For future reference, asking the hospital what your insurance covers will always result in a "we don't know" answer because they don't speak for your insurance. They can't risk saying "yes" when they aren't the ones deciding.
In these cases, call the insurance company. The reps deal with coverage questions like this all day long.
I understand the reasons why we structure our world using adversarial systems but geez, sometimes it really shows.
If you don't want to deal with the plethora of scummy apps to record call, you can go old-fashion and buy a telephone pickup microphone[1] for $20.
[1] https://www.amazon.com/Olympus-TP-8-Telephone-Pick-up-Microp...
I did that once, they told me "we don't know because we don't know what the hospital will bill".
So I decided that I don't know if I'll pay..........
Let’s not be hyperbolic.
Or, even if it's just the knowledgeable and responsible medical profession who knows how important that is, then surely that same knowledgeable and responsible medical profession would ensure that no one ever has to think about doing something they claim to care so much about avoiding. Right?
This responsibility to others argument falls dead flat.
You can set a broken bone yourself. You cannot treat MRSA. You do not walk out of a hospital with untreated MRSA AMA.
Do those grow back crooked or something?
I had gone to an urgent care clinic with abdominal pain. They pressed on my abdomen to see where the pain was and told me to immediately go to the hospital down the street and there would be a CT scan order waiting. At the conclusion of the scan, I was told to go down the hall to the ER for emergency surgery.
At the ER check-in counter, they took my information. My insurance was a PPO for which the hospital was in-network. After 20 minutes on the phone, they told me that my employer (a 6K person public company, not a small company just figuring out benefits) hadn't paid their premium so they would not admit me. I knew the head of HR and called her directly. She said that premium payments are automated and there were no issues. To make sure, she called our contact at the insurance company, and they confirmed everything was good. I told all of this to the front desk staff, and they said there was nothing they could do. They said they would contact the insurance company again the next day and call me if anything had changed.
Looking back, I should have gone straight to another hospital. But I was delirious with pain and went home to rest because I was exhausted and freezing cold from sweating profusely. The next afternoon they called and said it had been cleared up and that I need to get there immediately as it was life threatening. I got to the ER, and they started a series of tests to determine if my appendix had burst (it hadn't!). A doctor came over to review the test results, saw that the CT scan was the previous day, and yelled at me for several minutes about how I risked my life by listening to the front desk staff. I asked if I should have forced my way back to find an empty bed and just jumped into it. He continued to yell at me until a nurse physically pulled him away. I finally had the surgery late that night (with another doctor that was not so agitated), and everything went well from there.
So, I initially left the hospital against medical advice, but at the insistence of non-medical staff. A different situation, but sometimes taking medical advice is not an easy option.
Has he tried yelling at the front desk staff yet? I hope you know his name and contacted him afterwards.
> I asked if I should have forced my way back to find an empty bed and just jumped into it.
I assume that would get you arrested, and maybe even dragged to jail. :S
You survived the insurance system (or rather, despite it).
The hospitals can't tell you what is covered at the time of service, only well post facto (I literally got a call last week about a copay from surgery I had in May 2022). IMHO most of that blame lies with the insurance companies, but the hospitals are complicit.
I once got a bill nearly a year after the actual treatment, with a line item that differed only by the description field's whitespace and punctuation from a charge I knew I'd already paid. There was a smaller line item on that bill that I probably hadn't paid, but just through the magic of calling the phone number and sitting through hold, I was told not to pay anything.
I have a friend who was hospitalized on December 30th and released on January 2nd. And that's how they hit their max out of pocket two times over the course of 4 days.
It's an awful edge case. If they'd gotten terrible vertigo a couple days earlier or later, it would have cost them half as much.
but of course in practice, most US healthcare consumers don't really have an actual choice about who they buy their healthcare from.
I knew a guy. In 2008 his wife's company went under. So lost the health insurance she'd had for 15 years. No COBRA and in 2008 no ACA either. Her gall bladder got infected and they had to put a second mortgage on their house. Both of them had been paying for insurance for 25 years at that point.
Me I didn't have health insurance between 18 and 40 when I started working for a big corp. Two years later racked up $50k in medical bills. Insurance paid almost all of it.
Crazy.