Out of network Hospitalist charges

I guess things are different when you live in an area with an abundance of top doctors and hospitals. The only time that I have been unable to see any doctor that I want within a few days is because that doctor is out of the office. I have never had my insurance company delay or deny any procedures or medications.

Petitarte- I agree with Kazbern, I also wait 3-5 months to see a Dr. although I am in medium sized city. My insurance is classified as a decent plan through my spouse who also is covered under a government plan and we have average copays however the hidden costs are astounding. It is amazing what insurance companies exclude or require additional deductibles or copays. I was in the hospital for 6 days and so far my out of pocket costs exceed 6K. I am still waiting for at least half of my bills  to come in. No telling what the final tally will be.

I am very happy for you that your experience is better with hospitals and insurers than mine but I think most Americans are not as lucky. For most of us, going to a hospital can be a financially draining experience, unfortunately.

Cleanfreak- I agree. I wish our politicians could all agree to properly fix our HC system. I would propose taking the best ideas from each system in the world and integrate it to form our system. We deserve the best of the best 

Post Edited (pmedic) : 6/6/2012 3:56:06 PM (GMT-6)

Wow! I didnt know those type of policies still exisit. You are very lucky!

I have $300 per day inpatient copays plus additional copays and deductibles per procedure and for others such as xray, labs, ct, MRI and the list goes on and on. I also have so many exclusions and hidden deductibles. A trip to the hospital with my insurance can be a bankrupting event. The sad thing is my policy is considered a "good" policy, LOL.

I wait 2-3 months for Dr. visit unless I see a NP, then the wait drops to under 30 days.

I tend to think my policy is more representative of what the majority of Americans contend with but maybe (hopefully) I am wrong. Either way, it stinks. You dont even want to know what my Dr. copays or premiums are. If this trend continues, I dont know how most Americans will be able to afford to pay for coverage that really doesnt cover much. What good does it do to struggle to pay large premiums for an insurance that still leaves you holding the bag with more than you can pay when or if you get sick? It doesnt bode well for the future.

We had a choice of three plans to choose from and this was the "best" offerred by the employer. It is considered a high end plan because it only has 3 tiers for medications instead of 4. We paid much more for this plan for that reason alone in case I needed a biologic, which I did later. Most people in my area think I have a great plan in comparison to theirs, LOL. That is where this is going, sadly.

I could only wish I had such great insurance! I would have a large copay for Cimzia but I have a copay assistant card that brings that down to 0, thank goodness.

Oh, cleanfreak, I love that you spelled his name O'Bama!  It's really Obama, except on St. Patty's day, LOL.

I'm personally not opposed to the health care reform that Obama got through Congress.  I don't think it's the right solution, but I do think it's an improvement over where we are today.  I think a lot of people on the left want a single-payer system like yours, and are not happy that the new law didn't accomplish that.  A lot of people on the right think having Gov't collect money and then pay for health care is just not what gov't is for; they don't want gov't in their lives in that way.  I think those people are not well informed, because polls show that many people with that stated belief are also benefiting from medicare, which is exactly what we're talking about (single payer, gov't managed health care with an option for better services if you pay more) but for people in retirement age.  Of course, medicare has many problems, and it alone does not pay for itself, so that's not great.

It's a difficult problem.  DRs in the US aren't happy either.  With all the talk on this thread about how expensive medical care has become here, it is not the DRs reaping great financial rewards in most cases.  Insurance companies and the beaurocracy they have made necessary is where most of the cost comes from IMO.  And insurance companies are the primary beneficiary of the new health care reform.  Draw your own conclusions, LOL.

Hey, I agree with you, but things are generally more complicated than "red" or "blue."

A couple of years ago we had to renovate our house from the ground up because of a fire. We were stressed and trying to move fast, not spend over our limit etc. We hired a carpenter to build our kitchen cabinets because he was extremely good at it, worked for a reasonable rate and liked working with our designer. about 2 weeks into the job he told us that he was having health problems. He had a basal cell carcinoma that he had left untreated for 15 YEARS because a) he had no health insurance (it was "too expensive") and b) he didn't want to have a minor surgical procedure because it would disrupt his business and cost $$. At the point he told us this, the cancer had eaten through his skin, muscle and bone and he was septic and looking at either dying or having half of his upper body cut off. The surgery to keep him alive at that point was going to cost about $.25M. None of the [really great] cancer hospitals in our town would take him on as a charity case because he had assets (house, car, business) that they thought he should liquidate before they dipped into their endowments.

And I'm sure this guy was opposed to Obama's health care reform, because under the new law he would be made to buy insurance. He felt it was his right to NOT buy insurance, and yet he wanted to depend on the charity of the hospital system to save him in his time of need. As it turns out, the designer raised a bunch of money from her wealthy clients, the hospital agreed to cover his surgical costs and they ended up spending about $.75M to rebuild his shoulder, collar bone and scapula so he could continue in carpentry.

I was maddened by the whole situation. Bad decisions, bad industry, bad situation = expensive solution.

Totally off topic, though.

Cleanfreak- I agree with you completely and the example Kazbern used was spot on. With all my surgeries and hospitalizations and tests, no copays or deductibles sound real good and hard to argue with ! Sadly, many people who are healthy never picture their self in our position so I don't know if things will ever change, unfortunately!