Let me start by saying that I do have employer-provided health insurance. And this issue is being resolved.
But this situation made me stop and really pay attention to medical charges, what's covered, and what health insurance does for you.
And how screwed you could be without it.
OK. So back in November, I had an amnio. I paid my copay, they did their thing, and except for fretting about the results, I didn't really think about it again. Until I got a notice saying that if I didn't provide my insurance information, I could be liable for a $1,500 Labcorp bill.
As you would, I faxed them my insurance card.
About a month later, I got a Labcorp bill. For $1,500.
I started by calling the doctor's office, who said, "Oh, they clearly charged you for the entire amnio procedure, and they didn't process it through insurance. This is a mistake."
So I went to our HR person to ask who I should call next. Blue Cross? Labcorp? And anyway, what the fuck? She suggested I hand it over to our insurance broker, who would handle it for me.
Our insurance broker. Who is a very nice person. But it seems to me is also a reason why our insurance is expensive. Because her company is a layer between my office and Blue Cross. Which of course adds cost, no?
But she got involved very nicely. I gave her a copy of the bill, the fax, and the explanation of benefits that I'd gotten from Blue Cross. Which was for $1,200. But for the same day and the same doctor.
But you know how they break all these charges into parts? So you don't really know what's what? You've gone in for one thing but there are 15 different billing codes?
Yesterday she told me that actually, my explanation of benefits and my bill were for two different things. The $1,200 bill had been paid. The $1,500 second bill had never been processed by Blue Cross, but they were doing so now. I'd get an explanation of benefits in the mail soon.
Second bill? What second bill?
Here's the deal. My doctor's office charged my insurance $1,200 for their piece of the amnio. Genetic counseling, the sonogram, and the actual amnio, which was about five minutes of the doctor's time.
$1,200. What my insurance actually paid them was just under $500.
Now, Labcorp is charging $1,500 for their piece of the puzzle. Cell culture and so on. I don't know what all is involved, so I can't speculate on time, although holy hell, $1,500 seems like a lot to stick some cells into a culture and wait for them to grow, doesn't it? I also don't yet know what insurance will pay them.
What I do know is this: if you don't have an insurance company that has cut deal with doctor's offices, you are fucked. Seriously - you'd be charged $2,700 for an amnio.
I realize it's an optional procedure - not like having your leg reattached or something - and I don't know what we'd have done if we had to pay full charges, out of pocket.
But if you are in a non-optional leg-reattachment situation and you don't have insurance...what do you do? Forego the leg? Wind up going bankrupt because of astronomical fucking cost of American health care?