Americans and non-Americans alike: Check out this absurd medical bill for a physical

Oct 27, 2017
6,549
I live in New Jersey. I have some basic Aetna insurance plan at the cost of $30 a month which covers jack shit but I THOUGHT it would suffice for something as simple as a physical (with blood and urine analysis). I'm a healthy young adult, so a basic plan normally suffices for me. Mind you, in the past when I didn't have insurance, I visited a CityMD and paid approximately $400 for the visit, bloodwork (which included STD panel), and urine analysis, so I had no idea that going to this doctor WITH INSURANCE would be several times more.

Not only did I misunderstand what I would be paying out of pocket for an annual doctor's visit to get a physical (I thought the plan would have me pay a co-pay of $50, no more), but the place I visited charged an exorbitant amount for basic services, in a way I hadn't seen done before.

I went to an Englewood Medical doctor's office in my area. This is not a hospital. It is a regular doctor's office. This is where I chose to go get a physical in early January. I did nothing more than a 10 minute meet and greet with a doctor who did his normal routine and had his assistant draw blood and escort me to provide a urine analysis.

This visit? The doctor charged $320. For the VISIT.

The blood and urine analysis? The doctor shipped off my urine and blood not to some basic lab but to an affiliated HOSPITAL and charged $1,488 for it.

So not only did I misunderstand that my doctor's visit would have Aetna cover the physical (they don't) and that I would be on the hook for no more than $50 (apparently the $50 I saw under my plan coverage meant that was what Aetna would cover), but after Aetna footed $1400 of the bills for the visit and specimen analysis, I am left owing $305.

The facility I went to is also in-network, yet despite this, I still owe several hundred bucks for one of the most basic and essential fucking things a person can do once a year just to ensure their health is okay.

What are my problems with this? Besides the fact that this is absurdly expensive, in a roundabout way I am paying the cost of a HOSPITAL visit when I never visited a hospital. I went to a doctor's office, which itself was one of the most expensive places I've ever been to (unknowingly) who decided to use an affiliated hospital to do some of the most routine lab work possible.

I am going to owe $305 for this visit. The entire bill is $1808 without any coverage. It would've been cheaper to visit a CityMD WITHOUT INSURANCE and pay $100 for the visit (instead my doctor charged $320). And the equivalent bloodwork at a CityMD, which I have had in the past when I didn't have insurance, costed me $300 (with an STD panel, which I did not do this time). But with this Englewood doctor's office, they had a hospital do it which charged $1488.

TLDR:
Went for a physical that included bloodwork and urine analysis. Bill came out to $1800. I visited a DOCTOR'S OFFICE, but the visit itself was over $300 and they shipped off the specimen analysis to an affiliated HOSPITAL to do the basic lab work, which costed $1488. This is WITH Aetna insurance.

When I get the bill in the mail from the facility, I am going to tell them to kiss my ass. So far only Aetna sent me a list of what they covered, which is how I found out about this shit.

Of course I expect to be told that I should've asked for the cost of a physical there, and that part is on me. But having had many physicals with numerous doctors over the course of my life, I thought I knew what to expect. I've had this done with and without insurance dozens of times in the past, so I certainly didn't expect to see some shit like this. Blame me for not asking, but fuck this US healthcare system and cost of services. This is criminally expensive.
 
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John Dunbar

Member
Oct 25, 2017
3,939
that sucks.

anyway, i live in a country with free health care and it has been about 15 years since i've been to a doctor, and that was only because i was in the army. hearing about people having annual visits makes me think this is not normal?
 

Raysoul

Member
Oct 26, 2017
1,443
You can do all of that for $20-30 dollars (maybe less) here in the Philippines without insurance.
 
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astroturfing

Member
Nov 1, 2017
2,738
i paid literally half of that doctor visit, 160 in euros for 11 days of ICU treatment, countless CTs, MRIs, bloodwork, dental checks, antibiotics, physical therapy etc etc plus one week of recovering in a regular ward. food was great too.

160 euros for all that heh. this is in Finland.
 

Chikor

Member
Oct 26, 2017
6,277
By law, your insurance must provide you 3 preventive doctor visit per years. I suspect your doctor did some tests that are no covered by that, as they often do in those check-ups, my suggestion would be to always ask about what is covered and about how much it will cost.
A lot of doctors tend to get upset when you try to talk money with them, but honestly, I don't give a fuck.
 

Sendero

Member
Oct 25, 2017
380
Guess only people that travels and have had their health taken care of by a different country, can actually understand how insane this all sounds.
I mean, the fact that most LA countries can deal with that stuff in a much gracious way (despite all the disadvantages) should shame every one of you into action.
 

DJ_Lae

Member
Oct 27, 2017
3,656
Edmonton
That's nuts - even for the US.

The patient doesn't pay but for comparison the base rate for a complete physical here in Canada is about $110 (can be more or less depending on the physician's specialty) and bloodwork varies considerably depending on how many tests are ordered. Urinalysis is $15, I think, plus another $15 for a urine culture, and then you're looking at $5-$20 a pop for various blood tests (blood count, cholesterol, iron, etc). I'd imagine it would cost the system about $250CDN all told - just tack on another $60 for the physician to inform you about the results, I guess.

Having to babysit the GP to make sure they don't order unnecessary and expensive tests sounds awful.
 

adj_noun

Avenger
Oct 25, 2017
10,369
If you never go to the doctor, you can't go broke from going to the doctor.



#thismightsoundlikeajokebutitsreallynotalotofpeoplenevergojustforthatreason
 

Bio

Banned
Oct 27, 2017
3,096
Denver, Colorado
Back in May I had to go to the ER for chest pains, was admitted to the hospital overnight while they ran tests.

The total bill was $47,000 and change.

My insurance covered $2,300.

I pay over $7,000/year for my coverage.
 

Ser_Foxalot

Member
Jan 27, 2020
278
Washington, DC
Is this one of the new junk plans that the Trump admin allowed for by rulemaking? Under the affordable care act, preventative visits like that were supposed to be all covered.
 

Foffy

Member
Oct 25, 2017
7,401
This country is such a shithole I really cannot imagine what world people come from to talk about how great things are here...
 
OP
OP
TheFallenSaboteur
Oct 27, 2017
6,549
If you never go to the doctor, you can't go broke from going to the doctor.



#thismightsoundlikeajokebutitsreallynotalotofpeoplenevergojustforthatreason
No, and I totally hear that. As an American, I have the mindset of trying to be as healthy and active as possible so that I don't have to go to the doctor because it's too expensive. It is unreal that I and many others like me have to think this way. But it had been 2.5 years since my last physical so I figured I really needed to, because I had really undergone a big change in my diet. But had I known it was going to cost this? I would've just fucking ate ginger and peppers until my ass exploded and considered myself healthy.

This country is such a shithole I really cannot imagine what world people come from to talk about how great things are here...
I get really irritated when someone tries to earnestly argue that our healthcare costs as much as it does out of value, as if we do anything fucking special for basic ass services like the one I went for. "Best healthcare in the world." People who laud this up are assholes, for real.
 
Oct 30, 2017
2,070
Bonkers - I literally had a 1 hour surgical procedure today to deal with a hernia, this consisted of three sessions to check necessity and other pre-op checks, the surgery today and a bunch of pain medication - I've paid approximately £10, which was on the bus to the hospital and the Uber home.
 

El_TigroX

Member
Oct 27, 2017
1,923
New York, NY
You should definitely call your insurance company to figure out what happened there... because that doesn't seem right. Does the plan you have, have a huge deductible? Because it's so early in the year, you may have not hit your deductible amount, and that's why it's so expensive.

You may have had your specimens moved to an out of network situation, even if it was an in-network doctor. That's happened to me before, and eventually I got it negotiated down in price, because I didn't approve it or agree to it.
 
OP
OP
TheFallenSaboteur
Oct 27, 2017
6,549
There's an insurance policy that only costs $30/month?
My employer offered it. It was the cheapest of three Aetna options.

You should definitely call your insurance company to figure out what happened there... because that doesn't seem right. Does the plan you have, have a huge deductible? Because it's so early in the year, you may have not hit your deductible amount, and that's why it's so expensive.

You may have had your specimens moved to an out of network situation, even if it was an in-network doctor. That's happened to me before, and eventually I got it negotiated down in price, because I didn't approve it or agree to it.
Sorry if I wasn't clear. The cost of services in total was $1808 and insurance actually did cover $1400+ of it. I am left owing $300+. There were five or six separate lines of charges on the bill for the blood/urine analysis. I did speak to a woman at Aetna but she couldn't provide further details. I have to wait for the itemized bill from the doctor's facility. So the insurance did cover it but in so many crazy ways, they covered $1400+ for lots of lab work, but they don't cover a physical, but they covered the visit (apparently they separate a PHYSICAL from the VISIT).

Ugh, this is a fucking headache.
 

JaggedSac

Member
Oct 25, 2017
2,032
Burbs of Atlanta
Most insurance plans I believe are required to cover a yearly physical. The office filed the charges wrong with Aetna. This exact thing just happened to my wife. Call Aetna and tell them what happened. They should be able to sort it out with the doc
 

DrewFu

Banned
Apr 19, 2018
10,360
Back in May I had to go to the ER for chest pains, was admitted to the hospital overnight while they ran tests.

The total bill was $47,000 and change.

My insurance covered $2,300.

I pay over $7,000/year for my coverage.
Christ, what state are you in? Here in Cali with my insurance, I think my maximum out of pocket is like $14k and it would have to be something catastrophic to get anywhere close to that.
 

Isilia

Member
Mar 11, 2019
992
US: PA
It is pretty insane. Brother was looking into insurance since his workplace no longer offers it. Some of the plans were crazy. Pay nearly 250 a month for the privilege of a 10k deductible and 1500 ER visits. His meds are 300 a month as well.

Land of the free*
 
OP
OP
TheFallenSaboteur
Oct 27, 2017
6,549
Most insurance plans I believe are required to cover a yearly physical. The office filed the charges wrong with Aetna. This exact thing just happened to my wife. Call Aetna and tell them what happened. They should be able to sort it out with the doc
I did call Aetna and they didn't help much to say that it looked like anything wrong. I even clarified and said this was a physical with bloodwork/urine analysis. Does the required coverage for a physical include the lab work I mention?
 

Zoe

Member
Oct 25, 2017
7,454
ACA insurance is supposed to cover yearly preventive care physicals at no cost. Did they code it incorrectly?
 

Parch

Member
Nov 6, 2017
3,592
"With insurance" is the hard part. People pay ridiculous amounts to get health insurance, only to find out that a lot is not covered or they have to pay a huge deductible. Or the insurance company fights hard against any claim.
Having health insurance doesn't guarantee anything. It's such a broken system.
 

El_TigroX

Member
Oct 27, 2017
1,923
New York, NY
Ugh, this is a fucking headache.
Sorry to hear that - that is so annoying, and I really feel like insurance is just set up in a way that they want to frustrate you so much that you stop asking what happened and why the bills are so high. It's insane.

When it comes to open enrollment time at your company, you should take a look at the other plans your employer offered. Even if you end up spending a bit more money, you can save yourself a lot of cash in these situations. I ended up moving my plan after I got stung by a few bills and I chose an option with a higher cost, but a lower deductible, so that honestly saved me a lot.

CityMD man... blessing and a curse. Just got a couple quick tests there and I'm waiting for the shoe to drop on that one too ;)
 
OP
OP
TheFallenSaboteur
Oct 27, 2017
6,549
Sorry to hear that - that is so annoying, and I really feel like insurance is just set up in a way that they want to frustrate you so much that you stop asking what happened and why the bills are so high. It's insane.

When it comes to open enrollment time at your company, you should take a look at the other plans your employer offered. Even if you end up spending a bit more money, you can save yourself a lot of cash in these situations. I ended up moving my plan after I got stung by a few bills and I chose an option with a higher cost, but a lower deductible, so that honestly saved me a lot.

CityMD man... blessing and a curse. Just got a couple quick tests there and I'm waiting for the shoe to drop on that one too ;)
The thing is I only ever visit the doctor once a year for a physical (in the past when I got sick often I would visit maybe once more if I felt like I needed antibiotics). That's why I chose the cheaper plan. I'm not sure the plan above this one, which would instead cost $80, would be worth it. In six months I'll be paying several hundred bucks more, which would be the price of this visit that I apparently owe. I may just keep this shitty insurance and go to CityMD next time.

"With insurance" is the hard part. People pay ridiculous amounts to get health insurance, only to find out that a lot is not covered or they have to pay a huge deductible. Or the insurance company fights hard against any claim.
Having health insurance doesn't guarantee anything. It's such a broken system.
Yeah, and I even read the plan coverage too. My employer has a website to access your benefits and I thought I read it correctly. Apparently all the dollar amounts that I thought I would be paying out of pocket for were instead what Aetna would be covering. So hypothetically if the doctor's physical cost $1000, Aetna would only foot $50 of the bill, when initially I thought $50 is what I would be paying for the physical, nothing more.
 
Oct 27, 2017
1,011
I had a similar experience with my physical exam and Aetna. Had to fight for months to get it adjusted.

Shit is really fucked for people with ostensibly good plans (like mine, allegedly). And then that's not even touching the underinsured and the uninsured.
 

jwk94

Member
Oct 25, 2017
4,256
i paid literally half of that doctor visit, 160 in euros for 11 days of ICU treatment, countless CTs, MRIs, bloodwork, dental checks, antibiotics, physical therapy etc etc plus one week of recovering in a regular ward. food was great too.

160 euros for all that heh. this is in Finland.
Curious American, why didn't your Healthcare cover that, assuming you have universal Healthcare.
 

DrewFu

Banned
Apr 19, 2018
10,360
Threads like this make me happy to be in California. Our insurance is expensive, but at least it's really good.
 

Link

Member
Oct 26, 2017
2,496
i paid literally half of that doctor visit, 160 in euros for 11 days of ICU treatment, countless CTs, MRIs, bloodwork, dental checks, antibiotics, physical therapy etc etc plus one week of recovering in a regular ward. food was great too.

160 euros for all that heh. this is in Finland.
Yeah, but you have to live under socialism. So who’s the real winner here?
 

werezompire

Zeboyd Games
Verified
Oct 26, 2017
3,702
Curious American, why didn't your Healthcare cover that, assuming you have universal Healthcare.
Clearly their healthcare did cover that, otherwise they'd be paying tens of thousands or even hundreds of thousands of euros for that kind of care. Universal healthcare doesn't mean that everything is free.

One nice thing about being in a country with universal healthcare is that medical fees in general aren't hyper-inflated like they are in the US because they know the government won't stand for it. For example, while I was in Taiwan (which has some of the best universal healthcare in the world), I took a family member to a dentist's office as they were closing for an emergency operation. They stayed up, performed the operation, and the receptionist apologized that since we didn't have national insurance, she would have to charge us about $60 USD. Can you imagine how expensive an after-hours emergency operation at a dentist in the US would cost without insurance? Even with insurance, you'd end up paying way more than that.
 

Mashing

Member
Oct 28, 2017
783
My insurance covers 1 physical for free every year (blood work being extra, but that is usually less than $10 for a full work-up). Is this something atypical for insurance? This is for BCBSTX.
 

boxter432

The Fallen
Oct 28, 2017
2,246
that sucks.

anyway, i live in a country with free health care and it has been about 15 years since i've been to a doctor, and that was only because i was in the army. hearing about people having annual visits makes me think this is not normal?
I'd say not going to a doctor for 15 years when it's free is the most insane thing in this thread
 

Zoe

Member
Oct 25, 2017
7,454
My insurance covers 1 physical for free every year (blood work being extra, but that is usually less than $10 for a full work-up). Is this something atypical for insurance? This is for BCBSTX.
No, that's the law.

Either OP's visit got coded wrong or he asked for something outside of the scope of a physical.
 

Jisgsaw

Member
Oct 27, 2017
878
I'd say not going to a doctor for 15 years when it's free is the most insane thing in this thread
Well, I also rarely go (switching between Germany and France, which both have excellent health care)
I am in perfect health, so I really don't need to put a strain on the health system I feel like.
I did dislocate my shoulder thrice though, so It was nice not having to pay anything for that.
 

Crimsonskies

Member
Nov 1, 2019
243
Curious American, why didn't your Healthcare cover that, assuming you have universal Healthcare.
We pay something called doctors fees which ranges from 25 us to 30 usd here in Norway but if the medical expenses goes over 150 usd, then its automatically covered and any expenses you have will be covered for example my lung collapsed a few years back and I had to spend 11 days in the hospital, including a tube inserted in my abdomen to reinflate my lung total cost for me was 25 usd.


However if you are in a position were you can't pay the money doctors will still treat you and they will send you a bill, and if you are in dire financial straits you can get that small fee covered as well.

The fees is basiclly just a consultation fee and its there for small things any major expense is covered such as hospital visits, ambulance etc etc etc.
 

Kill3r7

Member
Oct 25, 2017
9,996
It sounds like it is a lab issue. Did you reach out to your insurance company to figure out where the bill is coming from?
 

TheGhost

Banned
Oct 25, 2017
17,472
Long Island
Well yeah that's what you get in the US for $30 a month.

I haven't paid $30 a month in 15-20 years and that was with my job paying the other $200 every month.
 

GaimeGuy

Banned
Oct 25, 2017
5,005
My mom gasped at lunch today when she heard I pay 250-270 a month for my Concerta/methylphenidate a month if I haven't hit my deductible.

I make 80k so I can handle it, but...

I don't think the boomers realize just how crippling this stuff is for gens x, y, and z, who don't have the built up liquidity or equity or medicare they have.


Especially when deductibles are 6-10k for most non employer plans, and even 2k at "good" employers.
 

LordofPwn

Member
Oct 27, 2017
2,989
I live in the US and pay almost nothing for health insurance and my doctors visits are less than $25... wtf? like i'm aware the US healthcare and insurance is fucking broken but that's just what??