The Right Price of Care – We the Patients New York – Medium
Judy is a 63-year old New Yorker who came to We The Patients after fighting a flurry of surprise medical bills last year. Like many us, Judy needed a routine blood test. Having this test many times before she knew seeing her specialist would cost her $40 per visit. That’s what she expected to pay.
Judy ended up being charged $275 for one visit.
Judy was a victim of multiple medical billing errors. She mistakenly received six additional copays on top of her expected $40 charge. Judy was vigilant; she knew this bill wasn’t right. After countless calls to her insurance company Empire Blue Cross Blue Shield and her doctor’s patient relations department, she was able to reverse the charges. Unfortunately, a few weeks later she went in to get her blood drawn again, she was billed another $275. Judy has stopped going to her specialist but defeatedly stated, “When you go to the doctor as much as I do, these kinds of things rear their ugly head a lot.” Why is this Judy’s norm? Why should she expect to fight with her doctor and insurance company to not be overcharged?
Now let’s talk about the charges Judy couldn’t get reversed.
After visiting Beth Israel Mt. Sinai and Kingsbrook Jewish Medical Center for a series of check-ups she was charged an $80 facility fee for each visit. She tried to dispute her charges. Why should she be hit with an unexpected bill just because she went to an outpatient clinic? She chose the facility that was closest to her home, she wanted her medical care to be convenient. It was anything but, before she even received care she signed paperwork (a patient financial liability form) stating that these medical centers could charge her for using their facilities on top of her doctor’s bill. Judy was blind-sided. “You know the big packet of paperwork you sign when you go to the doctor’s office? Apparently in the fine print, it states they could charge me a facility fee. No one reads the whole packet! It feels like I am signing my life away.”
After spending last year fighting with her insurance company and doctor’s offices just to get the right price of care, Judy now eagerly awaits to be eligible for Medicare. Financial stress is a daily reality for Judy. Her monthly premium is $1,130, more than her rent. She says she feels lucky her husband is on Medicare, it saves them a lot of money. She feels challenged by her experiences with our health care system and sometimes thinks about switching to a less expensive plan, “Maybe it’s crazy but I like my doctors, and I am loyal to them. If I were to switch plans, I couldn’t see my regular doctors, that’s not something I want.” Judy’s only option? To continue paying a high price for a health care system that mistakenly bills and upcharges her until she hits 65.