So, over the New Years holiday, I went to the emergency room because Bellagio slipped some walnuts into a dish that wasn’t supposed to have any in it…and didn’t label it. Shitty.
But, I have insurance. Coverage is supposed to help pay for such things, right?
Wrong.
It appears I will be paying nearly the whole thing out of pocket. This, to me, seems like horseshit. For emergency room visits, I have a $100 co-pay, and then 30% of costs on top of that. Overall I have a $750 deductible as well, so that comes into play, because I never get sick, so I don't use insurance all that often. Yeah, that’s a lot…but it is what it is. However, I’d expect the insurance company to actually apply the costs of the procedures to the deductible, and then start covering things after that. I guess that’s not how insurance works.
My bill is coming in two parts. One part is for the hospital and emergency room itself, and the other is for the doctor who was on call that night. Not sure why it has to be two bills, but whatever. However, the doctors on call just happen to be out of network. When the bill for the doctors went to Humana (for $667), Humana said they have a negotiated rate of $162.60, and applied that to my deductible. That’s fine, if that was actually what I’d be paying. Except I’ve gotten a bill for the whole $667 from the doctors. When I went to Humana about this, they said “oh, the 162 is just our max allowable rate. Because the doctors are out of the network, they don’t have to agree to that and can charge whatever they want. By the way, anything you pay over that out of your pocket doesn’t apply to the deductible. Have a nice day.”
Needless to say, I am not particularly pleased. This seems like horseshit to me. Either I should have to pay the negotiated rate…or the full rate should count against my deductible. I’m getting screwed twice here. Because now Humana has 550 bucks or so of deductible left for my emergency room bill…plus the co-pay…plus the 30%. Humana ended up paying the hospital just over $150. I will be responsible for the other $750. Because they didn’t apply the other rate to my deductible, I have to pay everything. Overall, it appears I will have to pay somewhere around $1400 out of my own pocket, while my insurance company pays $150. This seems outrageous. I would have been better off WITHOUT INSURANCE! I mean, at least then I wouldn’t have been giving free money to a company for apparently no reason.
So, I’m pretty much ready to cancel my insurance coverage at this point. It seems fucking pointless if they aren’t actually going to pay for anything. I’ll just put that money every paycheck into my own account, and keep it around for when shit crops up. Also, it looks like my entire tax return is spoken for…and then some. So yeah, I’m pretty pissed off right now. I'm also feeling really poor.
5 comments:
Call them twice a day, every day and keep asking for supervisors- annoy them to death.
JMB
I agree. I also heard on a talk show this afternoon that you can call the doctors and ask them to lower the fee because your insurance isn't covering them. Apparently this often works.
Or charge the Bellagio for giving you walnuts without warning.
Can you sue the Bellagio to cover the costs because you were reasonably led to believe that the food didn't contain walnuts? If other food was properly labeled but this was not because it was a substitute (I thought that was the case in your original post), I think it make sense, but it also depends on other liability issues which neither of us probably know much about. If you do have a case, you could also likely claim damages for lost vacation time and money spent on the vacation itself. Know any lawyers in Nevada?
- Sameer
P.S. Take this to Judge Judy. That would rock.
- Sameer
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