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Question regarding insurance and medical bills...

vhx

vhx

Golden Member
My friend a year ago or so almost died due to a reaction with some medicine. Anyways, after everything she ended up having to pay like $1,000 (after insurance) for the trip to the ER and other medical bills.

Fast forward to this year. Her uncle just got out of prison, won't get a job unless it comes to him, and basically lives off welfare and mooching. Recently, he had some bladder problem (I think it was a stretched bladder?) and he got taken to the ER. Then he had to get surgery done to correct it. He didn't have to pay anything, not the trip to the ER or for the surgery. Not a cent.

So my question is, how does one who pays for insurance pay $1000 in fees and one who has no insurance or money, gets everything for free? She wasn't able to get much information either. Thanks for any help.
 
People like her uncle are the reason WHY her out-of-pocket is around $1000. Since ERs and hospitals can NOT refuse to treat life threatening ailments, they shift the cost on to insurance companies for other peoples' treatments to make up for the loss (in the form of simply raising the cost for everything); who then shift the cost on to the consumer in the form of increased premiums, deductibles, co-insurance, co-pays, restricted drug formularies, restricted in-network providers, denied claims, more scrutinized procedure pre-approvals, maximum out-of-pocket costs, etc...
 
GF has really good insurance, and pays no copay for anything, went to the emergency hospital, and insurance covered everything! pretty neat, not sure why your friend had to pay....
 
Originally posted by: ViviTheMage
GF has really good insurance, and pays no copay for anything, went to the emergency hospital, and insurance covered everything! pretty neat, not sure why your friend had to pay....
Click to expand...

That's just the difference between policies. My wife's employer, luckily, has good insurance. So we only paid something like $200-$300 total for 4 days of inpatient treatment (out of a total bill ~$16,000) recently. Other peoples' policies just suck...namely wait staff who often are only offered policies which only cover up to some arbitrary but inevitable pathetically low amount ($7,000 from my old employer).

...which then is often partitioned in to certain criteria; like $500 for ER treatment per year, $2000 for surgeries, $1000 for inpatient treatment, etc...

My old co-worker had to have his appendix removed and admitted for a couple days since it actually did burst/leak a little and they were worried about sepsis. He ended up being about $18,000 in debt from it.
 
In this country you either need a GOOD insurance policy through your work, or you need to be totally destitute. In all other cases, you'd better just cross your fingers and hope you don't get sick.
 
As someone on disability I can tell you this:
If it isn't directly life threatening, they get much less treatment. Disability is the worst HMO on the planet... the only reason life threatening things are taken care of is think of the backlash the gov't would get if they let someone die from something that was treatable.
My problems are easily treatable with around $15,000 total of surgeries and treatment, and yet they have refused treating me for a decade for my problems (which would allow me to get back to work), instead making me sit on disability. In the end the expense will be much greater for them.

(side note, not pertinent to the thread) For those that care about my personal situation: I think I may have found a way around it, I just discovered that one of the major problems Ive been suffering through is porphyria, and began self-treatment. With any luck, my other problems will be manageable enough with my porphyria being treated that I can get into trade school and back into the job market. I am so excited about the possibility. I am trying to get everything together so that I can get into durham tech for fall classes. Once I get a job I should be able to save up enough to pay for my own surgeries and treatments... I am so happy I finally see a way out of this quagmire!
 
Originally posted by: jaqie
(side note, not pertinent to the thread) For those that care about my personal situation: I think I may have found a way around it, I just discovered that one of the major problems Ive been suffering through is porphyria, and began self-treatment. With any luck, my other problems will be manageable enough with my porphyria being treated that I can get into trade school and back into the job market. I am so excited about the possibility. I am trying to get everything together so that I can get into durham tech for fall classes. Once I get a job I should be able to save up enough to pay for my own surgeries and treatments... I am so happy I finally see a way out of this quagmire!
Click to expand...

That's awesome, good for you!:thumbsup:
 
Originally posted by: jagec
In this country you either need a GOOD insurance policy through your work, or you need to be totally destitute. In all other cases, you'd better just cross your fingers and hope you don't get sick.
Click to expand...

QFT...sadly. Even if you shop your own insurance, on the bad luck that you do actually acquire some sort of chronic illness, they'll end up raising your rates to rather unaffordable levels or just drop you entirely, throwing you into pre-existing condition territory.
 
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