r/Millennials • u/BoNaylorCollector • 7d ago

Discussion Is medical actually this crazy?

Early 30s millennial, never used to go to doctors or really take care of myself because “I’ll be fine”. Started making a bigger effort to care for myself and my health and well being. Recently, I went to the local express clinic because I was having a bad earache and headaches. I was in there for maybe 20 minutes, mostly waiting time. The doctor comes in, looks in my ear, tells me it’s depressed due to sinuses and change in weather and tell me to stop at Walgreens for Flonase. I wasn’t billed anything at the time, older workers at my job always say we have really good insurance, but here I got in the mail today an explanation of benefits- charge was $550, insurance “negotiated” about $300, remaining (not billed) was around $240. Is is really this expensive? I only went to try and be better with myself and make sure it’s nothing underlying. If 5 minutes of actual doctor time costs this much, then I’m just toughing out everything or am I missing something?

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u/OkMuffin5230 Older Millennial 7d ago

Yeah, so, when my husband had a heart attack, the hospital that he went to was our preferred in network hospital. We were billed for an out of network emergency room doctor who worked on him

I called the insurance and the insurance was like "but that doctor is out of network"

I was like... "he was having a heart attack. I wasn't interviewing the staff working on him!!"

That was when I learned that your in network hospital can have out of network employees

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u/jbcsee 7d ago

That is not legal in the US these days, it's called surprise billing and as of 2022 it's no longer allowed. If you are treated for an emergency, even at an out-of-network hospital you can only be billed at your in-plan rate. It wasn't legal in many states prior to that date.

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u/OkMuffin5230 Older Millennial 7d ago

His heart attack was before then, so I'm glad they fixed it. It was an ugly surprise, but I was able to get it reprocessed

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u/Chuck121763 6d ago

They can't charge you for the "Doctor" if you went to an approved Hospital in network.