Uninsured patients pay more: A first-person account

Filed Under: Costs, Patients, Providers

A friend came over to fill out our “tell us what you paid” forms.

I’ve taken out some of the details, and left others. “Kidnapped by ambulance” might be a better headline for this, a $2,859 unreimbursed emergency room experience (and don’t miss the $1,699 blood test).

I did know that uninsured people pay the full price (as opposed to the negotiated rate paid by the insurance company). What I didn’t know: there is a surcharge for uninsured patients — beyond the full price.

Everything below here is from my friend — who went from being insured in May 2010 to being uninsured by the time of her December experience.

Date: Wednesday, December 8, 2010
Price charged: $610.00
Reimbursement: $0.00
Out of pocket cost: $610.00
Procedure: ambulance
Provider: [name removed] Ambulance Corp. Inc.
Notes: This was a bill for an ambulance ride from Ardsley, NY, to [name removed] Hospital ER, 6 miles away. What is interesting about this is that I had a seizure at work (I have a longstanding seizure disorder), my colleagues called 911, the ambulance showed up–and, since I was awake by now, I said I was fine and did not want to go to the ER (I do not have medical insurance). They insisted; although conscious, I was obviously not fully with-it, or at least not enough to argue cogently. I felt I had been kidnapped.

Date: Wednesday, December 8, 2010
Price charged: $167.00
Reimbursement: $0.00
Out of pocket cost: $167.00

Procedure: Doctor visit in White Plains Hospital ER
Provider (doctor, hospital?): [name removed], [name removed] Hospital ER
Procedure code, if known (5 digits): 99283

Notes: This bill is for the ER doctor to spend 3 minutes with me and send me home (I was delivered by ambulance to the ER after having a seizure, something I have lived with for 20 years and that does not require an ER trip).

Date: Wednesday, December 8, 2010
Price charged: $2,082.00
Reimbursement: $0.00
Out of pocket cost: $2,082.00
Procedure:  various tests in ER
Provider: White Plains Hospital Center

Notes: This ER bill reflects several blood tests, other procedures that I cannot decode from the bill (APTT,  anyone?), and a pill. Examples:

I was charged $187 for the Lamictal pill; I pay $1 each when I fill my prescription at the local pharmacy.

Drug screen/blood test (to see how much Lamictal I had in my blood before they gave me the pill): $591. I paid $120 when I had the same test done at a walk-in clinic 2 months before.

ER charge, level IV: $834. I waited around for 3 hours, the doctor saw me for 3 minutes, they took blood, and sent me home.

My favorite: $182.97 for the New York State surcharge to cover uninsured patients–of which I am one.

Date: Friday, May 28, 2010
Price charged: $1,699.00

Reimbursement: $278.00

Out of pocket cost $0.00

Procedure: blood tests at routine physical

Provider: [name removed] Medical Center, Eastchester, NY

What is interesting about this bill is that it was sent in error, when the provider entered my insurance information incorrectly and, thinking I was uninsured, tried to bill me for the full, non-negotiated price. When they re-submitted it to Aetna, Aetna reimbursed only the negotiated rate, of course: $278. That’s all [the hospital] could collect. If you are uninsured, of course, they try to collect the full $1,699 from you. Did I mention that this is blood work I never requested? But if you’re not careful, you go in for a physical with [this doctor]  and leave with a bill of over $2,000 (including her fee).