Posted on 01/02/2014 3:06:08 PM PST by kristinn
Hospital staff in Northern Virginia are turning away sick people on a frigid Thursday morning because they can't determine whether their Obamacare insurance plans are in effect.
Patients in a close-in DC suburb who think they've signed up for new insurance plans are struggling to show their December enrollments are in force, and health care administrators aren't taking their word for it.
In place of quick service and painless billing, these Virginians are now facing the threat of sticker-shock that comes with bills they can't afford.
'They had no idea if my insurance was active or not!' a coughing Maria Galvez told MailOnline outside the Inova Healthplex facility in the town of Springfield.
She was leaving the building without getting a needed chest x-ray.
'The people in there told me that since I didn't have an insurance card, I would be billed for the whole cost of the x-ray,' Galvez said, her young daughter in tow. 'It's not fair – you know, I signed up last week like I was supposed to.'
The x-ray's cost, she was told, would likely be more than $500.
Galvez said she enrolled in a Carefirst Blue Cross bronze plan at a cost of about $450 per month through healthcare.gov, three days before Christmas.
'No one has sent me a bill,' she said.
Health and Human Services Secretary Kathleen Sebelius testified in a December 11 congressional hearing that the federal government can't say how many new enrollees have written checks for their first month's premiums.
'Some may have paid, some may have not,' she conceded.
It's unlikely that a valid insurance card would have changed Galvez' fortunes, however.
(Excerpt) Read more at dailymail.co.uk ...
Why did she go to a hospital for a chest x-ray? You go to a radiology clinic and pay cash and it would cost $66.50. You go to a hospital and you pay not only the $66.50 but the facility fee of $500.
Plus she didn't even make a payment! You aren't generally covered until your check clears.
My guess is that she has a high deductible, so it would behoove her to research the place where she intends to get her medical treatment. You go to the hospital and your bill is over $500 before anyone even takes your pulse.
The scenario you're ranting about certainly could happen to some people, some places, but I think you are overly concerned about my family.
Not only are we staying with the same PCP and specialist(s), but they are all part of the same regional medical center (http://www.kadlec.org/), and have a history of working closely and successfully with the insurance company and state (state exchange). For an entirely new patient I would be a little apprehensive, but as in the case of the other poster who went in with just the letter and received service, that's what I would anticipate for us. I don't travel much (at all, really), and so am not worried about out of network coverage or lack thereof.
I am not entirely carefree and we did stock up on Rx refills to the extent we could right before the end of December, but other than that I am not losing sleep. Several of the prescriptions are $4 Walmart cash anyway, so no possible problem there.
What will you do when FUBOCare FUBARs up and denies payment to your doctor and they bill you some $12,000 for a specialized treatment? Or some idiot programs you into the $10,000 deductible policy database and you get stuck with thousands of dollars in out of pocket expenses.
All of that could have happened pre-Obamacare, no change.
Thanks, my FRiend, for your kind concern and I wish you and yours all the best in 2014 also.
She didn't pay for it yet.
“boy philiipines/thailand basic medicine looks a lot better every day.”
Just wait a year. You’ll be getting albania/zimbabwe quality care right here in the USA.
That facility fee was ticking me off last year. I'm not sure if it's billed as a percentage or what (the charge was about $50 on an office visit), but it was definitely "unexpected".
AND, whether or not this hospital is in her ObamaCare network. From what I've read, it's likely not. Which means they can bill her the full charge.
For example, I recently went to the ER for kidney stones - provider in my network. They billed my insurance $1,481. The insurance paid $449.18. The amount I had to pay? Nothing; I was admitted. If I was under ObamaCare and my local hospital was not in the network (probably won't be), I'd be responsible for the $1,481.
That’s unexpected. Who would have guessed that socialism would not work as well in the real world as advertised by the DNC?
X-rays are digital now. Probably cost $1.10 in electricity & computer memory to do. Machinery cost is extra.
How many of these dolts signed up thinking obamneycare was free I wonder?
I'm glad you asked. IMHO, one of our biggest medical system problems is completely dishonest pricing. No one knows what anything costs--it's just a series of pricing clubs. If you're not in a club, the price can be five or ten times the "real" price, in the sense of what the provider normally gets.
So, this woman is being asked to pay $500 for a much less expensive service--it's a ripoff. If you are insured, the insurance company pays less. If you are on the dole, you pay nothing. But, if you don't have overpriced insurance, you get completely screwed. Fifty buck aspirins and bandaids. That's very bad--it's predatory, and it's coercive, forcing people into overpriced plans which then redistribute their money.
Of course, you can generally negotiate it downward for quick cash payment, assuming you are on good terms with the hospital otherwise, to the tune of 30-50%.
The radiologist’s look costs some money, too. But, I think we both agree that the $500 is a fantasy ripoff price for someone who isn’t on the dole and isn’t insured.
Lots of deductibles are arranged as a 70/30 or 80/20 payment once the deductible is met. There are also co-pays after the deductible is met.
Does ObamaCare pay 100% after the deductible or it is then on some kind of 70/30 for the remainder or the next 10 grand? Anyone know?
I’m self employed, so I increased my hourly rate to fund our (wife and I) deductible savings account. We need to fund the account to have about $12,000. We will continue to pay for our health care out of pocket, as we have done for years. If something happens, we will purchase the bronze plan, and pay the deductible. We dropped the wife from the payroll this year. That will help a little bit. I need to talk to my tax man to see if the corporation can offer this deductible savings account as a benefit for employees. The wife and I are the only employees.
They did not even build a mechanism to transmit payments to the insurance companies, and they do not have the software to know who has and has not paid.
Given the past patterns of medical deadbeats, it is LIKELY that few or none of these "enrollees" have paid a dime, or ever will.
But that's not the point of it all. The point is to fundamentally transform (in this case to destroy) the health industry. And that is working out very well.
Good job, OTrauma!
Imagine that!
<Why was this woman at a hospital for a cough? Paying straight cash I could see a doctor at a clinic or urgent care center with the x-ray in the $200 neighborhood.
Good point. I have a good insurance plan, but still go to the neighborhood clinics (run by the university I work for). I don’t pay anything for the visit, and can get in and out easily. Without insurance, I think the visit is $50, which isn’t bad. They’ve got nurse practitioners, you can get a prescription, and it’s not like waiting in an ER.
The only down side is you only get 1 scrip - if the problem persists, they really want you to see a doctor and not keep coming back to them.
Unless she had a history of TB or bronchitis or something, why did the woman think she needed a chest X-Ray for a cough? If I have a cough, I don’t go running for an X-Ray. Sounds like ER mentality to me.
Amen Kristin! Low information voters are low information because they are low energy, they don’t want to take the time to educate themselves. They need to suffer great pain for what they have done to America.
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