Planning on dropping Health Insurance. Change my mind.

[Jstpssng]

We have a major drug problem so LEOs and other first responders have started carrying Narcan as part of their regular gear. I was talking to somebody recently who's young daughter has a severe peanut allergy so they keep an epipen on hand, which costs about $800 and expires after a few years. He and his wife work hard, and don't understand why they should have to pay that price to ensure their daughter's safety; yet a drug addict gets the Narcan as many times as they need it, at no cost. Instead we taxpayers foot that bill.

 

[MossRoad]

You have some insight into this issue - what is the deal with these anesthesiologists that charge full freight as opposed to assigned rates? Are they just pirates gouging vulnerable people or do they have some legitimate excuse?

I'd guess anesthesiologists are the ones most likely to kill you, and therefore take the most risk. But that's just a guess. I had a friend who's brother was an anesthesiologist. He switched to pain management due to risk.

 

[Travelover]

I'd guess anesthesiologists are the ones most likely to kill you, and therefore take the most risk. But that's just a guess. I had a friend who's brother was an anesthesiologist. He switched to pain management due to risk.

But that doesn't explain it. You have an operation and Anesthesiologist A puts you under and since he is in network, fully covered. You have a second operation and Anesthesiologist B, out of network puts you under and you get a bill for many thousands of dollars. Oh, and you have no choice of A or B beforehand. You find out when you get the bill.

 

[goeduck]

But that doesn't explain it. You have an operation and Anesthesiologist A puts you under and since he is in network, fully covered. You have a second operation and Anesthesiologist B, out of network puts you under and you get a bill for many thousands of dollars. Oh, and you have no choice of A or B beforehand. You find out when you get the bill.

Totally agree with you, you did your due diligence, THEY were short staffed and passed the buck to you. Stick to your guns.

 

[MossRoad]

But that doesn't explain it. You have an operation and Anesthesiologist A puts you under and since he is in network, fully covered. You have a second operation and Anesthesiologist B, out of network puts you under and you get a bill for many thousands of dollars. Oh, and you have no choice of A or B beforehand. You find out when you get the bill.

I had a similar situation at an emergency room a couple years ago. Hospital was in our network. I confirmed with my insurance. Went to ER, got poked and such, got bill from out-of-network doctor. Took many calls to resolve, but it was resolved and I was only out my deductible.

 

[ultrarunner]

In network generally means you contract to accept a lower fee for service but make it up on volume... the network keeps you steadily employed.

Anesthesiologist, Surgeons, etc... have fixed costs that may vary little regardless of how many cases they perform.

There should never be an out of network charge for a schedule procedure... but, it happens all the time.

Billing Out of Network can be very costly to the patient as the patient shoulders the cost difference.

In emergency situations... the insurance will often cover Out of Network as being In Network or at a higher percentage than otherwise.

It is not like the practice of medicine is static... Docs come and go and contracts change.

 

[mscheeer772]

****, if you can afford all those toys, $2200.00 a year should be a no brainer IMHO.
My wife and I pay $2200.00 a month, does it suck-yeah.
Its better than draining my kids inheritance.

 

[tjkubota93]

****, if you can afford all those toys, $2200.00 a year should be a no brainer IMHO.
My wife and I pay $2200.00 a month, does it suck-yeah.
Its better than draining my kids inheritance.

Needs more toys. Has no kids, no inheritance.

 

[jerrybob]

But that doesn't explain it. You have an operation and Anesthesiologist A puts you under and since he is in network, fully covered. You have a second operation and Anesthesiologist B, out of network puts you under and you get a bill for many thousands of dollars. Oh, and you have no choice of A or B beforehand. You find out when you get the bill.

Interesting...two years ago I had a knee replacement. Everything was pre-approved through my doctor's office with the insurance company....doctor, anesthesiologist...hospital etc.... About 6 months after my surgery....got a bill from a PA who helped manipulate my knee while I was under....the bill was for over $5,000. Called my insurance co.....they said he was out of network. Called the PA office....they said that my doctor used him...therefore I would have to pay. Called my doctor's office....asked why he used an out of network PA....they couldn't explain why. Called back the PA's office...said I refuse to pay....I did not authorize this PA....everything was approved through the doctors office. All was well for another 6 months...when a second bill was sent for the same amount. Called the PA's office....they said they would take care of it. Another 6 months goes by....get a third bill. Called the PA's office again....spoke to manager....I was not nice. I now have written documentation that they have written off this bill. My bill is zero. Haven't heard from them for 6 months. I think it's resolved. Many people would have paid. It was very frustrating dealing with all parties.

 

[ultrarunner]

Many would not be able to or would agree to a payment plan...

My brother could have paid but it was principal... the medical team made the switch for their convenience.

I think calling and showing up at the Docs door and speaking to his wife kind of rattled them... brother is very professional... coat and tie... when not farming.

He said he was prepared to fight it all the way to the medical board, insurance and would go on the local consumer segment on TV... the bill was nearly 5k...