A few years ago my husband needed a medical test. An expensive medical test. It was one of those tests that was going to tell the doctor if he had something serious wrong with him. It was NOT covered by our medical insurance. Why? Because our medical insurance company deemed it not necessary. Aside from exploratory surgery, there was no other way to determine what the cause of the problem was. This was our only other option. They still denied it on grounds that since he wasn’t dying… he didn’t really need the test.
If my husband had been in the hospital, they gladly would have covered PART of the cost of the test. Fabulous.
We had a choice: either forgo the test and hope that he didn’t end up in the hospital, or, pay for the test ourselves. Out of pocket. With none of the cost going towards our rather high deductible. We opted to just pay the damn thing.
My husband decided that since we were coughing up the cash ourselves, we were going to get the best deal possible. He called around. Yes, that’s right… we shopped around for the best deal on this particular medical test. What we learned was disturbing. Each place he called gave us a different quote. They ranged from about $1,800 to $800. That’s quite a difference in price, wouldn’t you say? Same test. Completely different price.
Last Sunday, I was reading the Los Angeles Times when I came across an article about the high cost of medical tests. We all know how much those tests cost, but what was shocking was the complete range of costs given depending on whether you get the test done in a clinic or in a hospital. It also was shocking how much the same test cost depending on whether you had insurance or not.
Now logic would say that if you pay hefty premiums each month to provide you and your family with medical insurance, your medical bills should cost less… much less. Unfortunately, that is not the case. Doctors and hospitals have a completely different cost scale when it comes to the insured vs. uninsured. If you have insurance and you need a test done, my first piece of advice would be to NOT have it done at a hospital. Hospitals are notoriously known for inflating prices. Why? Because they know that medical insurance doesn’t cover the entire cost. They have negotiated rates with the insurance companies and when they bill the company $1,000 for a particular test, they know the insurance company will only pay about $500 of that. If your insurance company doesn’t pay any of the cost, that $1,000 is passed on to you. You get a whopping bill for $1,000 for a test that simply told you you had nothing wrong with you. But… if you didn’t have medical insurance, you would be billed directly from the hospital. Now, the hospital KNOWS you can’t afford $1,000 so chances are they would send you a bill for $500 which you could then contact the billing office and make arrangements to pay it over time. If that same test had been done in a clinic, you would most likely be paying around $250. So, without insurance you could be paying $250… WITH insurance (which they aren’t even covering because they deem the test unnecessary) you could be paying $1,000. WHAT????
This isn’t new. In fact, it’s been going on for a very long time. Think about all the medical bills you’ve paid out over your lifetime and then think about if you had even HALF that money back. Life changing, isn’t it?
How many of you even CHECK your hospital and doctor bills? Do you take it for granted that they are correct? We check all of our bills and then check them again. In most of our medical bills we have found mistakes. Enough mistakes that we were being charged large sums of money for tests that weren’t even performed. That’s right… simple things like a child’s urine sample…. that was never done because my child couldn’t “go” at the time of the office visit.
We were raised to trust doctors… and in return, we take for granted that the medical tests they perform and the bills we’re sent are necessary and correct. On very few occasions is this the case.
The more aware you are of what your medical needs actually cost vs. what you are paying for them, the better we can all work towards bridging the gap for all of us: the insured and the uninsured. No wonder so many people are uninsured. Maybe they know the secret… that you actually pay less than if you had insurance to begin with.