hi they charged my insurance over $10,000 for the mri I also take lyrica and I have a $ 40 copay for a month supply
There is no rhyme or reason to the US Medical system. Everyone gets charged differently for the same MRI at the same facilitiy.The same with Pharamceuticals.The Government sets the rates for Medicare reimbursement which is too low for service. The insurance companies one by one negotiate with the facilities and Drug plans every year or so, which is based loosely on Medicare. There are people without insurance because they can't afford it or can't get it because of pre existing conditions. Those with assets can be ruined those without can let medical bill go to collections if they do not own a home.
The hospitals have this debt. People think they write the debt off. What they do is collect it any way they can by hidden fees. Everyone with private insurance pays more than for there medical costs to help make up for the losses. Soon this plan will not be sustanable because they are squeezing blood out of turnips.
Customary and Reasonable Charge for the Denver Area is about $900 per body part for an MRI. So $900 for brain, $900 for C-spine and $900 for t-spine. List price is much higher. Most imaging centers can be negotiated (shhh! don't tell too many people) down to the CRC amount. Still more expensive than the UK.
There are way too many middlemen and "fiscal intermediaries" in the US health delivery model. Everyone tacks their "overhead and profit" on to every cost, so by the time the bill gets to the actual consumer, 15+ people may have jumped on for the ride.
One of our problems here seems to be the regulations and oversights of all things medical. At a luncheon yesterday I heard a neurologist speak on future treatments for MS.
He said that Europe is usually 5-10 years ahead of the US in approving drugs because there are not as many review processes that have to be done over there. He pointed out that when a NEW treatment arrives to us in the US it usually comes backed with years of experience from the European community as the initial guinea pigs as the test subjects.
Actual costs for services and drugs vary here. There is the suggested retail price, then there are the customary & resonable costs as Bob illustrates, and then there are the actual prices negotiated by insurance companies that Alex writes about.
What the patient is left to pay depends on their insurance coverage and what has been negotiated. It is a system that often defies explanation and always eludes logic.
If you have no drug coverage Lyrica will cost you about $350.00/mn. That for 3 tabs of 100mg/day ouch! Our FDA (food and drug association) is why. I have gotten my meds through Canada and they are so much cheaper. With the laws in place now here in the good ol' US of A it is being considered a narcotic. So you can't get Lyrica through the mail just like pain meds. The meds I got through Canada funny (well not real funny) most came from England or India. The FDa ie:: government will not let meds be bought cheaper. The pharmaceutical industry has us by the B____s. The reasoning they give is the cost of research. Not really because the other countries have put in all the information on so many of these drugs. We could have the cheaper meds too if we would combine with these other countries, probably bringing down their cost too.
Most drugs are made over seas by foreign drug companies. Then the big companies own hundreds of small drug companies which break other companies patents. They make enough money to pay the fines.My head ache Medication which is a TEVA generic is made in India.I did a lot of research for a paper. My favorite line is drugs from other countries are not safe because the U.S. can't inspect them. We pay more for medication than all the countries of the world combined.