Seattle man, 70, beats coronavirus -- then gets $1.1M hospital bill, report says

Robert59

Robert59

Well-known Member
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Now I live in Tennesee. Did live in Michigan.
The article states, as we no doubt already know-


Fortunately, because the 70-year-old man is covered by insurance, including Medicare, he will likely have to pay only a small portion of the tab.

In fact, if his deductible is met, he won't pay a dime after Medicare. Private insurance has an out of pocket limit, depending on the plan, anyway. Usually providers will accept Medicare's payment, although they are not forced to.

My 5 week stay plus surgeries was $1.7 million. I paid nothing. I'd already paid my 1,500. deductible earlier for the year with my private insurance.
 
RadishRose said:
The article states, as we no doubt already know-


Fortunately, because the 70-year-old man is covered by insurance, including Medicare, he will likely have to pay only a small portion of the tab.

In fact, if his deductible is met, he won't pay a dime after Medicare. Private insurance has an out of pocket limit, depending on the plan, anyway. Usually providers will accept Medicare's payment, although they are not forced to.

My 5 week stay plus surgeries was $1.7 million. I paid nothing. I'd already paid my 1,500. deductible earlier for the year with my private insurance.
Click to expand...

If the hospital is contracted with Medicare (and it would be a rare hospital that wasn't), they HAVE to accept Medicare's payment and are not allowed to "back-bill" the customer for the rest. Same thing with the doctors. Occasionally you get a doctor who doesn't contract with Medicare, but they're usually pretty up-front about that.

In the early days, a lot of services and offices routinely back-billed customers, hoping that some would not know they didn't have to pay. After getting slapped around by Medicare, they learned the errors of their ways and stopped the back-billing.

One shouldn't get back-billing confused with services that Medicare isn't obligated to pay and which must be paid by the patient. You and your doctor may think you need a supplement or a procedure or an appliance, but if Medicare doesn't feel that it is "medically necessary", they aren't going to pay for it. You'd be on your own then. If Medicare denies something as "medically un-necessary" or "not covered", your supplemental insurance isn't going to cover it either.
 

jujube said:
... You and your doctor may think you need a supplement or a procedure or an appliance, but if Medicare doesn't feel that it is "medically necessary", they aren't going to pay for it. You'd be on your own then. If Medicare denies something as "medically un-necessary" or "not covered", your supplemental insurance isn't going to cover it either.
Click to expand...
I was covered by Medicare but had no need to use it until late last year. I had the mistaken impression that they would pay 80% after the deductible for any ordered test or service. Reality hit when I was told that they might not pay for a rather routine blood test because I had one done 5 years previously! Thanks for pointing out this information!
 
Em in Ohio said:
I was covered by Medicare but had no need to use it until late last year. I had the mistaken impression that they would pay 80% after the deductible for any ordered test or service. Reality hit when I was told that they might not pay for a rather routine blood test because I had one done 5 years previously! Thanks for pointing out this information!
Click to expand...
Aren't you hooked up with a Medicare Advantage program or supplementary insurance? My blood work, doctor appointments, X-rays and other low-level care are either free or have very small co-pays, like $10-ish. (My Medicare Advantage plan is free, by the way.)

If you're paying out of pocket for routine blood work, you might want to look around for another health care plan or medical group.
 
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