I have written before about the crazy cost of health care but a recent experience has inspired me to write about it again.
I rarely go to the doctor. I think I’ve been to the doctor 4 or 5 times in the last decade. There are a couple of reasons for this. One being that for the first part of the decade I didn’t have any health insurance and since then I’ve had health insurance with high deductibles so going to the doctor is an expensive proposition. If it were not for the fact that I had a couple of “free” doctor visits when I was in law school I would have visited the doctor even less. The other reason is that I have been pretty healthy for the last decade. I haven’t had any significant injuries and very few illnesses. I don’t visit the doctor when I have a cold since there isn’t really anything they can do for it. Participating in medical studies also has a side benefit or providing me with a free physical.
But I did decide to visit the doctor earlier this year. I’d been having some pain and my wife suggested that I visit her doctor. When I got to the doctor I explained that I had high deductible insurance and needed to keep my costs down. Both the doctor and his staff were helpful and provided me with the cost of the visit and the tests to be run. They did explain that there was one test that they couldn’t be done in the office and would have to be done in the hospital lab. I paid for my visit and the tests that were done in the office at the time of the visit. They explained that I would be billed for the hospital test separately and after the cost was adjusted by my insurance company it should come to about $64.
I was not happy when a couple of months later I received a bill for $389. When I called the hospital to inquire why the bill was so high they explained that my insurance company said the test was not covered and this was the normal cost of the lab test. I knew my insurance company would not pay the bill but in the past they always reduced the bill to their usual and customary rates. This time they just stated that it was not covered. I later went to the billing office and asked if I could have the bill reduced to the $64 that I was quoted. I believe that is what my bill would have been if the insurance company would have processed it. The person there actually told me that everybody pays the same rate for the lab test whether they are an individual or an insurance company. I knew that couldn’t be true. When I showed the estimated bill the doctor’s office gave me she seemed confused and asked another worker to look at it. This worker looked the bill up on the computer and noted that the insurance company did not pay it and didn’t even apply it towards my deductible. She then told me that since the insurance company didn’t apply the bill towards the deductible I was eligible for a 40% self-pay discount. That seemed strange when I had just been told a couple minutes before that everybody paid the same rate but I figured taking the discount was my best option. I ended up paying $227 for what should have been a $64 lab test. If this had resulted in resolving my problem it would have been worth it but since I didn’t it seems like a big waste of money.
I don’t suppose there is much I can do about it. If I go to a doctor again I’ll see a different doctor and I’ll make extra clear that I want to pay all expenses at the time of the visit. Also I am going to visit eHealthInsurance and find a health insurance plan with a different company. Since I’m an affiliate of eHealthInsurance that will help offset some of the cost of getting a new health insurance plan.