Medical bills surprises: what to do and how to protect yourself

Tom Saputo was shocked when he received an unexpected medical bill for $ 51 000 dollars for an ambulance. His insurance covered most of the helicopter bill, but he still owes $ 11 000. Writes about this Good Morning America.

Фото: Depositphotos

“We don’t know how we’re going to pay this bill,” said Tom’s 53-year-old wife, Dana.

The family lives in California, and when they found out that Tom, who leads an active lifestyle, was diagnosed with pulmonary fibrosis, everyone was in shock.

To survive, he needed a double lung transplant; on 14 on July 2018, Saputo was delivered by helicopter to a medical facility for surgery. The family agreed to everything without hesitation.

“How can you think about money when your husband is dying?” - says Dana.

Now Tom 63 of the year, and his wife is very glad that at one time they did everything right. Moreover, she claims that a lung transplant operation costing $ 36 000 was fully covered by insurance.

But later, when the family received an invoice in the amount of $ 51 000, they found out that $ 11 000 insurance does not cover. The insurance agent said that "the costs of its transportation were paid in accordance with his insurance plan."

After repeatedly contacting the insurance company, the debt was canceled.

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According to a survey conducted by Kaiser Family Foundation in 2018, four out of ten insured Americans received an unexpected medical bill when they thought that all expenses were covered by insurance.

“Helicopter ambulances are the single most common complaint in our database,” said Elizabeth Rosenthal, editor-in-chief of Kaiser Health News.

According to a study conducted in 2017, more than half of all helicopter ambulance bills are out of insurance. According to the American Hospital Association, two-thirds of medical helicopters are privately owned.

What to do with an unexpected score?

According to a survey conducted by Kaiser Family Foundation in 2019, almost 80% of Americans want legislation to protect patients from unexpected medical bills.

In May last year, US President Donald Trump called for an end to unexpected accounts. Co-authors of this law, Frank Pallone Jr. and Greg Walden, say that it is very difficult to take into account all the factors.

“When it comes to ambulances or helicopters, there are many factors involved. They may be private or owned by local government or non-profit organizations. So it's very difficult for us to figure out how to take all of that into account,” Walden says. “We are doing everything we can.”

What can be done to protect yourself

1. In order not to get an unexpected medical bill, find out which services are the most likely reasons for this “surprise”. Emergency visits are the main source of unexpected medical bills, so find out which hospitals closest to you are covered by your insurance plan. Also, specialists such as anesthetists and radiologists are more likely to be outside the insurance plan, so check before using their services.

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2. In addition, ask the insurance company to explain to you your benefits and how much you should expect to pay for services.

3. Before paying an unexpected medical bill, experts advise trying to negotiate a lower payment.

4. Find out if your state has a law that protects against unexpected medical bills.

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