i realize all insurance pays differently, but i am curious to hear of costs left over after the insurance has paid. i am scheduled for surgery march 24 and am trying to figure out how i will pay for the remainder.
any replies will help!
thank you
rebecca
I just received the total bill from the hospital....................$44,000.00+. My co-pay is $100.00. I still have to pay all the co-pays for each PT session (9 sessions at $29.00 each) and a few co-pays for the doctor visits. I also have some stragglers that the insurance has denied for some reason or another that I have to follow up on. I am extremely grateful for the health insurance my employer carries! I could buy a couple of cars with what the hospital charged!
The $44K was for the hospital bill. The doctor bill was $15K+!!!
Does anyone have anything to add to this post, I'm trying to make my self feel better about the my cost. Hip is great insurance is not.
Tommy
My cost after insurance for bi-lateral hip resurfacing was $2,500.00 which was my insurance deductable (100% coverage after that). The surgeon's charge for both hips was about $4,000.00 The hospital (4 nights) was in the $40,000 range and included everything but the surgeon's and anesthesiologists' charges.
My PT is all covered.
Ted Roberts, BHR Bi-Lat 1-7-09 Dr. Nelson, MPLS, MN
I'm paying for half of the hospital charge and the price of the BHR device really suprise me. 35910.00 WOW! My wife works at a hospital that does BHR's so she is checking with the smith&nephew rep to get more info. thanks for replying Ted
Tommy
I know I'm resurrecting an old thread, but in my mind, this is one thread that can be beneficial for a long time...
I just had a resurfacing done on September 21st, through Kaiser Permanente. I have to say I feel very blessed, reading this section of the board. My cost for my surgery was a $250 admission fee, which was reimbursed to me through a program subscribed to by my employer. Aside from prescription costs, my only out of pocket was for a monthlong hostpital bed and commode rental, which totalled ~$220.00.
Overall surgery out-of-pocket: $0
I was very nervous, going into the pre-planning process, because words like "elective" were thrown around, which would have made me responsible for 100% of the costs. Turns out, it was a wording issue on a form that the surgeon filled out. Once he clarified, the surgery was deemed medically necessary and covered under my health insurance. Prior to 2010, my wife and I strongly debated returning to Kaiser, as we live out of the coverage area. A situation like this is precisely why we decided that it was worth it.
I am still fighting with United Healthcare over my out of pocket expenses and "deductible".
HSS in NYC charged $50K+ for 3 nights, and a skeleton nurse crew over the holiday weekend. Service was adequate. Surgeon fee was another $16K, anesthesia was another $4K. I am still getting random bills almost a year later. Another $600 for surgeon, $800 for anesthesia, $1000 for the HSS. I am happy I had the operation with the surgeon I did, but never having anything remotely close to this, I was and still am blown away by the charges levied upon me and my insurance company.
I also had surgery at HSS. My insurance paid for everything except about $500 co-pay and travel (except one night lodging at $80/nite for pre-op tests). This includes about $71,300 for surgery and $5,500 for 5 1/2 months physical therapy after surgery.
But I have a union managed health trust and the benefits are generous to members, compared to many other plans.
Just wanted to bump this up to see if anyone wanted to add their total insurance costs, both gross and net, to this thread. Might help others for planning purposes, also? I was anticipating total costs of about $50K but apparently may be underestimating it quite a bit, based upon these several posts. Thoughts or additional information?
Take care,
Kate
I am trying to keep track but currently I have 4 separate "account numbers" at the Clinic - it is like getting your car repaired and Joe who changed the oil send you a bill form the shop and Mike who changed the ties from the same shop sends you another bill on the same letter head....and on it goes, so I am trying to keep track. Then I have started to get the bills from the "independant contracts" - I think these are the PA's that saw me over the weekend.
I know just two bills (Surgeon and Hospital stay) added up to $55K
Also the cute things on our legs we "rent" were $1350 for the couple of weeks - hard to think they even cost that much
Good description of the Kafkaesque nightmare that is US hospital billing Phil.
I have gotten so many separate claims that they take up a page and a half on my Blue Shield website. I get separate claims from the hospital, the surgeon's practice, pathology service, anesthesiology, radiology, pharmacy, physical therapy, etc., etc. They come in at unpredictable intervals and I'm supposed to pay my share as I get them. Very hard to keep things straight.
The amount of each claim seems to have little relevance to the actual costs. For each surgery I got a claim from the hospital for about $55,000 and from the ortho practice for about $6,000. The "allowed" total for the hospital was around $19,000 and for the surgeon about $2,000. I have a spreadsheet on which I'm keeping track of what comes in and how much I have to pay. I don't have any totals yet, though
I have a $4,000 deductible (for the entire family) and then 20% coinsurance up to a $7,000 annual out of pocket maximum. I probably spent $1,000 of my deductible before having the surgery so, in theory, my total cost should be about $6,000. But...I should also have $0 medical out of pocket costs for the rest of the year due to the annual maximum. We'll see.
Hospital Bill for first hip - $52 K
Hospital Bill for 2d hip - $46 K (less complicated than 1st).
Doctor's bill for both - ???
My responsibility - $200 per hip / $400 overall.
Visiting nurse and in home PT - ??? - my responsibility - $0
Outpatient PT - ??? - my responsibility - $20/visit, about $200 total / hip, $400 total.
No pain - priceless.
Quote from: phillwad on May 03, 2011, 07:41:23 AM
Also the cute things on our legs we "rent" were $1350 for the couple of weeks - hard to think they even cost that much
I found them online for $1,800 to buy. I'm going to start a squeezy boots rental business! Maybe $100 a week rental charge, expect to rent them 1 week in 3, that's over $1700 a year. Allow 30% for overhead, 3 year depreciation ($600 a year) and I'm making over 30% a year ROI, which sure as hell beats my other investment returns.
It really is unbelievable how much hospitals rip people off.
http://www.google.com/products/catalog?q=huntleigh+flowtron&um=1&ie=UTF-8&cid=11298109515622603545&sa=X&ei=guHCTYeJLML2gAep3bmEAg&ved=0CDIQ8wIwBA#
The leg pimp I had did not look anywhere near a big or complicated - I will try and track down which one I had and find a price - Phill
Leg pimp?
At the prices they charge, they could indeed have a pimp somewhere in the chain of distribution.
:D
Kate - thanks for picking up on my spelling error - big difference from leg pump :-\
Phill
Just got the first bill from the hospital ... total billed a tad over $56K, with almost $19K for the device itself. Wow. Amazing.
Now, how come these foreign doctors can do the whole job at a quarter of the price or less? And still make money on it! I will have to look out for the itemised bill I got from hospital, but I am sure that $19,000 for the device is somewhere over a 1000% markup.
Quote from: lopsided on May 18, 2011, 09:30:26 AM
Now, how come these foreign doctors can do the whole job at a quarter of the price or less? And still make money on it! I will have to look out for the itemised bill I got from hospital, but I am sure that $19,000 for the device is somewhere over a 1000% markup.
But... didn't you get a pair of complimentary TEDS socks??? ;D
Quote
But... didn't you get a pair of complimentary TEDS socks??? ;D
There's a separate $1,000 bill for those in the mail. :o
But I'll throw them in for free if you rent my leg pimp ;D ;D
Quote from: halfdone on May 18, 2011, 10:28:42 AM
Quote
But... didn't you get a pair of complimentary TEDS socks??? ;D
There's a separate $1,000 bill for those in the mail. :o
But I'll throw them in for free if you rent my leg pimp ;D ;D
Halfdone, is that a hippo in your picture?
Hernanu, where is your picture?
Quote
Halfdone, is that a hippo in your picture?
Yup Lop, that's Hippy Hippo cruising the Zambezi
Quote from: katekosar on May 18, 2011, 06:52:06 AM
Just got the first bill from the hospital ... total billed a tad over $56K, with almost $19K for the device itself. Wow. Amazing.
Kate,
Have you seen the Explanation of Benefits or any kind of claim form from your insurance? The costs billed by the hospital are always highly inflated and they never collect that amount from insurance. The hospital bill from my first surgery was also around $56K (not including the surgeon, anesthesiologist, labs, etc.) and I had the same initial reaction ( :o ) but after being adjusted for the "allowed" amounts (which are pre-negotiated rates between the insurance company and providers) it came out to about $19K. Still a hefty price tag but not nearly the original.
Quote from: halfdone on May 18, 2011, 10:47:29 AM
Quote
Halfdone, is that a hippo in your picture?
Yup Lop, that's Hippy Hippo cruising the Zambezi
Ahha. Now I get the connection.
Quote from: halfdone on May 18, 2011, 10:28:42 AM
Quote
But... didn't you get a pair of complimentary TEDS socks??? ;D
There's a separate $1,000 bill for those in the mail. :o
But I'll throw them in for free if you rent my leg pimp ;D ;D
The items I have but no longer use include:
two pairs of knee-high TEDs
two pairs of those little skid proof hospital socks
one pair of slightly used but admittedly inferior axillary crutches
one grabber
one 6" bed wedge
one collapsible cane (black and bronze painted)
If we all got together and pooled our unneeded equipment we could start a pretty complete used home healthcare supplies store.
Plus one raised toilet seat.
But let's NOT recycle our unused opiate pain meds!
Quote from: FlbrkMike on May 18, 2011, 10:57:38 AM
If we all got together and pooled our unneeded equipment we could start a pretty complete used home healthcare supplies store.
And sell it all off at highly inflated prices to the insurance companies.
Quote from: lopsided on May 18, 2011, 10:41:35 AM
Quote from: halfdone on May 18, 2011, 10:28:42 AM
Quote
But... didn't you get a pair of complimentary TEDS socks??? ;D
There's a separate $1,000 bill for those in the mail. :o
But I'll throw them in for free if you rent my leg pimp ;D ;D
Halfdone, is that a hippo in your picture?
Hernanu, where is your picture?
Yikes! forgot to put one up
Quote from: hernanu on May 18, 2011, 12:22:48 PM
Yikes! forgot to put one up
Ahha. Now we know what you look like.
Quote from: hernanu on May 18, 2011, 10:23:49 AM
But... didn't you get a pair of complimentary TEDS socks??? ;D
I got a pair of TEDs (for BEDs) and two pairs of Venosan's (for day - nothing smart here - suggestions?).
Pretty much everything else I had to buy. Some will be able to be donated on, whereas others probably won't. The reacher is a new toy that my husband loves and whilst I'm not exactly sure what it's ongoing use will be, I just know that I won't be able to pass it on!
I think I'll end up out of pocket about 7K by the time all is said and done (this includes physio now I'm home). I'm pretty happy with that for both sides especially considering that so far the itemised bill I've received only covers the first week and not the surgeon and anaesthesiologist and we are at 45K. There was another three weeks in rehab that haven't yet been billed and if you add all those in I'd say I'll hit 85K or more.
Quote from: lopsided on May 18, 2011, 09:47:36 PM
Quote from: hernanu on May 18, 2011, 12:22:48 PM
Yikes! forgot to put one up
Ahha. Now we know what you look like.
Not my best side, but in the right light..... 8)
Kate,
Have you seen the Explanation of Benefits or any kind of claim form from your insurance? The costs billed by the hospital are always highly inflated and they never collect that amount from insurance. [/quote]
I use the Explanation of Benefits (EoB) - not SoB! - to track what I should and should not pay. Be carefull of the hospital bills as I saw some that were sent to me before they had got a response back from the insurance comapy - there is a column "what you owe now". It is like a little dective plot that we all need to track.
Amen to that Phill.
With these surgeries I've become very "pro-active" in following my costs, which I've never really done before with medical expenses. With all of the different charges and line items, the bills and EoBs can be very confusing so I've created a little spreadsheet to track "amount billed", "amount paid", "amount we (the ins. co.) paid", "non-covered", "deductible", and "copayment / co-insurance" amounts. Also, when and how much I paid, and which account (Health Savings Account or normal credit card) I used. I have a $7,000 annual out of pocket maximum so I will have eventually (before the end of the year) to go back to my "pre-surgery" costs and see exactly what I've paid out. I've already found through this tracking that PT, which has been billing my HSA directly, has been overcharging me for the past four weeks or so. I've blown way past my OOP maximum but they've still been charging me the 20% copay, not through their own fault but because of a mistake by Blue Shield in telling them what they should be charging me. I'll be getting a refund for that.
Hi Everyone. I'm just wondering for those of you with co-pays, when you pay your co-pays, is your share of the cost based on the price charged by the hospital or on the reimbursement paid by the insurer?
With me, who knows, since the amount was so small compared to the overall bill. ~$100,000 for both hips, $400 to me.
Quote from: halfdone on May 24, 2011, 07:05:08 AM
Hi Everyone. I'm just wondering for those of you with co-pays, when you pay your co-pays, is your share of the cost based on the price charged by the hospital or on the reimbursement paid by the insurer?
I'm pretty sure that my co-pay (which kicks in after the deductible is met and lasts until the annual out of pocket is met) is 20% of the allowed amount, which is the cost that the insurance company and provider have agreed upon. Even then, I blew through my OOP before paying off my first procedure.
$5k on Kaiser's individual 70% $2k deductible plan. They promise.
$5,000 means $7,000 with Kaiser. It's the new math ($2000 deductible + $5000 out of pocket. Out of pocket means out-of-pocket PLUS the ded.).
I did both in one year, the first was $1000 for the deductible, and the second had an additional $500 co-pay instated mid year because my insurance wants to deter people from doing HR, thereby saving themselves $40K to $50K per hip (US). They added the co-pay as soon as the FDA asked for more data, but they never could tell me that that is why they instated it. I think it would take more than a $500 co-pay to deter me, but don't tell them that. ;)