That explains a lot . . . 
We’ve never had UHC, so this is foreign to us (glad H and I have BC/BS). In Sept son gets to choose options again. Hopefully there will be some better choices…or at least one that doesn’t have that deductible. I think he chose that option because it has a very low monthly cost.
After looking it all over, because of the 1500 deductible and various coinsurance costs, even if there was some mistake and the original cost shouldn’t be THAT high, he’d still be facing 1500 plus coinsurance costs.
I forgot to screenshot the doctor’s visit costs as well. Since he had X-rays and an IV done there (dehydrated), that visit was understandably costly as well. So, it looks like he’ll be on the hook for $1900+ anyway.
H and I have offered to pay half of his share because we’re concerned that this will discourage him from seeking any sort of medical tests in the future. He’s asked us to help him evaluate the other offered plans in Sept. H is very knowledgeable about health plans, so he’ll provide a lot of input.
I found out the hard way last February that different imaging clinics and hospitals, even within the same city, can charge vastly different rates. I had to have an echocardiogram, with contrast, and it ran about $450 with insurance at hospital #1. I had another one a few months later at a different hospital, as I changed cardiologists. I was expecting it to be the same. My portion, after insurance was over $1,600. I called and they said that was correct.
I found some information, probably on the insurance website, that listed procedures and costs at various locations. All of them, except this one, came in close to the first hospitals price. I’m more than a bit miffed, but have learned my lesson to research this before I have anything done again.
Mom2- is this the son in med school?
@conmama - the price of the procedures was listed on the insurance website? That would be so helpful. I just looked at our website (BCBS) but I don’t see anything like that. They make it so hard to make an informed decision. I really,really wish that health care in this country was easier.
@mom2collegekids, you are correct that it is your son’s plan’s high deductible that made the cost to him of this procedure so pricey. His plan premium rates are relatively low compared to his other options due at least in part to that high deductible. He may well want to reevaluate at the next enrollment opportunity. Meanwhile, going forward, at least his deductible is now satisfied for this year.
There is a movement to have more transparency re procedure costs.
Here’s an article on the topic
http://guides.wsj.com/health/health-costs/how-to-research-health-care-prices/
Here’s a link to one website that provides some cost data by zip code.
http://fairhealthconsumer.org/index.php
I called around for somebody who needed a sinus ct scan no contrast. “cash” pay
$200.00 and $210.00 from two places including radiologist. I was shocked how cheap it was. the first one I thought the lady on the phone made it up. both calls were followed up with we can schedule it today if you like.
@jym626 no, it’s not that son. It’s our older son. Our younger son is (thankfully) still on our insurance because he’s under 26. If younger son had needed this, our out-of-pocket would have been very reasonable. Older son has a very good job, but he chose one of the cheapest insurance plans. Next Sept is the time he’ll be choosing again, so H will help him make a better choice.
I think one issue was that he was so used to having us pay for all of his health plan needs that once it became his responsibility, he chose chose cheap! Lol.
If he wants to “go cheap” again, then he’s going to have to open an FSA account and put some money in there for back up.
I just went online to look at his monthly contribution for health insurance. It is really low…like under $25 a month! ( I don’t think I’ve ever seen a comprehensive plan with that low of employee-portion premium…and there’s even a lower one for a higher deductible. This is a a management-level plan so it’s supposed to be an added bennie to have low premiums from the employee.)
I had UHC when I had cancer 12 years ago and had a number of abdomen/pelvis CT scans over the years when I had them (now have BCBS) and I only ever had to pay a $20 co-payent. In fact, I was pleasantly surprised at how much and how efficiently they paid for almost everything during my crazy expensive cancer treatment. I’m sorry others are having so much trouble with them.
That said, I cannot imagine why the barium drink could be so expensive. It’s hideous to get down, and then to be charged $900 for it is just adding insult to injury!
Nothing surprises me anymore when it comes to healthcare costs in the U.S. I have a family member in the U.S., who is on disability and is a dialysis patient. His care costs approach $1 million annually. Someone is making a fortune at the extreme rates charged. I am thankful, once again, to live in Toronto.
@alwaysamom my healthcare “costs” just went over the 100k mark for the year. And that is without a single hospital stay. It is outrageous.
m2ck’s son’s bills are a cautionary tale for all young people about choosing the cheapest insurance option- even supposedly healthy ones.
With that said, something still feels off about this. Has the hospital and the insurance both been contacted for an explanation?
I would call the insurance company and ask for the coding that was used for the procedure (and compare it to what hte hospital/practice billed). I’ve had things coded wrong in the past.
It hit my deductible the first week of January. Should be at out-of-pocket max soon. I run up $100k just in meds. Everything else will run about $30k this year (had meniscus surgery in January). DH’s plan is GEHA and administered by UHC. I am still trying to get a claim resolved from last September when they were all transitioning to ICD-10.
I had a pre-op CT scan for my knee and it was about $950. That was about 50% cheaper than the MRI, but UHC didn’t want to pay for the 3D imaging part of the CT scan. Made no sense – but UHC considers 3D imaging to be experimental (even as a more cost effective measure than an MRI and because my cardiac hardware prohibits me from having an MRI, it’s a medically necessary procedure). Really?!?
I would be tenacious.
I could fill pages with the things UHC has done. Including applying $500 of an anesthesiologists bill to my $450 deductible because it was not preapproved. My deductible had been met in January. The surgery was in August. They paid for the operating room, hospital stay and surgeons bill but the anesthesiologist was not preapproved and they claim that was my responsibility. ???
Earlier I said that UHC has denied a claim for treatment which was supposed to be done in May. After two more denials we sued them. Won yesterday. You would think they know by now that I’m not just going to quit. This was the second time I beat them in court. But I shouldn’t have to do that to get necessary treatment.
But they have paid for both CT scans I had done this year.
If anybody ever has a choice do NOT choose United Health Care.
Ugh, the new normal - suing your insurance to get health coverage. After reading about horror reimbursement stories, me thinks I will pay for D’s COBRA when she hits 26 if the insurance co will allow that.
Insane. I’d call around and ask for a cash price first.
Son has been gone on business all week, so tomorrow is the first day he’ll be able to get more info.
Just for the future, for non-emergency imaging: in-network freestanding imaging facilities NOT associated with a hospital usually have much, much, much more reasonable charges. My x-rays ran under 15% of what the hospital charges would have been, and the subsequent MRI was also hundreds cheaper. This was when I had UHC.
@mom2collegekids
Usually the insurance company is eligible for negotiated pricing. I think the hospital would have to be in-network for this. After the discounted price is applied, the insurance company pays their portion according to the terms of the insurance contract, and then the patient is responsible for their deductable/ co-insurance.
It sounds to me like their was no negotiated price with this provider- the hospital. It is possible that United Healthcare does not have any prices negotiated for lab services such as MRI and CT scans at the hospital.
I used to handle Workers’ Comp claims so I do have some experience in this matter. When we received bills for CT and MRI scans from hospitals, it was not unusual for them to be 2-3 times higher than if they were done at a facility that specializes in these tests. Also of note is that we received poor quality test results much more often from those done at hospitals. In my opinion, not only do hospitals charge way more for these tests, but the tests are not always of the best quality. I think it makes sense, though, that a facility that specializes in these tests would be better at it because that is all they do.
I would recommend calling United Healthcare and asking them if the CT lab at the hospital is part of their network. If so, you should be looking at a substantially lower bill.
In the future, you might want to get info on which specialty providers to use that have lower costs. We recently opted for a HSA high deductible insurance policy since you can put money aside and not loose it if you don’t use it. Also, it offers investment options, so your money can grow while it is in the account. Since we elected for that type of insurance, we have been getting letters giving us access to website(s) that give cost comparisons of different providers. With the new high deductible insurance, it pays to research costs and his company is encouraging their employees to be savvy healthcare consumers.
I had a full MRI series done of my back a couple of years ago, and the total cost was 1500 at an independent facility that was in network (my insurance covered about 1300 of it).
Not all of UHC is the same. We have UHC. When looking for a job people need to ask if the company has self insured health insurance. It can makes a huge difference. Our UHC is self insured meaning the company DH works for is paying the bills. UHC is just the manager and because of that it has been really good at approving and paying any bills. Over the years DH has worked at different companies and had different insurances. The self insured ones have always been the best.