Hospital Medical Services, Insurance, and Cheaper Options

Hey UC’ers, something pretty interesting happened today and I think its worth talking about.  This hopefully doesn’t affect all of you, but if you have a “fee for service” or PPO insurance plan, or no health insurance at all, this might hit home pretty hard.

Here’s the deal, my wife was referred to get a diagnostic test last week.  Nothing crazy, just a test which she’s gotten before.  So, her primary car doctor’s office referred her to the hospital that is right next door to where the practice is located.  And, sure enough, my wife assumed that all was fine and dandy and since she was supposed to go in tomorrow for the exam, she called to confirm the appointment today.  During her phone call, she asked what the costs would be to her.  We both have high deductible insurance plans, and that means that both of us pay the first $3000 of medical expenses each year, and after that, our insurance company covers the rest.  This is the deal with our “PPO Insurance”, maybe you have something similar.

But, when the woman on the other end of the phone told my wife she would owe $900 because she has not met her $3000 deductible, Michaela told her right away that she would have to cancel the appointment.  And thankfully she did.

Colitis Hospital Fees and Insurance comic

After hanging up the phone she told me the deal, and I asked her where she was scheduled to get the test.  “At the hospital next to my doctor’s office”, she said.  WAHHHLAH!

NINE HUNDRED BUCKS for a whimpy ultrasound?  Come one guys.  That sounded a bit too crazy to me.  I got out the computer, typed in “Ultrasound San Francisco” and came across several companies.  Literally within 3 minutes, a nice lady told me that the exact diagnostic test that my wife needed would only cost us $195 if we paid in cash and did not use insurance.  Simple as that.

So, as you guessed it, we’re going to go with the cheaper price for the identical service that the hospital was going to charge 900 bucks for.

Does this apply to people with UC?  Maybe yes, maybe no.  It all depends on your health insurance situation, and you need to make some judgement calls too.

Here are some common UC medical services that you may find much cheaper outside of a hospital setting:

  1. Colonoscopies (I myself almost paid a shinny nickel before I found a much cheaper scope center.  ALSO, definitely realize that many GI doctors either own or are part owners in many colonoscopy centers around the world.  That should be no mystery to anyone.  But, if you find a colonoscopy center that offers better pricing for the exact same butt probing, your GI doctor will probably be happy to do the service there as well.  Don’t worry, your GI doctor will still be getting paid pretty nicely, and you’ll potentially save alot of money too.)
  2. Blood Tests (come on folks, UC’ers are always getting these, and there’s TONS of local blood labs all over that are often less than half the price of hospitals for the exact same tests)
  3. Stool Sample Tests
  4. Infusions of certain medications (more and more private infusion centers are popping up these days)

One more thing to consider.  Take my wife’s case for example.  She needs to pay the first $3000 of her medical expenses each year BEFORE her insurance kicks in.(excluding preventative care of course)  So, with that said, had she been at the $2800 mark, or maybe at the $2500 area, we probably would not consider paying for this test she needs in cash.  The reason being, if this test put her over the $3000 mark, we would not worry at all about medical expenses until her calendar year with her insurance was over again.  But, since she has not had any expenses yet, we’re willing to bet she won’t need anymore medical attention.  We might be wrong with that bet, but again, its a decision we had to think about and made.

Good luck to you all, the health insurance world is tough to navigate.  But, from the previous UC Work Survey, I know there are some insurance experts reading this website, who might have some good ideas too on how to save money and reduce costs.  But one thing is for sure, for everyone who does not have health insurance, as tough as that is, think about your options.  No need to pay crazy money for services which are much cheaper for the exact same thing.

Have a great September,

-Adam Scheuer

9 thoughts on “Hospital Medical Services, Insurance, and Cheaper Options”

  1. Proof that our medical system is a bit of a sham(at the very least to our wallets) so always be sure to stay on top of your doctors/healthcare providers. While some will gladly share the information Adam found without asking, others will stay tight lipped unless you ask yourself but options are always there. Along with what Adam said, I would add three things.

    Where I live, not all hospitals are created equal. If you are ever admitted and the doctors cannot figure out what is wrong(they’ll be as frustrated with you as you are with them), ponder where you are. A change of venue, a little research, or even just speaking up to your current doctors may put you in touch with a different facility that is better equipped to help.

    Also, doctors will push for all kinds of tests when you are sick…not to run up your bills but to avoid liability. I’m cool with that but if you’re ever in a situation and you feel tests are truly unnecessary, speak up. Often there are other options available and being informed is your best weapon to avoid inflated medical costs.

    Last, if you are without insurance and struggling to get by there are likely programs in your area to help you get care at a lower cost or no cost depending on your situation. I was one of those people who didn’t think there were options so I never bothered to look.

    Thanks Adam for the insight and information! Steve

  2. !!!!!thank you!!!!! I’m in the same boat as you. I’m self employed , I have PPO, and my deductible is now somewhere around $7000.i would have never thought that this stuff could be cheaper by paying out of pocket. This info sure will be so helpful for this info. Thank you again.

    1. Glad these ideas might help you out. For sure Trina, with a PPO plan, you get to choose your providers of medical service. So if you need to shop around, you have that right for sure!

  3. Sheesh…in Canada it’s all free…believe it or not. All ultrasounds, x-rays, etc. I feel almost bad about that!

    Are Americans down with ‘Obama-care’ or not? I’m not sure what the real story is. The spin on it here is that the poor and middle class folks want it, and the rich folks don’t…anyone know the REAL facts?

    1. Hey Bev,

      Hearing how the healthcare system works in Canada is really great to hear. In my opinion, one of the best parts is that it seems the stressful “how am I gonna pay for this stuff” is not part of the equation. And when you’re dealing with nasty UC symptoms, way way cool that Canada doesn’t stress out UC’ers with finance stuff/insurance co-pays etc…. You know you just might be starting a mass migration to “OH Canada…” Bev… who knows…:)

      Down with Obamacare or not?… I think it probably depends on who you’re asking. My own personal group of friends are all over the place on it. I guess we’ll have to just wait and see how the voting goes.

      1. I know Adam…we are pretty fortunate here for sure. I can’t imagine the extra stress from worrying how I was going to pay for procedures…We do pay for our own meds too, tho, unless we have a plan through work, which is usually 80% paid by your company, and the other 20% out of pocket. Not too bad all in all. Apparently, our drugs are alot more expensive here than in the US. That’s the balance I suppose.

        Cheers…oh, and you are all so very welcome to mass migrate!! Come on up…)

  4. I’m down for it Bev…but I can’t say I agree with all of it because I’ve never sat and read every little detail. The fact is we’d be better off from a financial standpoint but the whole system should be moderated(we pay crazy prices because it is not). I think it is silly to not want some kind of overhaul, as we’re all affected by higher prices when those that cannot pay need healthcare. But…eh?

    1. I hear that!

      In countries like England and Sweden, there is total free health care…but high taxes are paid for it. Our taxes in Canada are kinda high as well…guess you gotta pay to get the good stuff…what a drag…

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