Do you read your medical bills? How about the "explanation of benefits" from your health insurance company? Granted, those latter are more like a "confusion of benefits" than an explanation, but let's let that go for now.
I don't generally read my medical bills, because they make me crazy, and not just because of the incomprehensible explanations of what I owe and why. I generally stack them up for about a month at a time--to avoid stress--and then open them all at one go.
Things are even better now that my friend Kelly is back on the case, sorting out my medical bills for me. This is a HUGE stress-reliever, and if you are handling your own medical bills I strongly suggest that you hand them off to someone you trust.
However, sometimes I get curious about what things cost, like the recent round of scans and tests that I've had. Well, two recent rounds of tests and scans. Or maybe a month of on-going tests and scans. Anyway, I've had a lot of tests/scans and I was wondering what they cost.
So I opened my most recent Medicare statement.
And I was shocked. To cut to the chase, Medicare is only paying about 10 percent of any given bill. How is this possible? I'm going to find myself fighting Medicare on behalf of my providers if I'm not careful.
For example, I had a brain MRI at Northwest Hospital on May 12. The total charge was $3,416.50, including the $22.50 for the contrast. Of this, Medicare paid only $370.45.
Medicare says my deductible/coinsurance will be $217.93, but I qualify for charity care at Northwest Hospital (and I've already done the paperwork), so I won't be paying anything.
And I have secondary insurance with WSHIP, the Washington state high risk pool for people who are considered uninsurable, so I could sift through my bills and see what, if anything, WSHIP paid on this claim.
Found it. WSHIP paid the $217.93 that was supposed to be the coinsurance payment, and that's it. And the hospital will have to eat the rest--about $2,800.
So now we get why medical providers refuse to treat Medicare patients.
As I said before, this is insane.
Oh, a couple more random numbers:
One dose of gemcitabine, that hateful chemo drug, cost $2,088 at Northwest, plus delivery costs of $622 ("injection") and $153 ("therapy"), much cheaper than at the two cancer centers where I was treated in the past.
Both Swedish Cancer Institute and the Seattle Cancer Care Alliance charged me about $2,000 in delivery costs--in addition to their marked-up charge for the drugs--each time I went in for chemo. That's more than twice the charge at Northwest.
(Note that this is about 10 years old.)
@ Jeanne Sather 2009.