Heathe care in TN - This is MESSED UP! (insurance, transfer)

[RS-1080]

Originally Posted by BNB

What I find more incredible than the fact that your GF is not able to be covered under some sort of state insurance coverage is that treatment for a broken nose and stitches cost her $7,000????

I know ER is expensive...but $7K??

That is a crime.

When our daughter was little, she broke her arm on the softball field chasing a ball and fell. I knew it was broke soon as I ran to her as it was in the shape of a banana between the wrist and elbo. We left the field to the ER and about an hours wait in the ER with her crying, they finaly called us to the desk to fill out our info after they were done with some immagants that didn't have paperwork,insurance,or speak english.This was UMC of Lebanon.

Anyways, the place was packed and no ER room space so the ER doc had them X-ray her arm, then he came out in the hall and said both bones were broken, and he set it right in the hall while she scream in front of everyone else. I asked him to please give her a shot in her arm to kill the pain first as she was just a little girl,but he said they didn't tell others how to do their jobs, or ask what they do,so please not give him advice on how to do his either.After the torture, he went back into the ER and another person came out in the hall and put a cast on it.Our bill was 4500.00, but after we paid our 100.00 ER co-pay our United Health Care paid 80% of the rest.Our co-pay would have been ''zero'' had UMC said it was an emergency, but I reckon in their eyes two totaly broken bones was not grounds for saving us that 100.00 co-pay. Sadly, the ladies at the desk told us we could thank all the ones like the ones they were trying to deal with when we first came in for that as they hardly get a nickel out of them, but yet can't turn them away either. We pay 272.00 a month for insurance through my wifes work, it's great that we had it though as we sure didn't have 4500.00 in our pockets when they billed insurance.

[Kim918]

I know there is a form you can fill out if you have no insurance. They send the form to different charities and one of them will pick up the bill. I know someone who did this and Catholic Charities paid it off for them. I will try and find out where they obtained the form from and get back to you.

Originally Posted by rossc

My girl friend took a fall on her bike and broke her nose and got a few stitches. She has no insurance and the bill was close to $7000. She went to DHS to see about TennCare and Medicaid and what she found out defies belief.

She was told that TennCare is not available for adults even though she does meet the income requirements. In order to get TennCare (medicaid) you have to meet one of the following...

(1) Have a dependent child, then I think only the child gets benefits.

(2) Be mentally ill, and you have to prove it.

(3) Be disabled and not making ANY money.

(4) This is the best one. The case worker told her point blank that if she were an illegal she could get 100% TennCare/Medicaid coverage.

[rossc]

No one is looking for a free ride. I think the hospital is going to work something out with here, but my point was that if you are an illegal you can get state funded health care...and that's a direct quote from a DHS case worker. It's not right that an American citizen and taxpayer can't get assistance but a Mexican right off the boat can.

$4000 of that $7000 bill were CT scans.

[rossc]

Originally Posted by Mary_Moon

That's really awful about your friend. A broken nose can be pretty painful. Does your friend have a job? Is she not eligible for health insurance through her employer or did she opt to not purchase it because it costs too much?

She is unemployed. She helps with my business which is teetering on the edge right now. She has insurance now. This accident happened 6 days before the effective date. It's the same major medical plan I have. It wouldn't have been of much help in this case because of the high deductible. It's the type of policy you have for major illness that can run into the hundreds of thousands.

I think in the next few months we will both have jobs. Being self employed is nice sometimes, but with the cost of health care I'd rather work for someone else and get some decent benefits.

[Nashter]

It's sad to hear what happened and to learn about the $7000 bill for nose stitches. But that's really how the system works. Get covered and pay the fee (despite it hurts our wallet) and get peace of mind.

Here's the other thing, get it while one is young and can bike or jog and able to get it because there WILL come a time that no matter what one does, insurance organizations (even public or government) WILL GIVE the person a difficult time getting in as member. They WILL find a hole in one's eligiibility application if it believes the costs will far outweigh the revenue. It's simple economics and politics. THERE WILL be competition in an organization's budget and everybody is pressured to perform to have a positive income.

I am so happy that I have coverage for my entire family even if it is a monthly slash of $ per month. Never mind the dental, I will just be like Michael Strahan. It's the IN thing you know !

I stray away from a lot of expenses but health insurance is something I enjoy spending money for.

[Mary_Moon]

Originally Posted by Nashter

I stray away from a lot of expenses but health insurance is something I enjoy spending money for.

Well, I don't enjoy spending $$$ on health and life insurance, but it is completely irresponsible not to, especially when you have a family. We spend close to $800 a month on group health insurance, dental and vision coverage provided through my husband's employer as well as independently purchased short and long term disability and term life insurance policies on each member of the family. I don't like having to pay for it and I could find a heck of a lot more fun things to do with that money each month, but I do have the peace of mind that if something happened to any of us, we'd be covered. Same goes for house and automobile insurance.

I absolutely don't agree that illegal immigrants who are not paying into our system gets a free ride/coverage. That's just wrong and needs to be changed.

[BNB]

Originally Posted by rossc

No one is looking for a free ride. I think the hospital is going to work something out with here, but my point was that if you are an illegal you can get state funded health care...and that's a direct quote from a DHS case worker. It's not right that an American citizen and taxpayer can't get assistance but a Mexican right off the boat can.

$4000 of that $7000 bill were CT scans.

Sorry but I am still having a hard time with the amount of her bill. I had a CT scan/with contrast done and it was $450. Even if she had more than one done...I cannot see how it would add up to 4k. I'm shocked. There must be an error somewhere in there.

Just as an example.....I was overcharged (wrongly charged) when I delivered my firstborn. She was born by C-section at 11:58 pm. And I was charged for that day for an isolette. There was no way she was even cleaned up and put in an isolette before midnight! But the hospital automatically charged me since she was born on that day. Crazy, but true.

[rossc]

Originally Posted by BNB

Sorry but I am still having a hard time with the amount of her bill. I had a CT scan/with contrast done and it was $450. Even if she had more than one done...I cannot see how it would add up to 4k. I'm shocked. There must be an error somewhere in there.

This is what the bill says...

CT CERV SPINE W/O CONTRA $1915.00
CT MAILLOFAC SINUS SCRN $1413.00

Hand and chest X-Rays that were not really needed came to another $881. We even questioned the doctor on those and mentioned that there was no insurance.

Maybe we should be asking for a written quote prior to treatment.

We'll know more next week, but I think the hospital is going to help her out. May only have to pay the plastic surgery bill, which is another $800. The $7000 ER bill did not include the stitches, that was billed by the plastic surgeon.

Some more craziness on the bill is...

2 CEPHALEXIN CAPSULES $35.26 (got 30 tablets at Walgreens the following day for $16.00)
20MG MORPHINE $231.92
1 HYDROCODINE TABLET $45.05
1 LIDOCAINE INJ $111.17
1 LORTAB $45.28
2 BACITRACIN OINT $55.10 (these are the single dose packs they usually give away)

We still don't know if the fire dept is going to charge for the ambulance ride.

[Rainna]

Yes they will charge. I believe the $7000.00 bill. I was in an auto acc. last year and was taken by ambulance to Vanderbilt along with another person and they charged us both. We were there for around 4 hrs. and my bill was $18,000.00 and hers was $26,000.00. I didn't have any serious injury but she had several broken bones in her hand which required 7 pins. I had an MRI on my back. Those bills did not include the Drs. bills. or ambulance ride. Luckly her car insurance covered all the bills. Hospital bills are ridiculous.

[storey13]

I know this won't help for this time, but depending on the circumstances, she could get CoverTN, which I believe would of helped in this situation. I work for a small business that doesn't provide health insurance and this is one of my only options that is affordable. Also, if she lives in Davidson County, she could also sign up for a program called Bridges to Care. With Bridges to Care, you must live in Davidson County and not have any kind of health insurance. It is not based on income. I currently am using bridges to care. I had some pain in my elbow a few weeks ago, so I went to the Mathew Walker Clinic, signed up for Bridges to Care, saw a doctor, they took x-rays, did bloodwork, all for $20 total! They then filled my two prescription at the clinic(pharmacy on site) for $8 each.
The Matthew Walker clinic does take walkins if it is an emergency and they are open late Monday through Saturday.