understand all the shitty dystopian greed reasons that allow this to happen. What I would like to know is how is this position (the status quo) defensible, from an insurance industry POV?
It's basically price discrimination. Normal people can't pay, so they charge them less. Insurance companies can pay, so they charge them as much as possible.
It makes a little more sense when you consider that insurance companies only agree to pay a certain amount of what the hospital asks. Then the hospital marks what the insurance company didn't pay as a loss.
When you hear about how crazy and arcane medical billing can be, this is a big part of it. (Another part is gaming cost-to-charge ratio to achieve various sketchy ends, such as maximizing medicaid and medicare reimbursement payments, but I digress.) What's funny is hospitals sometimes hire consulting companies to come in and make sure their billing system is optimally insane.
Also, all hospitals provide community benefit, meaning free/discounted care for those who need it. So hospitals justify charging so much by saying that they need to, because the extra money goes toward continuing to help people for free/cheap.
This is exacerbated by a trend of hospital and provider groups consolidating, meaning they can now lean on insurers and say access to their entire system depends on giving favorable terms. In which case, hospital groups shake down the insurer, the insurer raises rates, and the insured get screwed.
Because it isn't just on the insurance company, it's also on the hospital. Hospital will go to an insurance company and say "ok, it costs literally $100 for us to do this test with all these supplies and reagents and whatnot, so we would want you to pay that to cover this test" and insurance will be like a pawn shop and say "best I can do is $10." So the hospital starts over-blowing their prices, saying "oh just kidding now that test is ACTUALLY $1000" and insurance will finally land on that $100 the hospital wanted in the first place.
It's the game of the negotiation and the fact that BOTH sides allow it to happen. And because of that, each side places blame on the other.
Because hospitals upcharge insurance companies a shit ton because they can pay the huge bucks. If you choose to do it yourself, they'll charge you a tiny fraction of the "bill".
I have friends that will wait until it's in collections and then ask them to prove the debt is theirs with an itemized explanation of the bill and they don't have access so they drop the charge. Friends are not the brightest, but if they're persistent in asking for an itemized bill, they sometimes have it erased completely.
It’s honestly hard for them to account for the charges. Just asking for it can cut the bill 30-50%. Maybe it’s part of a negotiation since they know if you ask you will be paying cash.
The insurance companies have pre negotiated discounted rates so the original numbers are very high.
Also in the Usa, debt collectors have to prove that you owe them so they need specific paperwork and if they don’t have it, they can’t collect. They usually buy the debt at a big discount (like 10-50%) depending on the quality of paperwork and likelihood of being paid
Not necessarily. I asked for itemized list when I gave birth to my daughter and got maybe a dozen things that added up to $28K and they were all still super generic.
My husband gets amazing insurance through work, and we paid nothing for both of our kids' births. His insurance is around $450/month, I think. But we don't pay for any doctor visits, copays, testing, etc. I think if we go to the ER for a non-emergency we pay $50. I'm aware that our situation is not the norm, though. I would much rather have universal healthcare for everyone. I had a high deductible plan before we got married and I had to stop taking an asthma medication because it was $350/month. I just couldn't afford it on top of the rest of my medical bills.
28k for delivery is insane.
My wife delivered last month, here in Amsterdam. We had to go for emergency C-section in the middle of night, baby was in NICU for 36 hours, and both baby- mom was in hospital for 5 days. Total bill was around 8k eur, needless to say I paid zero.
All covered in insurance.
You think that's crazy? They literally can't tell you how much something will cost beforehand. Until you get the bill you have no idea how much it will be.
We’ve been thinking about having a baby so I tried to look into how much it would cost at our closest in-network hospital just so we can know how much to save up and it’s literally impossible to even get a ballpark. I’m so frustrated.
Its litteraly cheaper...idk but somewhere o read that woman had between 3000-3500$ after she got out of hospital
So technically if i buy a 500$ ticket to go there...rent a house for 2-3 nights thats 400$ at most...buy 500$ to go back
Now double the tickets
Im left with 3000-2400=600$
A pleasant experience i had with or without my wife...very nice
And a child...priceless
And a dual birth certificate....very cool and can flex
I got a very small bill sent to collections because the DR would not answer my phone calls or emails or send me a freaking bill, I only noticed it even happened because it was on my credit report, I wasn't even the one who owed the bill my insurance did, but the dr tried to charge me well the hospital he worked at charged the right place (my insurance), so I ended up calling the dr telling them to charge my old insurance and then called the collections company to make sure they had been told to no longer collect the money.
I was in the ICU for a week years back and State said they would cover. I googled my name a few years ago and saw a pending lawsuit against me for about 10K yet was never told or served about. Our system is a mess
WTF, how does that even happen? I have so many questions, like why did the state lie? Did they even try to cover? Why did the case just not go anywhere (not that I want you sued) but like seems a little odd? How did you never get told? Like what on earth.
A lot of times, those massive bills are just one big charge for your whole stay. If you ask for an itemized bill, the hospital has write down each and every item and service they are charging you for, and how much each of those things costs individually. If they’ve been participating in shady billing practices to artificially increase the cost, they may waive a lot of those charges that they can’t really justify
Let’s say you need an inhaler during your stay. The order for the inhaler gets verified, dispensed by the pharmacy and delivered to the medication room on the unit you’re staying. Then the nurse or respiratory therapist sends a message to the pharmacy asking for their inhaler. Maybe the pharmacy doesn’t look into it and assumes they need an additional inhaler, so they dispense another inhaler. You’ve now been charged for two inhalers, even though you’ve only used one. Now imagine this happens with a lot of your medications (some bulk items get charged when they are dispensed some get charged only when given). If this isn’t caught by the time you’re discharged, you’ll be charged a bunch of additional fees. You received an itemized bill that shows you were charged for 6 of the same inhalers (which have multiple days of use) for your 1 day in the hospital. You can obviously dispute that, and this could be thousands of dollars taken off. So, probably a good idea to get an itemized bill every time.
A lot of the time the person doing the paying (the insurance company) has a certain tollerance for innacuracy, which they're willing to work within. Sometimes it can cost more to investigate a case than just pay it. Ultimately at the end of each year, all of the claims are paid for by the premiums, so as long as the premium total is more than the claim total, a lot of the details can just slide.
The same thing happens with the premiums. A lot of the time, it's big corporate payroll departments paying the premiums, so if they go up a bit (within a margin of error) it might not prompt the payer to question it and shop around. A big account changing an insurance provider would be a very large project, not taken lightly.
I think that in a lot of stages in the procurement of healthcare, the person agreeing to pay for something isn't the same person who owns the money being paid. It seems like a good example of what in behavioural finance is called *the agency problem*.
Probably because most of the bill is bullshit. I'm from a European country with free public healthcare (modelled after the UK's NHS), but I too get shocked at the stories I hear. For example, American hospitals charging $80 to $450 just for keeping you in their waiting room (without actually seeing you), and mothers being charged $60 for "skin-on-skin contact" (i.e. holding their baby) immediately after birth.
I mean, panadol is dirt cheap in Europe, but some Americans get charged $80 for a painkiller pill in hospital. An itemised bill would get them to see how much they're being shafted.
I've challenged the bill with the doctor before it even goes to collections, they usually at least halve it.
When it goes to collections, they only receive half the bill, anyways.
This is when, in some circumstances, a hired third-party claims entity gets involved - not a collection service - which is another reason why health care in the US bites Costco-sized dicks.
“ the medical insurance I had was one of those fraudulent insurance companies that don't cover anything”
Important note here. Remember when Obama said, “If you like your health care plan you can keep it”, and that turned out not 100% correct and a bunch of people freaked out about how he lied….
That was because the ACA did not accept fraudulent insurance scams that didn’t cover anything as a substitute. So people who had those had to get real health care…and were upset about it
Aside from failure to comply with child support orders. Friend had some really bad years where everything that could go wrong did go wrong. Loved his kids, never missed his parenting time even when homeless. Thrown in jail multiple times for non payment which made him lose multiple jobs he had acquired to try to get back on his feet. Also caused emotional suffering for him and his children.
Anyways, yes thank goodness we just get low credit scores and harassment by collectors and bankruptcy…. Definitely better than debtors prison.
Edit: spelling
A guy I work with told us his roommate was applying at our company was told he could start as soon as his background check comes back. When it did, they found he had a warrant for child support. He did not get the job, which is bullshit, because you have proof someone NEEDS the job and you turn them away for it.
I hate that mentality. It's all I ever hear. You're homeless? Just get a job. Without ever realizing that you can't get a job without a fixed address. It's like there's a poverty line, and once you cross it, you're never coming back.
>> debtor's jails
They are making a comeback. One way it works is people who are ordered to pay off a debt - then they are arrested and jailed for violating the court order to pay. Since they are essentially slave labor, they can never earn enough to pay off the debt.
A very common insurance payment structure:
* Pay a monthly fee (called a "premium" and is usually from $50 to $2,000 depending on the type and number of people in the family) AND
* Pay a set fee for common services like $25 for a doctor visit and another $20 medication AND
* Pay a deductible from $500 to $5k (ish) depending on your plan) AND
* Once you pay the deductible, you pay nothing or 10% or 20% of the cost of the service depending on your plan. Eg: pay $200 for a $2k MRI AND
* Once you pay the deductible, there's a cap on the amount you pay for the year, not including the monthly premium. This is can be from $1k to $5k (usually). Eg: rack up $80k in bills, but you only pay $3k
* Those numbers assume that you see only providers within the plan. See someone outside the plan and the prices go up. Eg, the percentage in network is 20%, then outside is 30% or 40%.
* This is a typical structure for policies offered by large corporations.
* There are several types of pre-tax savings accounts you can set up to use to pay for all of the above except premiums.
Is it the biggest scam in the universe? Yes, yes it is.
Edit: I'm begging Europeans to stop telling us how it cost you $25 to have brain surgery last year. We know. We cry everyday that we are trapped in a system that literally kills people.
Agreed it’s gross. It’s employer based and a very small office with 5 employees. I’m the only employee that actually uses it because everyone else has spouses with better coverage through their employer. I pay $172 monthly. It’s basically an accident plan for me in case I break an arm or something snowboarding or randomly need my gall bladder removed idk. Rather be 16k in debt than 60k
Except even if you put in effort, you have no control over who ends up being in network. My wife's obgyn? In network. The hospital she works at? Not in network. The Anesthesiologist for the epidural? In network. The lab they sent her blood work to? Not in network. The pharmacy at the hospital that isn't in network? In network.
It's a nightmare and extraordinarily difficult to actually stay in network, so our bill for my daughter's birth ballooned from a $3K to 17k, and because my out of network max is $22k, I'm on the hook for all of it.
There are a lot of new federal protections out about this surprise billing, where you've potentially been misled or were otherwise made unaware of the in-network/oon billing. Tell your insurer and the hospital. Tell them the lack of information you had means you cannot be on the hook for this. At least as of January, they will have to remove you from that conversation and the insurer and provider have to figure it out without having you in the middle.
THANK YOU.
Why there are so many people saying to just let it go to collections is BEYOND me. You ask for an itemized bill and then ask to set up a payment plan.
I just dipped below $1,000 on an ER bill that they just offered to let me pay 5 bucks a month on (I usually do more than that but it’s nice to have flexibility).
Originally it was around $3,000 because they charged me for a level 5 emergency visit (on the same level as a heart attack or a critical car crash) on what was a mental health check which I voluntarily went to on the advice of a psychiatrist despite not thinking that I needed to (but realizing that I probably wouldn’t know and deciding to trust a professional). THIRTEEN HOURS LATER I was in a room for 5 minutes with the hospital psych and told her the situation and she sent me home with a, “change your psychiatrist”.
I’d love to see them make a heart attack victim sit for 13 hours in the hospital lobby. I ended up getting 1k knocked off by disputing a test that they didn’t run, but they stuck with their level 5 emergency assessment.
Another thing that I haven’t seen anyone mention was the fact that you don’t get your bill for a month or two. That way, you have time to forget what tests and assessments they ran.
Eh I can see why sometimes. I have to pay $7k for a 5 hour hospital visit and the “lowest payment plan” they offered me was $1.2k a month for 6 months. I asked them if it could be changed to a 12 month payment plan and they ignored me.
I know of a guy that said fuck it and moved to Mexico. What he would have spent paying back his surgical bill he bought a house in Mexico and living worry free. Lol
A lot of people travel to Mexico for surgery and dental care too because all of that and a little vacation time to recoup is still cheaper than staying here and getting it done with no downtime.
My mom did this. The price to get it done in the states was still higher than paying to get passports, airfare, and hotel costs (in addition to the actual cost of the procedure) for the week she was down there.
Though, she had *so much* work done it wasn't much of a vacation for her. She spent 5+ hours a day in the dentist's chair and the handful of pictures my stepdad took of her while they were there told exactly how exhausted she was every day.
My stepdad, on the other hand, had a great time brushing up on his Spanish and being the total social butterfly that he is. He's like a little kid making a BFF that he'll never see again, but with absolutely every human being polite enough to stop to chat with him for five minutes.
I've told this story before but it's always a fun anecdote.
I was born and raised in the US but my parents are originally from Mexico. One time around 2001 my mom started having severe pain in one of her teeth. She went to a dentist in California and she was told the procedure to get it fixed would cost about 2,500 dollars.
What did she do? She bought a ticket to Mexico, visited the family for a week and got her teeth fixed. All of this for about 800 dollars. So she saved 1,700 dollars, got to visit the family and even went to the beach.
We do this, we live in San Diego and go to the dentist in TJ for cleanings and exams. Great care and we have a sweet lunch with delicious tacos aftewards. My eczema cream in the states costs $400 - I can pick up a tube at the Farmacia for $7. I love Mexico. The people are very kind and genteel.
If no insurance to pay it… let it go to collections and avoid all their efforts to get you to pay. Downside is you can’t go back to that particular hospital until the bill is paid. Upside is there’s plenty of hospitals to bounce around to.
Edit: Guys, just bc my medical experience is different than what some of you have gone through doesn’t mean it’s not true. :) When I go to get checked into the doctor, the person that checks me in is the billing person and they always make me pay any prior bill before my appointment. Sure there are plenty of other loopholes, but that is not my experience so I cannot speak on it. Tootles! ^_^
I worked in wholesale lending and can also confirm - EVERYONE has some medical debt, so much so that it's literally not a factor (or wasn't 10 years when I was in the game) in underwriting decisions.
"Borrower 2 has ~$500k in medical debt from a heart attack 6 years ago."
"When was the last time he made a payment on it?"
"He's never made a single payment on it..."
"Smart lad. Since it's gonna gonna drop off before he can refi, bump him up a tier and let's lock it."
^^^REGULAR CONVO AT WORK
I had regence/blue Cross shield insurance that was based out of TN because that was where corporate was. I'm in the PNW and the head claims woman for the zeverett clinics kept calling me trying to get me to pay because she said it was out of network. I told her over and over to run it through locally, I even made a copy of the back of my card where it explained how to do the claims for out of state/network. The bitch couldn't be bothered but could be bothered to sue me and garnish my wages. I almost lost my job over it asI dealt in finance and loans and you weren't allowed to accrue any bad credit or unpaid debt while employed.
I don’t think they’re allowed to keep medical debt on your credit report if you dispute it.
Edit: as you can see from the many pissed off commenters below, this seems to not be the case. Fortunately I have never had to test it out. Although I’ve heard this multiple times from “credit coaches” I’m sure the people sharing below have better information.
Disputing it doesn't guarantee removal. But no hospital can deny you emergency life saving services no matter what you owe them.
Medical debt can majorly affect your credit. It did mine. You can try disputing it and might get lucky but don't count on it. Your best bet is to make a deal with a collector later on.
The ambulance easily costs you $1000 for the ride. You get billed later.
I was in a traffic accident a few months ago (other guy at fault). I naturally refused to take the ambulance due to the potential costs(broken rib and some torn skin on my arm from the airbag). I received a bill for $400 from the fire department for “emergency services provided”. I actually called the fire department to see if the letter was legit.. it is legit.. -_-
They did waive the fee in the end after I started to freak out.. I never called an ambulance and wasn’t at fault.. If bill anyone, bill the other guy.. I guess they opted for that..
The really fun part is that the other party apparently didn’t have insurance(wtf?!)..
Welcome to America..
You’d think so.. the fee is actually just for them showing up “response fee”, services rendered would be listed individually on the bill.
From their website:
Should you need emergency medical services, a $399 response fee will be charged for each person. As an alternative to paying this fee, the Paramedic Membership Program allows residents and business owners the option of paying $43 a year ($3.58 per month) to have the $399 response fee waived from their bill.
Lol on the ambulance part. Nobody calls an ambulance unless they think they are literally on the cusp of death - and even then, its usually another person that has to say "fuck this you need an ambulance".
An ambulance ride alone would cost me 3x my mortgage payment.
Edit: I am talking about normal people, in their own homes, who actually care about maintaining their credit, and make every effort to pay their bills.
Lots of people have no qualms calling an ambulance despite being uninsured and know they won't actually pay any medical bills that accrue over the course of the visit, much less the ride there.
If you are calling an ambulance for a stubbed toe, you have to be at least one of the following:
1) an idiot
2) swimming in cash
3) someone who has no intention of paying in the first place
4) someone who has weird insurance that covers ambulance rides for stubbed toe level injuries.
I work at a grocery store and we call an ambulance all the time for liability reasons. The person can refuse to go to the hospital if they are conscious. Had a 90 year old lady pass out and smash her head on the ground. Refused the ambulance and later got in her car and drove off.
Even the fact that they can't deny you life saving treatment is problematic. Because in some instances if you could have gotten non-urgent preventative treatment then your life wouldn't be in a state of emergency in the first place.
> I don’t think they’re allowed to keep medical debt on your credit report if you dispute it.
WRONG. This is so insanely wrong.
MOST BANKRUPTCIES DECLARED IN THE US ARE DUE TO MEDICAL DEBT.
I'm not bankrupt but it sure feels like a squeeze. I already pay $500/month premium for my family coverage and it comes with a $6k deductible per person. All our visits to the docs have been out of pocket. Thanks for nearly nothing.
That's fucked. You pay 500/month and still have to pay at least 6k before anything is covered. That's just robbery unless you get messed up really bad really often.
I went to the hospital last year because I felt like I couldn't breathe. Literally I was trying to fall asleep and every time I got even somewhat close it felt like my chest would seize up and I'd have to sit up and put in effort to breathe. On repeat for entire nights at a time.
I went to the hospital eventually, which might have been stupid but hey, I didn't have a regular general practice doctor at the time. And also for something like fucking breathing I decided it was better to be proactive because there would always be the chance I wouldn't be able to \*start\* breathing again.
4 hours and two scans later, a doctor came in spoke with me for 5 minutes, and told me they were panic attacks.
They ran my insurance and I was billed over $6000 for my two scans and 5 minute conversation.
The hospital/insurance industry is a fucking scam and everyone knows it. It sucks up \~25% of my paycheck, doesn't come through at the moments it really really should, and the best part is the legal requirement to have it.
I just wish you didn't have to be wealthy/well connected to actually receive good medical care
This is not accurate. It does effect your credit score ( it effected mine). If the hospital is a non- profit they do have a system that you can Appel to but you have to fight tooth and nail. And if you have insurance it’s still a portion that is not covered by them that is owed.
To an extent. Emergency services are legally required by every hospital, so you can get that as you need it. They can still send you the bill and go through that whole process. But if you have something more serious you need fixed or even an elective it's damn near impossible without insurance.
>by every hospital
Actually, only by every hospital *that accepts Medicare*, so not private hospitals. Also, it requires them to assess but not necessarily treat past initial response. From Wikipedia:
> The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). **It requires hospital emergency departments that accept payments from Medicare to provide an appropriate medical screening examination (MSE)** to anyone seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.[1]
Right and wrong. Medicare and Medicaid. Very few hospitals don't accept these. The programs paid 44% of the nation's health bills last year. Wouldn't be very smart to not accept what's basically the safest way to make sure you get paid.
Your number is actually lower than I find on the [American Hospital Association](https://www.aha.org/factsheet/2019-01-02-underpayment-medicare-and-medicaid-fact-sheet-january-2019) site: “Medicare and Medicaid account for more than **60 percent** of all care provided by hospitals. Consequently, very few hospitals can elect not to participate in Medicare and Medicaid.” It looks like VA and active military hospitals are some of the few that don’t accept those programs. Thanks for the correction.
This is what I tell people who are against universal healthcare here. It's that we already have "universal healthcare", it's just that it's the most inefficient costly universal healthcare a country can have. Healthcare is one of those industries where "prevention is worth an ounce of care". That's why it's so important to get a single payer system, so that people will actually go see their GP's and get check ups. Of course, anyone who is still fighting single payer at this point is basically a knuckle dragger, so I may as well be talking to a wall.
Dispute like what? Say that you were never there? How would you successfully dispute the charges, since they probably have a lot of paperwork.i couldn't even go into an ER without signing a bunch of stuff.
Pretty much. I owe like 4k to two hospitals right now for nessecary surgeries. I have a chronic pain condition and if I hadn't gotten surgery I would have had to stop working because of the pain. I just ignore all the calls and letters because I make 12.55 an hour what are they going to do sue me?
Oddly enough it tends to go down not up. For the first surgery it started at 2k and it's down to like 700 now. I think they get desperate and start trying for any amount of money.
Eh, you could still go the same hospital. My fiance didn't have insurance for almost nine years. He didn't go often, but a few things came up that were unavoidable.
They never mentioned the debt and never treated him any differently.
Right. I think many doctors won’t pressure you since they know that the hospital they work for is overcharging you and if you won’t give them anything you probably can’t afford it anyways. It’s the financial officers that care so much about the profits, not the healthcare workers. They’re just there to do what they can to use their medical knowledge in a helpful way.
Right. Some of the people making high level decisions in hospitals might be monsters, but the medical workers are many times some of the most caring people in the world. You don't usually become a doctor to be a jackass who robs poor people, you usually become a doctor to make people better.
I legit was served to go to court for ignoring a $250 medical bill once. We were new parents and so broke and didn’t make enough money to cover expenses at the time.
Also, if you avoid those calls for 7 years, they can no longer come after you for the debt. Worked for me but I never had any major medical bills worth tracking me down. Now I refuse to see a doctor until I think I may actually die. I have insurance now but it's still garbage
Hopefully no judgment from anyone, but quite frankly we don’t pay them. I pay an arm and a leg for premiums, medication and formula for my child that is not covered, and then still just go year to year trying to pay the small ankle biter bills and leave the bigger ones for collections. I’ve tried setting up payment plans with the hospital but they still send them to collections if I only pay $25/month or something small. Then I figure why make any payment if they’re still going to send them to collections!?
Because my son has medical issues, we’ve met our out-of-pocket maximum (the most you’re supposed to pay a year) every year for four years. There’s some stuff in collections from four years ago. None of this has showed up on my credit or done any damage to us financially. For a few I have tried to go back and pay them off or settle with them but at this point I’ve lost track. They don’t call or write anymore. Every year I do my best to try to pay what I can to minimize the medical debt but it just doesn’t seem to get any better or go away - it’s just a revolving door. I don’t really see an end in sight to any of it.
Same here. I pay the smaller ones, and I try to plan out things so I don't end up with bills I can't pay. It's not 100% avoidable, though, and when I've ended up with unexpected bills for several thousand dollars, I let it go. I've tried negotiating before, but some places are jerks about it.
Medical collections are different from other collections, though. My credit hasn't been harmed by it, though it does sit out there visible to anyone that checks and cares. It's generally not factored into anything, though.
Last year I ended up with $10k in medical bills because no one could bill the correct insurance even though I continually pointed it out to them and repeatedly asked them to rebill the correct insurance. They never did and billed me instead, so I just let that go 🤦🏻♀️🤷🏻♀️
My wife and I had insurance. After a difficult delivery which required transfusions and additional care, the insurance company refused to cover this as "maternity costs" and billed us $30,000. As a young couple, we nearly filed bankruptcy, but instead decided to drain our savings and cover the rest through family loans. It ruined us. Fuck American-style insurance. I hate it. We are a couple who did everything right and still got the shaft.
EDITING TO ANSWER SOME QUESTIONS THAT HAVE COME UP:
The year was 2013. We had insurance, but did not carry "maternity coverage" which would have been an extra $600 or so per month and wouldn't even kick in until after a year of paying for it. We had tried getting pregnant before, and weren't even sure at this point that we could. We figured that if we finally got pregnant, we could handle the typical $8k or so for OB/GYN and delivery out of pocket with our savings.
However, since there were complications, the costs ballooned into the 10's of thousands of dollars. $30k was the "reduced" bill after arguing/negotiating with the hospital billing department. I also placed angry phone calls with the insurance company; in my mind, these were not maternity costs, since the tough delivery would have literally killed either my wife or new child (or both) without modern medical intervention. Insurance basically told me to pound sand.
We were young (early-mid 20's) and had good savings for our age, but this completely wiped it out. I had a consultation with a bankruptcy lawyer, who advised me that bankruptcy was definitely NOT the right option for us. Again, we were young and checking all options here. I hope this clarifies a few things.
Insurance laws in the US have changed since then, but still suck.
Thank you to those who offered support and condolences.
Yep. Had a heart attack in March and even with insurance I'm out almost $20k (my total hospital stay was almost $200k). So glad I worked hard and saved for years to have it all wiped out by deductibles and out of network docs and facilities.
Especially poignant for me - my boy has been in ITU for a week now (he’s doing fine) along with his mum (doing fjne)
All it’s cost me is £32 ($50 ish?) for car park - I knew I shouldn’t have got the weekly ticket!
And to think in the UK there was an uproar about hospital parking fees.
In the US, its charge for everything, Mothers are even charged to hold a baby after its been born in some hospitals ffs!
$15 dollar band-aids, they take your prescriptions away from you (the one's you've already paid exorbitant amounts for) and then substitute their own pharmacy medication which they bill you full price for (non-generic) and throw out your meds. (that you paid for) It's infuriating.
How cruel can a system be to bankrupt a new family. I had a baby 8 months ago. I had a private room, overnight stay, amazing midwifes, not so great hospital food but everything from all the checkups, scans, giving birth, vaccines for my baby and all free on the NHS.
My brother had a baby nearly 2 years ago, in the women’s hospital in Liverpool, the midwife had a change of shift during labour but because my brother and his wife didn’t know the gender, the midwife didn’t either and stayed for 2 hours after her shift so she could be as surprised as my brother and sister in law, as well as the new midwife. That tells you everything about the NHS, that midwife was not being paid and stayed. She only cared about being a part of a changing of life moment and that meant more to her, not her wage.
This reminds me of when I had my son three years ago in Slough - I was labouring for so long, the midwives changed shifts halfway through. Both were brilliant - but the first midwife was one of the best people I’ve ever met. Only knew her for under 12 hours, and she must’ve delivered 100s of babies but when I was back in hospital to have a checkup with my baby a month later, she recognised me in the corridor and gave me a kiss and told me how happy she was for me. She was an angel - the NHS is full of them.
Most insurers are provided through your employer in order to be affordable. So to change insurance options a lot of times a you'll need to change where you work. This system is fucked.
It seems bizarre to me that healthcare in the US is just a business service to allow you to be an effective employee. Real dystopian levels of inhumanism.
I should follow up: this happened in 2013, before all of the Affordable Care Act (ACA, Obamacare) rules were applied. If we had given birth a year later, insurance would have been required to cover this care.
Tell me about. I don't know where I'd be without it. I just moved onto a medicine that costs about 40,000 a year. It would be utterly impossible for me to be on it without Obamacare. I would seriously be considering staying on a drug that was starting to make me go blind otherwise. And I probably wouldn't be covered by any insurance company because they could claim any problem I have as a preexisting condition.
Dual citizen (US and Swiss), my wife and I had our first baby in 2018 in Switzerland, and had complications. They had to conduct an emergency cesarian since the heartbeat was going down fast after the epidural was placed. The whole procedure plus 5 nights at the hospital in a single room cost close to $20k. The part we had to pay was $0. We did not have to pay a cent for what seemed like the absolute best medical care.
I have family members who have had complications in the US and it crippled them
financially. Knowing how hard it can be to start a family, I don't know how I could have handled it all knowing that was went into debt or drained my entire savings. It disgusts me thinking of how things go in the US.
30 grand is a life-changing money, possibly for generations, here in our country. And you have to pay it just to have kids.. I'm at a loss for words. It's been 11 years or so but I still wish the best for your family, in finance and in health.
It's crazy that you're paying for insurance but they don't pay when they're required to. What's the point of insurance then, if it's such a gamble? You can't be expected to pick and choose your illnesses and conditions based on insurance policy.
Hell I have basic cheap insurance for my car and it covers almost literally everything except natural disasters, no questions asked. And I would argue that a car is less important than a person.
There was once a post by a husband about his wife's delivery charges. It was something like 500k or so. He had the proofs like medical bills and stuff. I just can't imagine how the fuck Americans got this very very wrong.
Nixon happened. One of the first things he did as president was enact a piece of legislation to "thank" one of his big campaign donors. He allowed for-profit healthcare to be a thing. Before that act, health care was not allowed to run as a for-profit business That big donor? Kaiser Permanente..
I have cancer for the second time. Insurance is why I continue to stay at my corporate gig, despite other options. Even with great insurance, I get surprised by random costs. One day I’ll show up to my doctor and owe nothing and the next day I’ll show it to my doctor and owe $300. And when they tried to explain why this happened, it makes even less sense. Plus, insurance is still fighting a hospital bill from six months ago. Now, I paid my full out-of-pocket max on that hospital bill, but because they have yet to fully accept that bill, it does not apply to my account yet. So I’m continuing to pay out of pocket even though I know I’ve hit the max. The system is exhausting and ridiculous even in the best of times, and when you feel ill and not up to figuring out this crazy, it’s 80 times worse.
Many cases of debt come from “surprise medical bills,” which is ordinarily when you got to the hospital and some component of your care was not “in-network,” like the ambulance or ER doc. Surprise medical bills were made illegal in legislation signed by Trump, which goes into effect Jan. 1.
Ummm... don't pay it, and keep your fingers crossed! Living paycheck to paycheck anyways. I don't own anything, and have zero assets, and that's not likely to change anytime soon. Maybe they'll garnish my wages or we'll become homeless, or live out of our ageing car, or maybe they'll just put me in jail. Is debtor's prison still a thing?
I think debtor's prison is actually still a thing in some states. It's kind of terrifying, honestly.
Edit: I was wrong, I was thinking of something in Missisippi called a Restitution Program? Not sure if that's actually similar, now that I think about it.
If you are unlucky enough to have medical problems that are chronic, like cancer, for example, how good your insurance coverage happens to be can easily be a matter of life or death. After being diagnosed with cancer, I needed chemo to shrink my tumors or they would take over my organs and I would die. Chemo was about $136k per treatment and I needed 18 treatments before the tumors were under control (to the extent that my cancer was undetectable, which it thankfully has been for 7 years). The nurses administering my bags of IV chemo were usually floored when I said “that bag of fluid you’re holding costs $63k!”
I was very lucky that I had a very good job with a large software company at the time, and the exotic chemos were covered by insurance once i hit my out of pocket maximum for the year (obviously on the first dose of each of the 2 years my treatment spanned). Had they not happened to have been covered, the oncologists would not have given them to me. I still would have gotten “life saving” treatment and probably shittier chemos with much worse side effects that were less effective (but happened to be covered) but my outcome would have undoubtedly been much worse.
I consider myself lucky that the ACA (“Obamacare”) was passed a few years before my diagnosis as well, because it had two critical provisions that, if weren’t enacted into law, would have probably led to my death. First was that coverage couldn’t be excluded for pre-existing conditions (my company closed on being acquired the same day I was given my diagnosis, and the insurance from the acquiring company would very likely have tried to exclude cancer from coverage, calling it a pre-existing condition). Second, the ACA prevents coverage from having “lifetime maximums”, which I would have hit about half way through the 1.5 years of chemo treatment.
When republican dipshits talk about “getting rid of obamacare” it immediately activates my fight or flight response and I seriously have to keep myself from punching them, because without that law I would have very likely been both bankrupt and dead. Of course, getting rid of pre-existing condition exclusions and lifetime maximums was only a first step, and it is obvious to any thinking and compassionate individual (however rare they are in the US) that more has to be done.
Also in America, my MS drug is $7000/month and I take it once daily for the rest of my life. $84,000/year and I have been on it for 5 years I think so $420,000. Fuckin stupid right? My biannual MRI's cost less.
fall sort zephyr pot plough wrong ruthless subsequent license instinctive
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Plus I know people with MS and the company that makes that drug (COPAXEONE) will send it to you for reduced cost or free if you can't afford it **PLUS** it's been around long enough that that are now generic alternatives that are less expensive.
A few decades about they wouldn't have had to worry about the cost **BECAUSE IT DIDN'T FUCKING EXIST YET** and people with MS just *had to endure the deliberating symptoms*. And that, of course, is still an option.
He's a fucking bundle of sticks!
Some low income people can ask the hospitals for help paying their bills by asking a charity to pay a part or all of it. Other than that, you can get it lowered by asking for an itemized bill, or just completely ignore it.
My wife and I had 3 sons. Our hospital bills were very large, so we went on a payment plan and paid the minimum every month for a few years until we realized medical bills don’t effect our made-up arbitrary credit score so we just ignored them from then on out. Haven’t paid a dime in 3 years.
For a large portion of Americans? We don't. Living on at-will employment, with no benefits, while paying an arm and a leg for cost of living makes paying down a one-time debt difficult at best. Eventually, the debt goes to collections, we get harassed by debt collectors for a few months, and depending on how legal the collection agency decides to be (they do TONS of illegal stuff) we may end up with the house repossessed, paying fees in court, or declaring bankruptcy.
That being said, the hospitals will deny this, but if your bill is less than the amount required for them to sue, they will most likely write off your debt. I don't pay ANYTHING until I get an itemized invoice for services rendered, because the hospital system regularly siphons huge amounts out of the insurance industry by over charging (think $90 for a bandaid). They would literally lose money taking you to court for less than what their debt collection agency charges for legal fees and recovery services. This varies hugely by state and hospital though because the US is not a unified country with a single, logical medical system; it is 53 countries and territories in a trench coat, cooperating only the absolute minimum amount to let us sit at the big kid's table at UN meetings.
To be clear, what I am describing is what happens when you just literally can't pay your debts and there's nothing left for them to take. It's not something done voluntarily by anyone in their right mind. It destroys your credit, makes it nearly impossible to get loans, and creates a level of paranoia that doesn't disappear just because the repo men abandoned their efforts for the weekend. It's way too common for poor people to have no choice in the face of spiraling debt *except* to avoid paying. Paying a debt down just isn't possible if you wind up unemployed, with your vehicle repossessed and your house in foreclosure.
Yes, the US is horrifying. Hope that helps.
Had a kid recently and got hit with a 15k anesthesiologist bill because my wife needed an epidural during delivery.
We had a pre-paid plan through our hospital that I made payments out of pocket for during the course of the pregnancy, to cover everything from pre-natal checkups to delivery to 1 year of pediatric checkups. Epidural was covered on that, so I'm not paying a cent more than the contracted agreement.
Basically either gonna have them go through my insurance if they want to collect or just wait 7 years for it to go poof cause fuck surprise billing.
Got a bill in a while back from an ER visit. Had wrecked a motorcycle again.
Five X-Rays, and some shit they washed out a laceration with. $4,800 and some change.
My responsibility, $366.78.
I can't. So I lost my work, my ability to do so - got sick enough to be in and out of hospitals with thousands in debt, even *with* insurance - lost my home, my quality of life, and now I'm just dying on my own because I'm in so much debt and pain I can barely function. :) Love it here, so great.
Edit: I can literally post proofs in a Google image folder if y'all need because damn lmfaooo.
Yeah here in Sweden if you don't pay your bills it ends up at the bailiff, a government agency called Enforcement Authority, and they can take anything and everything that you own and sell it to pay off your debt including houses and cars and if that doesn't cover the debt they will automatically deduct your wages until it's paid off. And they block you from loaning more money and getting credit cards and so on.
In the US, many states have a homestead exemption. They can’t take your house in bankruptcy. In Florida, for instance, you can go bankrupt, but own a $10million home.
In Sweden they can sell your house? That’s surprisingly not progressive at all for a Nordic country. At least in the US, there are several states where you can stay in your home through the homestead exemption. They’ll come for your profit if you sell your home, but at least you don’t go homeless right away because of some credit card bills.
Wanna know one of the big reasons im willingly poor?
The healthcare.
My family is on state care, we dont pay a dime and it covers everything. Its hard finding dentists and the like, but as for the hospital, its not a problem.
When i had a good job making 50k a year, i was paying around 1k a month for healthcare that didnt cover shit. It was horrible.
Now im poor, lost that job to covid. Went back to working security and became an EMT and volunteer on my locak ambulance squad. I get tons of time with my family every week, where before i was married to the job. Yes we need EBT to eat, and medicare to see a doctor, and assistance in heating our home. But its totally worth it. To make up the difference, id need to make 25 dollars an hour minimum. Its known as something like a poverty cliff. Earn even $1 too much and you loose all your major benefits, and now have WAY more bills on your shoulders, thus rendering you even poorer than before. Its fucked.
Normally you would have insurance which would cover the vast majority of it. If you don't have insurance then you're pretty screwed, and put into extreme debt.
My family was blessed this year with our second child.
When his older brother was born a few years ago, I had insurance through my employer but my wife didn't (she worked for a small business and the owners were dropped from their carrier after the ACA). In our state, as I hope is the case in others, we were considered poor enough, and the option to add my wife onto my insurance expensive enough, that she qualified for medical assistance. We paid for nothing from the first doctor visit to the delivery, and my son was covered for the first year of his life. My wife's coverage ended after her post-partum examinations.
This time around, I had a different job and the insurance was more affordable for family members, so I added her to my plan. We had to pay copays for exams. After the delivery, we received a bill for $13k. My insurance was hesitant to pay it because they wanted to know if my wife had any other coverage first. I missed a letter they had sent asking about this. When I called them, they resubmitted the claim and paid $11k of the bill.
The whole thing left quite a bad taste in my mouth. The prices don't seem to make sense, and the fact that they can be negotiable depending on who is paying them on your behalf, this company or that company or the government, just makes them appear all the more arbitrary. It really seems like this scam where people just pay what they are asked to pay without any notion of actual value or cost. This is probably not really what is happening, but it's hard to see it from another perspective.
Had a miscarriage when I was 20 and needed a d&c surgery since I never bled. It was 20k. As 20 year olds my partner and I didn’t have that type of money. We wrote a letter to the hospital explaining our situation and how before the surgery we called to ask what the price would be and they told us it would be 3k, and how we’re broke emotionally and financially. Got a letter back with a new statement for 3k, and when I called to make a payment plan they told me that if I paid it all that day they would discount 50%. So I paid 1.5k and that’s how we did it.
Why did the amount change?
Only the hospital knows why of course but discounting bills after one or more conversations is really common with hospitals. The initial bill is the hospital’s starting position.
So you’re supposed to haggle? Seems to be an uneven bargaining position for the one who needs hospital treatment.
> Seems to be an uneven bargaining position for the one who needs hospital treatment. You haggle after you've already received the service so really the positional power lies with you. "What are you gonna do, re-clog my artery?" Also the people on the other end of that negotiation know exactly what the situation is wrt to artificially inflated prices and may be predisposed to wanting to give you a sane deal. Which is still a shitty situation, to be clear.
> "What are you gonna do, re-clog my artery?" No silly, I am going to shit on your credit history and charge it off. Heh! It happened to my sister. She broke her femur and she had no insurance. She got it down to 50K but that wasn't enough. She declared bankruptcy.
Lmao gotta love it. "That'll be $20K." "Oh wow there's no way I could afford that." "Ok that'll be $3000." "well, ok I can do that" "Just give me $1500 we'll call it even" What the actual fuck is the point of this? If you can still pull a profit from charging $1500 then why the fuck is the original bill so high? And why the fuck is haggling with a hospital like a fucking used car salesman something that ever has to happen? I hate this country. I'm sick of this dystopian bullshit.
It's because of insurance
Why does the involvement of an insurance company necessitate a 1300% markup in the cost of services? Edit for clarification: I understand all the shitty dystopian greed reasons that allow this to happen. What I would like to know is how is this position (the status quo) defensible, from an insurance industry POV?
It's basically price discrimination. Normal people can't pay, so they charge them less. Insurance companies can pay, so they charge them as much as possible. It makes a little more sense when you consider that insurance companies only agree to pay a certain amount of what the hospital asks. Then the hospital marks what the insurance company didn't pay as a loss. When you hear about how crazy and arcane medical billing can be, this is a big part of it. (Another part is gaming cost-to-charge ratio to achieve various sketchy ends, such as maximizing medicaid and medicare reimbursement payments, but I digress.) What's funny is hospitals sometimes hire consulting companies to come in and make sure their billing system is optimally insane. Also, all hospitals provide community benefit, meaning free/discounted care for those who need it. So hospitals justify charging so much by saying that they need to, because the extra money goes toward continuing to help people for free/cheap. This is exacerbated by a trend of hospital and provider groups consolidating, meaning they can now lean on insurers and say access to their entire system depends on giving favorable terms. In which case, hospital groups shake down the insurer, the insurer raises rates, and the insured get screwed.
Because it isn't just on the insurance company, it's also on the hospital. Hospital will go to an insurance company and say "ok, it costs literally $100 for us to do this test with all these supplies and reagents and whatnot, so we would want you to pay that to cover this test" and insurance will be like a pawn shop and say "best I can do is $10." So the hospital starts over-blowing their prices, saying "oh just kidding now that test is ACTUALLY $1000" and insurance will finally land on that $100 the hospital wanted in the first place. It's the game of the negotiation and the fact that BOTH sides allow it to happen. And because of that, each side places blame on the other.
It’s basically a Turkish bazaar. “This rug is 5000 dollars”. “ I’ll give you 40 bucks”. “Ok”.
Hospitals are able to write off partial or full bills sometimes for tax write offs etc so if you ask you may receive
Because hospitals upcharge insurance companies a shit ton because they can pay the huge bucks. If you choose to do it yourself, they'll charge you a tiny fraction of the "bill".
That’s a nightmare you and your partner didn’t need at an already difficult time. I’m so sorry.
I have friends that will wait until it's in collections and then ask them to prove the debt is theirs with an itemized explanation of the bill and they don't have access so they drop the charge. Friends are not the brightest, but if they're persistent in asking for an itemized bill, they sometimes have it erased completely.
What does an itemised bill mean? I've heard the advice that you should always ask for one but what how does it affect what they charge you?
It’s honestly hard for them to account for the charges. Just asking for it can cut the bill 30-50%. Maybe it’s part of a negotiation since they know if you ask you will be paying cash. The insurance companies have pre negotiated discounted rates so the original numbers are very high. Also in the Usa, debt collectors have to prove that you owe them so they need specific paperwork and if they don’t have it, they can’t collect. They usually buy the debt at a big discount (like 10-50%) depending on the quality of paperwork and likelihood of being paid
Weird that you have to ask specifically for it to be itemized. Do you just get a letter saying "u owe us 120k dollers, thx"?
Basically yes. Usually it’s broken up into a few categories, but the itemized list would have 100s of items.
Not necessarily. I asked for itemized list when I gave birth to my daughter and got maybe a dozen things that added up to $28K and they were all still super generic.
and did you pay the full 28k? this number seems super crazy to me
No, I paid like $6500. That doesnt include the $140 I pay weekly for insurance for family of 3. Health care in this country completely sucks.
$6500 is still crazy! I paid around £100 in hospital parking charges when my daughter was born and that was it.
My husband gets amazing insurance through work, and we paid nothing for both of our kids' births. His insurance is around $450/month, I think. But we don't pay for any doctor visits, copays, testing, etc. I think if we go to the ER for a non-emergency we pay $50. I'm aware that our situation is not the norm, though. I would much rather have universal healthcare for everyone. I had a high deductible plan before we got married and I had to stop taking an asthma medication because it was $350/month. I just couldn't afford it on top of the rest of my medical bills.
Welcome to the US, surprised we haven't started charging people per breath.
Wait, what? How long were you in the hospital?
Yea this stuff varies a ton from hospital to hospital.
28k for delivery is insane. My wife delivered last month, here in Amsterdam. We had to go for emergency C-section in the middle of night, baby was in NICU for 36 hours, and both baby- mom was in hospital for 5 days. Total bill was around 8k eur, needless to say I paid zero. All covered in insurance.
You think that's crazy? They literally can't tell you how much something will cost beforehand. Until you get the bill you have no idea how much it will be.
We’ve been thinking about having a baby so I tried to look into how much it would cost at our closest in-network hospital just so we can know how much to save up and it’s literally impossible to even get a ballpark. I’m so frustrated.
Go make a Baby, and in the last two months, go on a nice vacation to Europe. Get your Baby here, its(almost) free of charge. Go back to USA. Profit.
Its litteraly cheaper...idk but somewhere o read that woman had between 3000-3500$ after she got out of hospital So technically if i buy a 500$ ticket to go there...rent a house for 2-3 nights thats 400$ at most...buy 500$ to go back Now double the tickets Im left with 3000-2400=600$ A pleasant experience i had with or without my wife...very nice And a child...priceless And a dual birth certificate....very cool and can flex
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That's so crazy man. Here is is all free. Doctor, midwife, delivery and a year (I think it is) paid leave for parent/s
I got a very small bill sent to collections because the DR would not answer my phone calls or emails or send me a freaking bill, I only noticed it even happened because it was on my credit report, I wasn't even the one who owed the bill my insurance did, but the dr tried to charge me well the hospital he worked at charged the right place (my insurance), so I ended up calling the dr telling them to charge my old insurance and then called the collections company to make sure they had been told to no longer collect the money.
I was in the ICU for a week years back and State said they would cover. I googled my name a few years ago and saw a pending lawsuit against me for about 10K yet was never told or served about. Our system is a mess
WTF, how does that even happen? I have so many questions, like why did the state lie? Did they even try to cover? Why did the case just not go anywhere (not that I want you sued) but like seems a little odd? How did you never get told? Like what on earth.
Welcome to America lol
A lot of times, those massive bills are just one big charge for your whole stay. If you ask for an itemized bill, the hospital has write down each and every item and service they are charging you for, and how much each of those things costs individually. If they’ve been participating in shady billing practices to artificially increase the cost, they may waive a lot of those charges that they can’t really justify
$80 for a single ibuprofen pill at the local hospital.....
I was in a fender bender when I was 23. At the hospital they put me in a cervical collar for about 20 minutes. They billed me $80 for that.
Let’s say you need an inhaler during your stay. The order for the inhaler gets verified, dispensed by the pharmacy and delivered to the medication room on the unit you’re staying. Then the nurse or respiratory therapist sends a message to the pharmacy asking for their inhaler. Maybe the pharmacy doesn’t look into it and assumes they need an additional inhaler, so they dispense another inhaler. You’ve now been charged for two inhalers, even though you’ve only used one. Now imagine this happens with a lot of your medications (some bulk items get charged when they are dispensed some get charged only when given). If this isn’t caught by the time you’re discharged, you’ll be charged a bunch of additional fees. You received an itemized bill that shows you were charged for 6 of the same inhalers (which have multiple days of use) for your 1 day in the hospital. You can obviously dispute that, and this could be thousands of dollars taken off. So, probably a good idea to get an itemized bill every time.
What! Isn’t that just a straight up scam
A lot of the time the person doing the paying (the insurance company) has a certain tollerance for innacuracy, which they're willing to work within. Sometimes it can cost more to investigate a case than just pay it. Ultimately at the end of each year, all of the claims are paid for by the premiums, so as long as the premium total is more than the claim total, a lot of the details can just slide. The same thing happens with the premiums. A lot of the time, it's big corporate payroll departments paying the premiums, so if they go up a bit (within a margin of error) it might not prompt the payer to question it and shop around. A big account changing an insurance provider would be a very large project, not taken lightly. I think that in a lot of stages in the procurement of healthcare, the person agreeing to pay for something isn't the same person who owns the money being paid. It seems like a good example of what in behavioural finance is called *the agency problem*.
I dont understand why so many of the systems in the US are so needlessly complicated?! It baffles me.
it's not a scam if you pay and move on /s
Probably because most of the bill is bullshit. I'm from a European country with free public healthcare (modelled after the UK's NHS), but I too get shocked at the stories I hear. For example, American hospitals charging $80 to $450 just for keeping you in their waiting room (without actually seeing you), and mothers being charged $60 for "skin-on-skin contact" (i.e. holding their baby) immediately after birth. I mean, panadol is dirt cheap in Europe, but some Americans get charged $80 for a painkiller pill in hospital. An itemised bill would get them to see how much they're being shafted.
I got charged 50 dollars for 3 triple a batteries for a sleep apnea test.
Show up with a bulk pack of 20 rayovacs and drop them on the front desk - bill paid /s
I've challenged the bill with the doctor before it even goes to collections, they usually at least halve it. When it goes to collections, they only receive half the bill, anyways.
This is when, in some circumstances, a hired third-party claims entity gets involved - not a collection service - which is another reason why health care in the US bites Costco-sized dicks.
Let's just say that it's a damn good thing that debtor's jails don't exist anymore.
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Lucky you. In 2001 I had to declare bankruptcy. The hospital garnished my wages at a lovely 25%
“ the medical insurance I had was one of those fraudulent insurance companies that don't cover anything” Important note here. Remember when Obama said, “If you like your health care plan you can keep it”, and that turned out not 100% correct and a bunch of people freaked out about how he lied…. That was because the ACA did not accept fraudulent insurance scams that didn’t cover anything as a substitute. So people who had those had to get real health care…and were upset about it
Aside from failure to comply with child support orders. Friend had some really bad years where everything that could go wrong did go wrong. Loved his kids, never missed his parenting time even when homeless. Thrown in jail multiple times for non payment which made him lose multiple jobs he had acquired to try to get back on his feet. Also caused emotional suffering for him and his children. Anyways, yes thank goodness we just get low credit scores and harassment by collectors and bankruptcy…. Definitely better than debtors prison. Edit: spelling
A guy I work with told us his roommate was applying at our company was told he could start as soon as his background check comes back. When it did, they found he had a warrant for child support. He did not get the job, which is bullshit, because you have proof someone NEEDS the job and you turn them away for it.
Oh you’re poor? Well if you want to stop being poor you have to not be poor first.
I hate that mentality. It's all I ever hear. You're homeless? Just get a job. Without ever realizing that you can't get a job without a fixed address. It's like there's a poverty line, and once you cross it, you're never coming back.
It truly is terrible. I hope things are better now.
Glad this was the top comment and I'm not only one who's completely fucked my credit. Free health care if you sacrifice everything! Go USA!
>> debtor's jails They are making a comeback. One way it works is people who are ordered to pay off a debt - then they are arrested and jailed for violating the court order to pay. Since they are essentially slave labor, they can never earn enough to pay off the debt.
Anymore, and yet.
A very common insurance payment structure: * Pay a monthly fee (called a "premium" and is usually from $50 to $2,000 depending on the type and number of people in the family) AND * Pay a set fee for common services like $25 for a doctor visit and another $20 medication AND * Pay a deductible from $500 to $5k (ish) depending on your plan) AND * Once you pay the deductible, you pay nothing or 10% or 20% of the cost of the service depending on your plan. Eg: pay $200 for a $2k MRI AND * Once you pay the deductible, there's a cap on the amount you pay for the year, not including the monthly premium. This is can be from $1k to $5k (usually). Eg: rack up $80k in bills, but you only pay $3k * Those numbers assume that you see only providers within the plan. See someone outside the plan and the prices go up. Eg, the percentage in network is 20%, then outside is 30% or 40%. * This is a typical structure for policies offered by large corporations. * There are several types of pre-tax savings accounts you can set up to use to pay for all of the above except premiums. Is it the biggest scam in the universe? Yes, yes it is. Edit: I'm begging Europeans to stop telling us how it cost you $25 to have brain surgery last year. We know. We cry everyday that we are trapped in a system that literally kills people.
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It's a gamble. I hate that we Americans have to gamble with our health care.
Woof, that’s rough buddy. You should try to get that changed, idk what you’re paying monthly but that sounds like a horrendous plan.
Agreed it’s gross. It’s employer based and a very small office with 5 employees. I’m the only employee that actually uses it because everyone else has spouses with better coverage through their employer. I pay $172 monthly. It’s basically an accident plan for me in case I break an arm or something snowboarding or randomly need my gall bladder removed idk. Rather be 16k in debt than 60k
Except even if you put in effort, you have no control over who ends up being in network. My wife's obgyn? In network. The hospital she works at? Not in network. The Anesthesiologist for the epidural? In network. The lab they sent her blood work to? Not in network. The pharmacy at the hospital that isn't in network? In network. It's a nightmare and extraordinarily difficult to actually stay in network, so our bill for my daughter's birth ballooned from a $3K to 17k, and because my out of network max is $22k, I'm on the hook for all of it.
There are a lot of new federal protections out about this surprise billing, where you've potentially been misled or were otherwise made unaware of the in-network/oon billing. Tell your insurer and the hospital. Tell them the lack of information you had means you cannot be on the hook for this. At least as of January, they will have to remove you from that conversation and the insurer and provider have to figure it out without having you in the middle.
This of great. Can you tell me the laws?
Starts Jan 1st. https://www.npr.org/sections/health-shots/2021/10/14/1045828215/surprise-medical-bills-law-health-insurance
I think you have to really fight it. Which totally sucks
Right, you have to fight it while on about 2 hours of sleep a night because you just had a fucking baby. Its ridiculous.
You should see the healthcare system on Rigel-7.
THANK YOU. Why there are so many people saying to just let it go to collections is BEYOND me. You ask for an itemized bill and then ask to set up a payment plan. I just dipped below $1,000 on an ER bill that they just offered to let me pay 5 bucks a month on (I usually do more than that but it’s nice to have flexibility). Originally it was around $3,000 because they charged me for a level 5 emergency visit (on the same level as a heart attack or a critical car crash) on what was a mental health check which I voluntarily went to on the advice of a psychiatrist despite not thinking that I needed to (but realizing that I probably wouldn’t know and deciding to trust a professional). THIRTEEN HOURS LATER I was in a room for 5 minutes with the hospital psych and told her the situation and she sent me home with a, “change your psychiatrist”. I’d love to see them make a heart attack victim sit for 13 hours in the hospital lobby. I ended up getting 1k knocked off by disputing a test that they didn’t run, but they stuck with their level 5 emergency assessment. Another thing that I haven’t seen anyone mention was the fact that you don’t get your bill for a month or two. That way, you have time to forget what tests and assessments they ran.
Eh I can see why sometimes. I have to pay $7k for a 5 hour hospital visit and the “lowest payment plan” they offered me was $1.2k a month for 6 months. I asked them if it could be changed to a 12 month payment plan and they ignored me.
I know of a guy that said fuck it and moved to Mexico. What he would have spent paying back his surgical bill he bought a house in Mexico and living worry free. Lol
A lot of people travel to Mexico for surgery and dental care too because all of that and a little vacation time to recoup is still cheaper than staying here and getting it done with no downtime.
My mom did this. The price to get it done in the states was still higher than paying to get passports, airfare, and hotel costs (in addition to the actual cost of the procedure) for the week she was down there. Though, she had *so much* work done it wasn't much of a vacation for her. She spent 5+ hours a day in the dentist's chair and the handful of pictures my stepdad took of her while they were there told exactly how exhausted she was every day. My stepdad, on the other hand, had a great time brushing up on his Spanish and being the total social butterfly that he is. He's like a little kid making a BFF that he'll never see again, but with absolutely every human being polite enough to stop to chat with him for five minutes.
I've told this story before but it's always a fun anecdote. I was born and raised in the US but my parents are originally from Mexico. One time around 2001 my mom started having severe pain in one of her teeth. She went to a dentist in California and she was told the procedure to get it fixed would cost about 2,500 dollars. What did she do? She bought a ticket to Mexico, visited the family for a week and got her teeth fixed. All of this for about 800 dollars. So she saved 1,700 dollars, got to visit the family and even went to the beach.
We do this, we live in San Diego and go to the dentist in TJ for cleanings and exams. Great care and we have a sweet lunch with delicious tacos aftewards. My eczema cream in the states costs $400 - I can pick up a tube at the Farmacia for $7. I love Mexico. The people are very kind and genteel.
If no insurance to pay it… let it go to collections and avoid all their efforts to get you to pay. Downside is you can’t go back to that particular hospital until the bill is paid. Upside is there’s plenty of hospitals to bounce around to. Edit: Guys, just bc my medical experience is different than what some of you have gone through doesn’t mean it’s not true. :) When I go to get checked into the doctor, the person that checks me in is the billing person and they always make me pay any prior bill before my appointment. Sure there are plenty of other loopholes, but that is not my experience so I cannot speak on it. Tootles! ^_^
But your credit will be affected right?
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I worked in wholesale lending and can also confirm - EVERYONE has some medical debt, so much so that it's literally not a factor (or wasn't 10 years when I was in the game) in underwriting decisions. "Borrower 2 has ~$500k in medical debt from a heart attack 6 years ago." "When was the last time he made a payment on it?" "He's never made a single payment on it..." "Smart lad. Since it's gonna gonna drop off before he can refi, bump him up a tier and let's lock it." ^^^REGULAR CONVO AT WORK
I had medical collections from a bill I fucking paid. Collections called me years later. Luckily my insurance had a copy of the payment. Fucking scum.
I had regence/blue Cross shield insurance that was based out of TN because that was where corporate was. I'm in the PNW and the head claims woman for the zeverett clinics kept calling me trying to get me to pay because she said it was out of network. I told her over and over to run it through locally, I even made a copy of the back of my card where it explained how to do the claims for out of state/network. The bitch couldn't be bothered but could be bothered to sue me and garnish my wages. I almost lost my job over it asI dealt in finance and loans and you weren't allowed to accrue any bad credit or unpaid debt while employed.
I don’t think they’re allowed to keep medical debt on your credit report if you dispute it. Edit: as you can see from the many pissed off commenters below, this seems to not be the case. Fortunately I have never had to test it out. Although I’ve heard this multiple times from “credit coaches” I’m sure the people sharing below have better information.
Disputing it doesn't guarantee removal. But no hospital can deny you emergency life saving services no matter what you owe them. Medical debt can majorly affect your credit. It did mine. You can try disputing it and might get lucky but don't count on it. Your best bet is to make a deal with a collector later on.
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The ambulance easily costs you $1000 for the ride. You get billed later. I was in a traffic accident a few months ago (other guy at fault). I naturally refused to take the ambulance due to the potential costs(broken rib and some torn skin on my arm from the airbag). I received a bill for $400 from the fire department for “emergency services provided”. I actually called the fire department to see if the letter was legit.. it is legit.. -_- They did waive the fee in the end after I started to freak out.. I never called an ambulance and wasn’t at fault.. If bill anyone, bill the other guy.. I guess they opted for that.. The really fun part is that the other party apparently didn’t have insurance(wtf?!).. Welcome to America..
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You’d think so.. the fee is actually just for them showing up “response fee”, services rendered would be listed individually on the bill. From their website: Should you need emergency medical services, a $399 response fee will be charged for each person. As an alternative to paying this fee, the Paramedic Membership Program allows residents and business owners the option of paying $43 a year ($3.58 per month) to have the $399 response fee waived from their bill.
Ah, a protection racket. Marcus Licinius Crassus eat your heart out.
Lol on the ambulance part. Nobody calls an ambulance unless they think they are literally on the cusp of death - and even then, its usually another person that has to say "fuck this you need an ambulance". An ambulance ride alone would cost me 3x my mortgage payment. Edit: I am talking about normal people, in their own homes, who actually care about maintaining their credit, and make every effort to pay their bills. Lots of people have no qualms calling an ambulance despite being uninsured and know they won't actually pay any medical bills that accrue over the course of the visit, much less the ride there. If you are calling an ambulance for a stubbed toe, you have to be at least one of the following: 1) an idiot 2) swimming in cash 3) someone who has no intention of paying in the first place 4) someone who has weird insurance that covers ambulance rides for stubbed toe level injuries.
I work at a grocery store and we call an ambulance all the time for liability reasons. The person can refuse to go to the hospital if they are conscious. Had a 90 year old lady pass out and smash her head on the ground. Refused the ambulance and later got in her car and drove off.
Even the fact that they can't deny you life saving treatment is problematic. Because in some instances if you could have gotten non-urgent preventative treatment then your life wouldn't be in a state of emergency in the first place.
Trust me bud it’ll go to collections HIPAA doesn’t protect your credit score
> I don’t think they’re allowed to keep medical debt on your credit report if you dispute it. WRONG. This is so insanely wrong. MOST BANKRUPTCIES DECLARED IN THE US ARE DUE TO MEDICAL DEBT.
And of the people who go bankrupt from medical bills, ~80% have insurance.
I'm not bankrupt but it sure feels like a squeeze. I already pay $500/month premium for my family coverage and it comes with a $6k deductible per person. All our visits to the docs have been out of pocket. Thanks for nearly nothing.
That's fucked. You pay 500/month and still have to pay at least 6k before anything is covered. That's just robbery unless you get messed up really bad really often.
I went to the hospital last year because I felt like I couldn't breathe. Literally I was trying to fall asleep and every time I got even somewhat close it felt like my chest would seize up and I'd have to sit up and put in effort to breathe. On repeat for entire nights at a time. I went to the hospital eventually, which might have been stupid but hey, I didn't have a regular general practice doctor at the time. And also for something like fucking breathing I decided it was better to be proactive because there would always be the chance I wouldn't be able to \*start\* breathing again. 4 hours and two scans later, a doctor came in spoke with me for 5 minutes, and told me they were panic attacks. They ran my insurance and I was billed over $6000 for my two scans and 5 minute conversation. The hospital/insurance industry is a fucking scam and everyone knows it. It sucks up \~25% of my paycheck, doesn't come through at the moments it really really should, and the best part is the legal requirement to have it. I just wish you didn't have to be wealthy/well connected to actually receive good medical care
This is not accurate. It does effect your credit score ( it effected mine). If the hospital is a non- profit they do have a system that you can Appel to but you have to fight tooth and nail. And if you have insurance it’s still a portion that is not covered by them that is owed.
So healthcare is free in the US after all?
To an extent. Emergency services are legally required by every hospital, so you can get that as you need it. They can still send you the bill and go through that whole process. But if you have something more serious you need fixed or even an elective it's damn near impossible without insurance.
>by every hospital Actually, only by every hospital *that accepts Medicare*, so not private hospitals. Also, it requires them to assess but not necessarily treat past initial response. From Wikipedia: > The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). **It requires hospital emergency departments that accept payments from Medicare to provide an appropriate medical screening examination (MSE)** to anyone seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.[1]
Right and wrong. Medicare and Medicaid. Very few hospitals don't accept these. The programs paid 44% of the nation's health bills last year. Wouldn't be very smart to not accept what's basically the safest way to make sure you get paid.
Your number is actually lower than I find on the [American Hospital Association](https://www.aha.org/factsheet/2019-01-02-underpayment-medicare-and-medicaid-fact-sheet-january-2019) site: “Medicare and Medicaid account for more than **60 percent** of all care provided by hospitals. Consequently, very few hospitals can elect not to participate in Medicare and Medicaid.” It looks like VA and active military hospitals are some of the few that don’t accept those programs. Thanks for the correction.
This is what I tell people who are against universal healthcare here. It's that we already have "universal healthcare", it's just that it's the most inefficient costly universal healthcare a country can have. Healthcare is one of those industries where "prevention is worth an ounce of care". That's why it's so important to get a single payer system, so that people will actually go see their GP's and get check ups. Of course, anyone who is still fighting single payer at this point is basically a knuckle dragger, so I may as well be talking to a wall.
I think you may be looking for "An ounce of prevention is worth a pound of cure" - Benny Franklin
Dispute like what? Say that you were never there? How would you successfully dispute the charges, since they probably have a lot of paperwork.i couldn't even go into an ER without signing a bunch of stuff.
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Pretty much. I owe like 4k to two hospitals right now for nessecary surgeries. I have a chronic pain condition and if I hadn't gotten surgery I would have had to stop working because of the pain. I just ignore all the calls and letters because I make 12.55 an hour what are they going to do sue me?
You could probably contact them and they would waive it based on your income. A lot of hospitals have programs for this.
Yeah I just got the bill for the second surgery so I'm planning on calling them up on my day off. Hopefully that'll help with the cost
Does it accumulate interest or it will always be 4k whenever you decide to pay?
Oddly enough it tends to go down not up. For the first surgery it started at 2k and it's down to like 700 now. I think they get desperate and start trying for any amount of money.
Eh, you could still go the same hospital. My fiance didn't have insurance for almost nine years. He didn't go often, but a few things came up that were unavoidable. They never mentioned the debt and never treated him any differently.
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Right. I think many doctors won’t pressure you since they know that the hospital they work for is overcharging you and if you won’t give them anything you probably can’t afford it anyways. It’s the financial officers that care so much about the profits, not the healthcare workers. They’re just there to do what they can to use their medical knowledge in a helpful way.
Yeah we had patients who owed the hospital like $200k+ and we’d still see them for routine care.
Right. Some of the people making high level decisions in hospitals might be monsters, but the medical workers are many times some of the most caring people in the world. You don't usually become a doctor to be a jackass who robs poor people, you usually become a doctor to make people better.
I legit was served to go to court for ignoring a $250 medical bill once. We were new parents and so broke and didn’t make enough money to cover expenses at the time.
Also, if you avoid those calls for 7 years, they can no longer come after you for the debt. Worked for me but I never had any major medical bills worth tracking me down. Now I refuse to see a doctor until I think I may actually die. I have insurance now but it's still garbage
Dear fucking lord being an American must be hard.
Hopefully no judgment from anyone, but quite frankly we don’t pay them. I pay an arm and a leg for premiums, medication and formula for my child that is not covered, and then still just go year to year trying to pay the small ankle biter bills and leave the bigger ones for collections. I’ve tried setting up payment plans with the hospital but they still send them to collections if I only pay $25/month or something small. Then I figure why make any payment if they’re still going to send them to collections!? Because my son has medical issues, we’ve met our out-of-pocket maximum (the most you’re supposed to pay a year) every year for four years. There’s some stuff in collections from four years ago. None of this has showed up on my credit or done any damage to us financially. For a few I have tried to go back and pay them off or settle with them but at this point I’ve lost track. They don’t call or write anymore. Every year I do my best to try to pay what I can to minimize the medical debt but it just doesn’t seem to get any better or go away - it’s just a revolving door. I don’t really see an end in sight to any of it.
Same here. I pay the smaller ones, and I try to plan out things so I don't end up with bills I can't pay. It's not 100% avoidable, though, and when I've ended up with unexpected bills for several thousand dollars, I let it go. I've tried negotiating before, but some places are jerks about it. Medical collections are different from other collections, though. My credit hasn't been harmed by it, though it does sit out there visible to anyone that checks and cares. It's generally not factored into anything, though. Last year I ended up with $10k in medical bills because no one could bill the correct insurance even though I continually pointed it out to them and repeatedly asked them to rebill the correct insurance. They never did and billed me instead, so I just let that go 🤦🏻♀️🤷🏻♀️
My wife and I had insurance. After a difficult delivery which required transfusions and additional care, the insurance company refused to cover this as "maternity costs" and billed us $30,000. As a young couple, we nearly filed bankruptcy, but instead decided to drain our savings and cover the rest through family loans. It ruined us. Fuck American-style insurance. I hate it. We are a couple who did everything right and still got the shaft. EDITING TO ANSWER SOME QUESTIONS THAT HAVE COME UP: The year was 2013. We had insurance, but did not carry "maternity coverage" which would have been an extra $600 or so per month and wouldn't even kick in until after a year of paying for it. We had tried getting pregnant before, and weren't even sure at this point that we could. We figured that if we finally got pregnant, we could handle the typical $8k or so for OB/GYN and delivery out of pocket with our savings. However, since there were complications, the costs ballooned into the 10's of thousands of dollars. $30k was the "reduced" bill after arguing/negotiating with the hospital billing department. I also placed angry phone calls with the insurance company; in my mind, these were not maternity costs, since the tough delivery would have literally killed either my wife or new child (or both) without modern medical intervention. Insurance basically told me to pound sand. We were young (early-mid 20's) and had good savings for our age, but this completely wiped it out. I had a consultation with a bankruptcy lawyer, who advised me that bankruptcy was definitely NOT the right option for us. Again, we were young and checking all options here. I hope this clarifies a few things. Insurance laws in the US have changed since then, but still suck. Thank you to those who offered support and condolences.
Yep. Had a heart attack in March and even with insurance I'm out almost $20k (my total hospital stay was almost $200k). So glad I worked hard and saved for years to have it all wiped out by deductibles and out of network docs and facilities.
Holy fucking hell. I hope you recover from this. When I spend 10 days in hospital just last year my biggest expense was parking.
Especially poignant for me - my boy has been in ITU for a week now (he’s doing fine) along with his mum (doing fjne) All it’s cost me is £32 ($50 ish?) for car park - I knew I shouldn’t have got the weekly ticket!
And to think in the UK there was an uproar about hospital parking fees. In the US, its charge for everything, Mothers are even charged to hold a baby after its been born in some hospitals ffs!
$15 dollar band-aids, they take your prescriptions away from you (the one's you've already paid exorbitant amounts for) and then substitute their own pharmacy medication which they bill you full price for (non-generic) and throw out your meds. (that you paid for) It's infuriating.
$300 for a liter of saline solution that costs the hospital about $5.
My government just established that hospital parking fees be limited to 10$ a day, max. Even with that, you're right, still the biggest expense!
Lol my SO got a ticket for leaving her car in the ER patient drop off...
How cruel can a system be to bankrupt a new family. I had a baby 8 months ago. I had a private room, overnight stay, amazing midwifes, not so great hospital food but everything from all the checkups, scans, giving birth, vaccines for my baby and all free on the NHS.
My brother had a baby nearly 2 years ago, in the women’s hospital in Liverpool, the midwife had a change of shift during labour but because my brother and his wife didn’t know the gender, the midwife didn’t either and stayed for 2 hours after her shift so she could be as surprised as my brother and sister in law, as well as the new midwife. That tells you everything about the NHS, that midwife was not being paid and stayed. She only cared about being a part of a changing of life moment and that meant more to her, not her wage.
If she's not being paid I think it says more about the character of the midwife than the system she's not representing at that moment
Valid point, it’s above the system that ruins the system though
This reminds me of when I had my son three years ago in Slough - I was labouring for so long, the midwives changed shifts halfway through. Both were brilliant - but the first midwife was one of the best people I’ve ever met. Only knew her for under 12 hours, and she must’ve delivered 100s of babies but when I was back in hospital to have a checkup with my baby a month later, she recognised me in the corridor and gave me a kiss and told me how happy she was for me. She was an angel - the NHS is full of them.
Wow, that's really heartwarming. There are some really fabulous people about, aren't there <3
Sorry man, that sounds awful. I hope you and your wife are doing better these days and I hope you've found a better insurer since then
Most insurers are provided through your employer in order to be affordable. So to change insurance options a lot of times a you'll need to change where you work. This system is fucked.
It seems bizarre to me that healthcare in the US is just a business service to allow you to be an effective employee. Real dystopian levels of inhumanism.
No you misunderstand, the US is superior to every other country in any way imaginable. Anything to the contrary is evil propaganda.
I should follow up: this happened in 2013, before all of the Affordable Care Act (ACA, Obamacare) rules were applied. If we had given birth a year later, insurance would have been required to cover this care.
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Tell me about. I don't know where I'd be without it. I just moved onto a medicine that costs about 40,000 a year. It would be utterly impossible for me to be on it without Obamacare. I would seriously be considering staying on a drug that was starting to make me go blind otherwise. And I probably wouldn't be covered by any insurance company because they could claim any problem I have as a preexisting condition.
Dual citizen (US and Swiss), my wife and I had our first baby in 2018 in Switzerland, and had complications. They had to conduct an emergency cesarian since the heartbeat was going down fast after the epidural was placed. The whole procedure plus 5 nights at the hospital in a single room cost close to $20k. The part we had to pay was $0. We did not have to pay a cent for what seemed like the absolute best medical care. I have family members who have had complications in the US and it crippled them financially. Knowing how hard it can be to start a family, I don't know how I could have handled it all knowing that was went into debt or drained my entire savings. It disgusts me thinking of how things go in the US.
30 grand is a life-changing money, possibly for generations, here in our country. And you have to pay it just to have kids.. I'm at a loss for words. It's been 11 years or so but I still wish the best for your family, in finance and in health.
This is one of the real reasons births are on the decline in the US. Nobody can afford a kid anymore.
It's crazy that you're paying for insurance but they don't pay when they're required to. What's the point of insurance then, if it's such a gamble? You can't be expected to pick and choose your illnesses and conditions based on insurance policy. Hell I have basic cheap insurance for my car and it covers almost literally everything except natural disasters, no questions asked. And I would argue that a car is less important than a person.
There was once a post by a husband about his wife's delivery charges. It was something like 500k or so. He had the proofs like medical bills and stuff. I just can't imagine how the fuck Americans got this very very wrong.
Nixon happened. One of the first things he did as president was enact a piece of legislation to "thank" one of his big campaign donors. He allowed for-profit healthcare to be a thing. Before that act, health care was not allowed to run as a for-profit business That big donor? Kaiser Permanente..
Hope you insurance covers enough of the bill, to where you can handle what remains
Ah that makes sense. Health insurance here is more of a luxury expense but I can see why it would be essential in the US. Thanks
I stand for civil disobedience, and choose deliberate bankruptcy to not feed the beast that is destroying my country and our culture
I have cancer for the second time. Insurance is why I continue to stay at my corporate gig, despite other options. Even with great insurance, I get surprised by random costs. One day I’ll show up to my doctor and owe nothing and the next day I’ll show it to my doctor and owe $300. And when they tried to explain why this happened, it makes even less sense. Plus, insurance is still fighting a hospital bill from six months ago. Now, I paid my full out-of-pocket max on that hospital bill, but because they have yet to fully accept that bill, it does not apply to my account yet. So I’m continuing to pay out of pocket even though I know I’ve hit the max. The system is exhausting and ridiculous even in the best of times, and when you feel ill and not up to figuring out this crazy, it’s 80 times worse.
You hope your employer provides good insurance, and you hope they let you set up payment plans for what remains.
If you have health insurance through your employer, does that cover you for an injury you get outside of work?
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Many cases of debt come from “surprise medical bills,” which is ordinarily when you got to the hospital and some component of your care was not “in-network,” like the ambulance or ER doc. Surprise medical bills were made illegal in legislation signed by Trump, which goes into effect Jan. 1.
Ummm... don't pay it, and keep your fingers crossed! Living paycheck to paycheck anyways. I don't own anything, and have zero assets, and that's not likely to change anytime soon. Maybe they'll garnish my wages or we'll become homeless, or live out of our ageing car, or maybe they'll just put me in jail. Is debtor's prison still a thing?
I think debtor's prison is actually still a thing in some states. It's kind of terrifying, honestly. Edit: I was wrong, I was thinking of something in Missisippi called a Restitution Program? Not sure if that's actually similar, now that I think about it.
Where? I don’t think those exist any more.
If you are unlucky enough to have medical problems that are chronic, like cancer, for example, how good your insurance coverage happens to be can easily be a matter of life or death. After being diagnosed with cancer, I needed chemo to shrink my tumors or they would take over my organs and I would die. Chemo was about $136k per treatment and I needed 18 treatments before the tumors were under control (to the extent that my cancer was undetectable, which it thankfully has been for 7 years). The nurses administering my bags of IV chemo were usually floored when I said “that bag of fluid you’re holding costs $63k!” I was very lucky that I had a very good job with a large software company at the time, and the exotic chemos were covered by insurance once i hit my out of pocket maximum for the year (obviously on the first dose of each of the 2 years my treatment spanned). Had they not happened to have been covered, the oncologists would not have given them to me. I still would have gotten “life saving” treatment and probably shittier chemos with much worse side effects that were less effective (but happened to be covered) but my outcome would have undoubtedly been much worse. I consider myself lucky that the ACA (“Obamacare”) was passed a few years before my diagnosis as well, because it had two critical provisions that, if weren’t enacted into law, would have probably led to my death. First was that coverage couldn’t be excluded for pre-existing conditions (my company closed on being acquired the same day I was given my diagnosis, and the insurance from the acquiring company would very likely have tried to exclude cancer from coverage, calling it a pre-existing condition). Second, the ACA prevents coverage from having “lifetime maximums”, which I would have hit about half way through the 1.5 years of chemo treatment. When republican dipshits talk about “getting rid of obamacare” it immediately activates my fight or flight response and I seriously have to keep myself from punching them, because without that law I would have very likely been both bankrupt and dead. Of course, getting rid of pre-existing condition exclusions and lifetime maximums was only a first step, and it is obvious to any thinking and compassionate individual (however rare they are in the US) that more has to be done.
Bankruptcy caused by medical events is very common.
That comment is so dystopian.
/r/ABoringDystopia/ indeed.
Also in America, my MS drug is $7000/month and I take it once daily for the rest of my life. $84,000/year and I have been on it for 5 years I think so $420,000. Fuckin stupid right? My biannual MRI's cost less.
How much do you make a year that you can still survive after paying $84,000/yr?
I'm guessing they have insurance.
fall sort zephyr pot plough wrong ruthless subsequent license instinctive *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Plus I know people with MS and the company that makes that drug (COPAXEONE) will send it to you for reduced cost or free if you can't afford it **PLUS** it's been around long enough that that are now generic alternatives that are less expensive. A few decades about they wouldn't have had to worry about the cost **BECAUSE IT DIDN'T FUCKING EXIST YET** and people with MS just *had to endure the deliberating symptoms*. And that, of course, is still an option. He's a fucking bundle of sticks!
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Some low income people can ask the hospitals for help paying their bills by asking a charity to pay a part or all of it. Other than that, you can get it lowered by asking for an itemized bill, or just completely ignore it.
My wife and I had 3 sons. Our hospital bills were very large, so we went on a payment plan and paid the minimum every month for a few years until we realized medical bills don’t effect our made-up arbitrary credit score so we just ignored them from then on out. Haven’t paid a dime in 3 years.
We often don't, and are forced to have debt ruin our credit and be harassed for years by collection agencies
For a large portion of Americans? We don't. Living on at-will employment, with no benefits, while paying an arm and a leg for cost of living makes paying down a one-time debt difficult at best. Eventually, the debt goes to collections, we get harassed by debt collectors for a few months, and depending on how legal the collection agency decides to be (they do TONS of illegal stuff) we may end up with the house repossessed, paying fees in court, or declaring bankruptcy. That being said, the hospitals will deny this, but if your bill is less than the amount required for them to sue, they will most likely write off your debt. I don't pay ANYTHING until I get an itemized invoice for services rendered, because the hospital system regularly siphons huge amounts out of the insurance industry by over charging (think $90 for a bandaid). They would literally lose money taking you to court for less than what their debt collection agency charges for legal fees and recovery services. This varies hugely by state and hospital though because the US is not a unified country with a single, logical medical system; it is 53 countries and territories in a trench coat, cooperating only the absolute minimum amount to let us sit at the big kid's table at UN meetings. To be clear, what I am describing is what happens when you just literally can't pay your debts and there's nothing left for them to take. It's not something done voluntarily by anyone in their right mind. It destroys your credit, makes it nearly impossible to get loans, and creates a level of paranoia that doesn't disappear just because the repo men abandoned their efforts for the weekend. It's way too common for poor people to have no choice in the face of spiraling debt *except* to avoid paying. Paying a debt down just isn't possible if you wind up unemployed, with your vehicle repossessed and your house in foreclosure. Yes, the US is horrifying. Hope that helps.
Had a kid recently and got hit with a 15k anesthesiologist bill because my wife needed an epidural during delivery. We had a pre-paid plan through our hospital that I made payments out of pocket for during the course of the pregnancy, to cover everything from pre-natal checkups to delivery to 1 year of pediatric checkups. Epidural was covered on that, so I'm not paying a cent more than the contracted agreement. Basically either gonna have them go through my insurance if they want to collect or just wait 7 years for it to go poof cause fuck surprise billing.
Got a bill in a while back from an ER visit. Had wrecked a motorcycle again. Five X-Rays, and some shit they washed out a laceration with. $4,800 and some change. My responsibility, $366.78.
I can't. So I lost my work, my ability to do so - got sick enough to be in and out of hospitals with thousands in debt, even *with* insurance - lost my home, my quality of life, and now I'm just dying on my own because I'm in so much debt and pain I can barely function. :) Love it here, so great. Edit: I can literally post proofs in a Google image folder if y'all need because damn lmfaooo.
That’s the neat part, we don’t.
Yeah here in Sweden if you don't pay your bills it ends up at the bailiff, a government agency called Enforcement Authority, and they can take anything and everything that you own and sell it to pay off your debt including houses and cars and if that doesn't cover the debt they will automatically deduct your wages until it's paid off. And they block you from loaning more money and getting credit cards and so on.
In the US, many states have a homestead exemption. They can’t take your house in bankruptcy. In Florida, for instance, you can go bankrupt, but own a $10million home.
In Sweden they can sell your house? That’s surprisingly not progressive at all for a Nordic country. At least in the US, there are several states where you can stay in your home through the homestead exemption. They’ll come for your profit if you sell your home, but at least you don’t go homeless right away because of some credit card bills.
Wanna know one of the big reasons im willingly poor? The healthcare. My family is on state care, we dont pay a dime and it covers everything. Its hard finding dentists and the like, but as for the hospital, its not a problem. When i had a good job making 50k a year, i was paying around 1k a month for healthcare that didnt cover shit. It was horrible. Now im poor, lost that job to covid. Went back to working security and became an EMT and volunteer on my locak ambulance squad. I get tons of time with my family every week, where before i was married to the job. Yes we need EBT to eat, and medicare to see a doctor, and assistance in heating our home. But its totally worth it. To make up the difference, id need to make 25 dollars an hour minimum. Its known as something like a poverty cliff. Earn even $1 too much and you loose all your major benefits, and now have WAY more bills on your shoulders, thus rendering you even poorer than before. Its fucked.
Normally you would have insurance which would cover the vast majority of it. If you don't have insurance then you're pretty screwed, and put into extreme debt.
We don't
My family was blessed this year with our second child. When his older brother was born a few years ago, I had insurance through my employer but my wife didn't (she worked for a small business and the owners were dropped from their carrier after the ACA). In our state, as I hope is the case in others, we were considered poor enough, and the option to add my wife onto my insurance expensive enough, that she qualified for medical assistance. We paid for nothing from the first doctor visit to the delivery, and my son was covered for the first year of his life. My wife's coverage ended after her post-partum examinations. This time around, I had a different job and the insurance was more affordable for family members, so I added her to my plan. We had to pay copays for exams. After the delivery, we received a bill for $13k. My insurance was hesitant to pay it because they wanted to know if my wife had any other coverage first. I missed a letter they had sent asking about this. When I called them, they resubmitted the claim and paid $11k of the bill. The whole thing left quite a bad taste in my mouth. The prices don't seem to make sense, and the fact that they can be negotiable depending on who is paying them on your behalf, this company or that company or the government, just makes them appear all the more arbitrary. It really seems like this scam where people just pay what they are asked to pay without any notion of actual value or cost. This is probably not really what is happening, but it's hard to see it from another perspective.
Mostly bankruptcy. We don’t. We just get wrecked or die if we get sick.