While I’m in a sort of writing mood, let me tell the story of the $76 container of medicated talc.
First, know that I have what is called a Medicare Advantage plan. It is Cigna, if anybody knows of it. This means that Cigna, NOT Medicare, takes care of all of my medial bills. Cigna, as I am to understand, gets reimbursed by Medicare.
Anyway, my medical people accept Cigna here in Delaware where we have an older population. Obama desperately tried to get rid of Medical Advantage plans....NOT the same thing as a Medicare supplemental plan.
So I went into the hospital to have a stent put into my vein going into my leg. It was at first to be an out-patient thing but they said if they did the stent (evidently there was some question if the cardiovascular guy could get to the blockage) then I would spend one night in the hospital.
So the did the stent, all went well, no problems. I spent the night in the hospital but where the incision was made to insert the stent was rubbing on my fat belly and at some point it became irritated. The nurse came in, handed me a vial of sort of talc powder with medicine in it, so I was told. I was to sprinkle this stuff on the irritation and I did and it helped.
Then I was given a daily dose of my medicine, medicine I could have brought with me to the hospital but they told me not to. It was about four pills, cholesterol med....that sort of thing.
FOUR PILLS.
Anyway, like Medicare there are co-pays with Cigna but it’s handled very differently. Not that important.
But I am told by Cigna WHAT to pay in the form of co-pay and it NEVER matches what the medicos, be it out-patient or a hospital or even a doctor’s office....it never matches what they say I should pay.
As a Cigna patient, I am to pay what Cigna tells me to pay.
My co-pay for this little medical procedural, nightly hospital stay, payment to the cardiovascular guy....was $300.
I sent the hospital $300 bucks BUT....they charged me $405.95.
So this is $105.95 MORE than Cigna authorized me to pay so I didn’t pay it.
Of course they call me, they are going to hang me in public square, I will be turned over to the Russians to hack.
So I must study what’s going on.
Turns out that the extra $105.95, get this, includes $76 bucks for that container of medicated talc (hey I got a fat belly hangs down and I use Desitin, about four bucks from Walmart, and it works fine) with the rest being for those few pills that I could have brought with me from home but they told me not to.
Seriously? $76 for two ounces of medicated talc powder? Over $25 bucks for four pills that I already had?
I have been talking to Cigna, who told me the hospital, if they expected payment for that talc costing over a thousand bucks a pound they would have to submit THAT part of the bill to Cigna’s pharmacy.
Of course I am still fighting this and it will probably end up on my credit record and I shall suffer. Because I assure you nobody at that hospital will ever remove those charges from my bill. Maybe I can get somewhere with Cigna.
Whatever....if this isn’t an example of how absurd hospital costs are and why it’s a hot mess....I just can’t imagine a better example
I suspect that's how ‘the poor’ are charged for a case of the sniffles when they go to an emergency room in lieu of a private doctor.
Then hospitals take it off their taxes meaning the taxpayer gets hit more than once.
ObamaCare incentives MUST be changed... Rumor is that OUR GOVERNMENT pays insurance companies $100,000 a year PER PERSON for those on Advantage Plans... then they nickel and dime the folks on the plans.
Trump and Ryan need to look into all this stuff before they start to 'change' the disaster known as ObamaCare...
It's called "cost shifting" a crooked practice that gouges people like you to subsidize all the "free healthcare" to medical-welfare parasites.
Tell the hospital you are going to expose them and others to the public, and work to get the unethical "cost shifting" practice banned outright.
Pat do not pay the extra the hospital changed you. it’s illegal for the hospital to balance bill a medicare member, you can call medicare on the hospital as well. Cigna knows this as well.