Many healthy seniors choose a Medicare Advantage plan with high out of pocket costs and high deductibles. This is quite understandable for someone who does not have a chronic medical condition and has “not seen a doctor in years.” But, they may get hit hard if they visit the hospital emergency department with a routine emergency.
NPR – National Public Radio- has collected many stories of shockingly high medical bills in their “Bill Of The Month” series. Some involve major surgeries, but even a simple trip to the Emergency Room of a hospital can cut deep into a couple’s retirement savings. Here’s an example from Tennessee.
Station WPLN reported that Jason Dean cut his knee while working in his home business. He went to emergency and received a tetanus shot and six stitches. His bill was $6,000! His wife later needed emergency care and went to a different hospital and was charged only $600.
What’s going on? Hospitals are finding ways to make the Emergency Room a profit center. Some have a flat emergency room fee that is in the thousands of dollars. But other shocking charges are hidden in the medical billing, such as the use of “upcoding.”
In The Bill Of The Month series a journalist went in depth in a matter where a routine childbirth ended up being coded a level 5 emergency, generating the highest charges. Caitlin Wells Salerno’s first childbirth cost $30. Four years later, with the same health insurance, her second childbirth cost her $3,609.09. There was a $2,755 charge for “Level 5” emergency services. But, this was a routine childbirth. She tried fighting it but eventually paid the bill. Medicare beneficiaries have an additional option: Medicare fraud.
What if you receive a shocking bill? You would be well served to review every detail of your bill and demand explanations. The Wells Salerno report includes a link to the five billing codes of emergency so your Emergency Room visit was correctly billed.
If you suspect Medicare Fraud call 1-800-MEDICARE (1-800-633-4227).
The NPR Bill Of The Month series can be found at https://www.npr.org/series/651784144/bill-of-the-month