Emergency Room Visit -- HDHP

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Re: Emergency Room Visit -- HDHP

Postby expat » Wed May 22, 2013 3:49 pm

mikep wrote:
expat wrote:
livesoft wrote:If one has a HDHP and negotiates and pays instead of submitting the bill to their insurance, doesn't that mean that the expense does NOT apply to their deductible? If one keeps doing that then they essentially don't have health insurance at all because their deductible will never be met and they will always be paing out of pocket.


According to my insurance company, if I submit documentation (receipt etc) that shows payment, they will include the amount against the deductible.

So it's possible to negotiate a lower amount and have it included against the deductible.


I tried that and it was counted as "out of network" since the rule is all in network claims must be paid at the insurance contract price. So only the "reasonable & customary" amount of the "out of network" price counts toward deductible.. even though the in-network amount is higher :annoyed ... so this strategy may backfire as you could end up paying more.


In my case, I negotiated and paid an amount that was lower than the "reasonable and customary" amount. My insurance said they would apply that amount to my deductible as long as I provided them with documentation.
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Re: Emergency Room Visit -- HDHP

Postby EmergDoc » Wed May 22, 2013 4:38 pm

frugaltype wrote:
EmergDoc wrote:Here's another tip: If you've been there 9 hours, and you're not dead yet, it might not be an emergency. I'm just kidding of course, but it's usually a good sign when you're stuck in the back of an emergency department and ignored for a while.


How about my neighbor, in such pain from kidney stones that she was vomiting, who didn't get seen at the ER even though she and her husband waited there all night? Not an emergency?


I replied to this a few days ago, but the post is gone. Probably because it qualified as medical advice.
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Re: Emergency Room Visit -- HDHP

Postby LadyGeek » Wed May 22, 2013 4:44 pm

^^^ If you're serious, please check this thread: reloaded. We lost 2 days of posts due to a server crash.
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Re: Emergency Room Visit -- HDHP

Postby deanbrew » Wed May 22, 2013 5:01 pm

staythecourse wrote:Consumers get the power to be consumers and thus have the onus to PAY for the charges they ELECT to receive. If one doesn't like it then feel free to drive/fly to an outside country for their care. BTW, that is the point of HDHP the thought is if one has to pay out of pocket they will be more judicious with its use.

Good luck.


I agree that a major component of a HDHP plan is that it makes consumers/patients more aware of health care costs, but it can be maddening to impossible to find out how much the bill will be before treatment. I'm sure you've seen the surveys and studies that show the same procedure can range by a factor of 10 or more depending on where it was performed. I'm guessing a similar situation occurs at various ERs. And finding out what the "sticker price" that nobody pays is just a starting point, right? The only way I know how much I will actually pay is to have it run through my insurance company. It's a catch-22.
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Re: Emergency Room Visit -- HDHP

Postby Jeanz » Wed May 22, 2013 8:52 pm

At McDonald's they post the prices over the counter -- or, at least, they did on my last visit, which was several years ago. One problem with looking at medical care as a consumer good is that we rarely know the prices in advance, and even if we do, unless we're very unlucky we have too little experience to make a decent choice.

For instance, I recently had to choose which kind of intra-ocular lens I wanted. I looked at online reviews and comments, and talked to my older sister, but still, I had to rely on the advice of my ophthalmologist quite heavily. I don't believe that I really made an educated choice, but at least so far all is well, or at least OK. I'll never know if another choice would have been better. It's not like buying a burger; I can learn at small cost that McDonald's burgers aren't very good, and next time make an informed decision.
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Re: Emergency Room Visit -- HDHP

Postby yehudimenuhin » Thu May 23, 2013 12:39 am

Jeanz wrote:At McDonald's they post the prices over the counter -- or, at least, they did on my last visit, which was several years ago. One problem with looking at medical care as a consumer good is that we rarely know the prices in advance, and even if we do, unless we're very unlucky we have too little experience to make a decent choice.


Bingo! I had a cortisone short (shoulder), which constitutes surgery. In advance, I asked the ortho's support team to quote the cost in advance and they pretty much couldn't. But hey, they said, I'd met my deductible so it was free! No worries.
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Re: Emergency Room Visit -- HDHP

Postby HomerJ » Thu May 23, 2013 11:03 am

staythecourse wrote:What I don't get (not saying this in reference to the OP) is folks complaining after they get the treatment they sought they decide to later complain about the charges?? Does anyone go to McDondald's eat a burger and then go up and say "boy I don't think I should have had to pay full price".


Umm... really? Is there a menu explaining what everything costs BEFORE I buy? People think they shouldn't have to pay "full price" for a $8 tylenol, because we know they don't cost that much.

Consumers get the power to be consumers and thus have the onus to PAY for the charges they ELECT to receive. If one doesn't like it then feel free to drive/fly to an outside country for their care. BTW, that is the point of HDHP the thought is if one has to pay out of pocket they will be more judicious with its use.


Yeah, my kid is vomiting with a 103 fever at 3 am... I should be negotiating costs at that point, and if I don't like the numbers, [Snarky comment removed by admin LadyGeek]

Is there really no difference between McDonalds and health care?

Or maybe since you capitalized ELECT, maybe you're talking about plastic surgery or something, and not ER care. Probably should have that more clear in a ER thread.
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Re: Emergency Room Visit -- HDHP

Postby Default User BR » Thu May 23, 2013 1:39 pm

staythecourse wrote:What I don't get (not saying this in reference to the OP) is folks complaining after they get the treatment they sought they decide to later complain about the charges?? Does anyone go to McDondald's eat a burger and then go up and say "boy I don't think I should have had to pay full price".

If you went into McDonalds and the guy in front of you in line paid 50% less for the same meal you received, wouldn't you complain?


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Re: Emergency Room Visit -- HDHP

Postby LadyGeek » Thu May 23, 2013 5:10 pm

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