Uninsured, extortionate hospital bill, freaking out.

5 months ago I visited the ER because I thought I had sprained a rib. They took an x-ray, then did a blood test to check for something else. They found no injuries or problems, so I left, that was that. I had an international health plan because I had been living abroad for 3 years. I thought I was covered, but it had expired; therefore technically I was uninsured.

I braced for the worst.

Couple months later I got a bill for $423. Not too bad, but I couldn't afford it and appealed. They wanted bank account details and tax records. Bill or no bill, this is invasive and humiliating, not to mention private in my opinion. I had no records because again I had been living abroad (and living in a healthcare system where patients didn't get bills). I bit the bullet and scraped together the cash and paid the bill.

Then yesterday, 5 months after the visit, I get another bill for a whopping $1404. My blood began to boil, my heart raced, I could feel my stress-o-meter rising. Do they really, honestly think they just send out a bill for this kind of money and I am going to cheerfully whip out my checkbook and send them fourteen hundred dollars? If I had ever known a brief, routine visit to the ER would cause me so much stress and grief, I would NEVER, EVER have gone. And in the future, I will think twice about going back. Great system, America.

I simply will not pay this bill, ever. I don't really know or care if this garners any sympathy, but my question is what kind of effective recourse do I have in challenging this?

[Amir Mostafaie]

Dear seeeker,

I believe I can provide you with some information and background on the health care system that will help you understand the charges!  

Majority of the insured population in United States are covered under some sort of network plan like PPO (Preferred Provider Plan) or HMOs (Health Maintenance Organization.
Why insurers like offering these types of plans is because they are able to reach out to the majority of the provider population (like doctors & hospitals) & pre-negotiate discounted fees for all services & benefits including lab work, procedures, facility charges and prescription medications. Pre-negotiated discounted fees work like whole-sale prices and are one of the biggest advantages of PPO & HMO type plans to plan members too.

That said you can’t benefit from any of these discounts if you don’t have a network plan (PPO, HMO) or don’t have any coverage at all.

When hospitals & ERs deal with patients without a network type plan, they will charge them according to their “list price” which is high enough to cover the high cost of running an ER where a lot of people treated don’t have any insurance & never pay their bills.

In other words the paying patients pay higher prices to cover the overhead. That’s why Tylenol can cost you $18 in the ER!

Now this doesn’t mean that you can not contact the billing dept. of the hospital & negotiate with them. By negotiating, you are basically bargaining with the hospital about the charges.

When contacting the hospital to negotiate, remember the following tips;
Stay calm, collected & professional throughout the call,
Be courteous to the representative,
Don’t be afraid to escalate the call to a supervisor if you feel you have tried everything else,
Establish that you have every intention to pay your bills & that is why you are negotiating to achieve a reasonable amount, then only you can afford to pay them.
After you negotiate lower rates, ask for a payment plan with no interest.

Sincerely,

Amir Mostafaie

[seeeker]

Thanks amir,

I am American so I do know the system here I was just not used to this at all. I've seen it all on the news, and felt sympathy for those with $65,000 bills, or those who have gone bankrupt because of this system, and it is truly shocking the level of stress that this all brings on. Unbelievable. I have read by now numerous posts from people with similar and far worse situations than mine, gosh my heart goes out to them.

I called the hospital (after cooling off for a day and doing a little research). They would not lower the amount, but initiated a payment plan, which I have to call back about in a couple weeks. I offered to pay them $1 a month for the next 1404 months.

The saddest part of all of this is, I will probably never return to a hospital unless I am bleeding out of my ears or have broken all limbs. What a f******g headache.

Health care is a right not a privilege. This is NOT the greatest country on Earth, in fact it is quite cold and brutal. Better hope you're not one of the 47 million uninsured. This comment will surely invite criticism, but I will not continue any debate, that is for another forum.

Thanks again for your advice

[mags59]

I am also uninsured and went to the ER for a racing heart (thought I was having a heart attack).  I ended up with approximately $4000 in medical bills. And no, they would not negotiate a lower price, that's bull.  I cannot afford any of it, yet I can't get any kind of financial assistance because they say i make too much money.  I barely get by eating ramen noodle soup for breakfast, lunch and dinner.  I never, ever go out, don't have a cell phone or cable, haven't purchased new clothing in years, and live paycheck to paycheck.  Yet I make too much for assistance.  What makes my blood boil is that incarcerated criminals are ENTITLED to free medical care while serving time.  I am a law-abiding, tax-paying citizen, and even I'm not entitled to that.  It makes me want to move to Canada or Europe.  If I had the money, I would.

[seeeker]

Hi,

I understand your story and that makes me fuming mad as well.  It's totally wrong. The entire health care system in this country is an absolute disgrace. The most fundamental thing you can realize about the US is that you are absolutely on your own and will have no assistance for anything, ever. You might even lose our retirement if you have any.  It's amoral, cruel, and lacks any compassion. What infuriates me the most is the contradiction between the compassionate and loving passages from the bible (bible thumping America), and the socio-political reality that you shall receive no compassion or assistance. It's all ********.

I lived in London for 3 years, and unfortunately I couldn't stand it there for different reasons. There were definitely reasons to complain about their National Health Service, but in this situation you wouldn't even see a bill ever. It was a breeze to make an appointment, see a doctor within hours, get the care you need - even substantial life-saving care, be on your way and that was that. I have to commend the European health care for its convenience. No stress. No bills. No bankruptcy.

In my situation described above, they would not reduce the bill, in fact they chuckled when I asked (f***ing a**holes). We established a payment plan for a minimum amount per month, *no interest*. That's probably what you should do as well.

Good luck. Yesterday I felt the same pain in my ribs that caused me to go in the the ER. Now I think I know its not serious, but I will certainly never go into an ER again, or get any care, unless I know I'm half dead. Great system.

[seeeker]

I meant "...you might even lose *your* retirement..." not "our" retirement.