Hospital billing - Ugh!

[George Bokros]

My wife had a hospital bill that I requested I be permitted to pay over three months. I had no response to my request to pay over three months. Next thing I get is a letter from a collection agency. I called them and they offered to let me pay over six months. Guess the hospital lost on that one. They had to pay the collection agency probably 1/2 of what they collected and took them twice as long to get their money as I originally offered.

[Wade Lippman]

I do have insurance, but I still have to pay 20% myself.

Be very careful of this. You only have to pay 20% of what the insurance company negotiates with the provider; not what the provider bills.

We got a $950 bill for an ambulance. I told them to put it though my insurance. I had to pay 100%, but it was reduced to $400 because that was the insurance company's cost.

[Brian Elfert]

Be very careful of this. You only have to pay 20% of what the insurance company negotiates with the provider; not what the provider bills.

Correct. In the case of my sleep study the insurance contracted cost was $1122.69. I had to pay 20% of the $1122.69. I always check to be sure the providers are charging me the correct amount and they have never over billed me, so far.

I stayed overnight in the hospital once. The hospital charged over $7,000 for their services and my insurance only paid them $2,250. The hospital had to eat about $5,000.

[Michael Weber]

I've been entertained by insurance EOB's for years. What the insurance pays as a percentage of the charge is often ridiculous. Sometimes just a few cents on the dollar. I always feel bad for those without insurance who are billed for the entire amounts. Of course they may not pay but the health industry knows that. A businessman once told me hospitals love those big uncollectable debts. Probably worth more in tax write offs than the percentage they would have been paid by an insurance company. It's just way to complex a situation to last. Powerful people and companies constantly butting heads to maximize profits. Sad

[Brian Deakin]

To Contrast

I live in the United Kingdom and if treated within the National health service there are no costs other than prescription charges and dental charges

(There are no prescription charges when you are in hospital and no prescription charges for your discharge medicines )

The prescription charges when seeing your doctor are are £8.20 per item ($12 approx )and that cost is only made if you fall outside the groups below

Further you have a number of medicines you can buy a pre payment certificate which costs about $150 per year which covers the cost of all prescriptions



Who is entitled to get free prescriptions in England?

• If you are aged 60 or over.
• If you are aged under 16.
• If you are aged 16, 17 or 18 and in full-time education.
• If you are pregnant, or have had a baby in the previous 12 months, and have a medical exemption certificate (see below).
• If you have a listed medical condition and have a medical exemption certificate (see below).
• If you are an NHS inpatient.
• If you (or your partner) get one of the following:
  
  • Universal Credit.
  • Income Support.
  • Income-based Jobseeker's Allowance.
  • Income-related Employment and Support Allowance.
  • Pension Credit Guarantee Credit.
  
  
• If you are entitled to, or named on, a valid NHS tax credit exemption certificate.
• Some war pensioners - if treatment is connected with the pensionable disability.
• People on a low income who have a certificate HC2 (see below).

If you are entitled to free prescriptions, complete the declaration on the back of the prescription and sign it. You may be asked for proof that you are exempt.

Who can get a medical exemption certificate?

If you are pregnant or have had a child in the past year

You need to apply for a Maternity Exemption Card, using form FW8. The form is available from doctors, nurses, midwives and health visitors. You are required to complete the form and your doctor, nurse, midwife or health visitor will sign the form to confirm the information given by you is correct.
The card will last until 12 months after the expected date of the birth (you can apply for an extension if the baby is born late). If you have a Maternity Exemption Card all your prescriptions are free, whatever the medication is for.
Related articles

• Help With Health Costs
• Employment and Support Allowance
• Healthy Start
• More related content

People who have certain medical conditions

Although there are many conditions requiring regular medication, only the following qualify for an exemption certificate:

• Treatment for cancer; note this includes treatment for the effects of cancer, or treatment for the effects of a current or previous cancer treatment.
• A permanent fistula requiring dressing.
• Forms of hypoadrenalism such as Addison's disease.
• Diabetes insipidus and other forms of hypopituitarism.
• Diabetes mellitus, except where treatment is by diet alone.
• Hypoparathyroidism.
• Myxoedema (underactive thyroid) where thyroid hormone replacement is necessary.
• Myasthenia gravis.
• Epilepsy requiring continuous anticonvulsive medication.
• A continuing physical disability which means you cannot go out without help from another person.

If you have one of the specified conditions ask for an application form, FP92A, from your doctor's surgery. You need to fill it in and your doctor (or an authorised member of the practice staff) will sign to confirm the information you've given is correct. You will then be sent a Medical Exemption Certificate which is valid for five years.
If you have a Medical Exemption Certificate all your prescriptions are free, whatever the medication is for.

How can people on a low income apply for help?

Some people on a low income may qualify for help with prescription charges. Your entitlement to help is based on your circumstances, such as your level of income, savings, etc. You will have to fill in an HC1 form 'Claim for Help with Health Costs' giving various details of your circumstances and then send it off in the prepaid envelope provided.
If you qualify for help, you will be sent an HC2 Certificate for full help, or an HC3 Certificate for partial help, which you will need to produce when paying for your prescription. The certificate will tell you whom it covers and how long it lasts. If your circumstances change for the better, you can continue using the certificate until it expires. If your circumstances change for the worse during the period of the certificate, you should make another claim. If your circumstances will remain unchanged after the time period then make a new claim before the current certificate expires.


regards Brian

[Terry Hatfield]

To Contrast

I live in the United Kingdom and if treated within the National health service there are no costs other than prescription charges and dental charges

The prescription charges are £8.20 per item ($12 approx )and that cost is only made if you fall outside the groups below



You can get free NHS prescriptions if, at the time the prescription is dispensed, you:

• are 60 or over
• are under 16
• are 16-18 and in full-time education
• are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
• have a specified medical condition and have a valid medical exemption certificate (MedEx)
• have a continuing physical disability that prevents you from going out without help from another person and have a valid MedEx
• hold a valid war pension exemption certificate and the prescription is for your accepted disability
• are an NHS inpatient

You are also entitled to free prescriptions if you or your partner (including civil partners) are named on, or are entitled to, an NHS tax credit exemption certificate or a valid HC2 certificate (full help with health costs), or you receive either:

• Income Support
• Income-based Jobseeker’s Allowance
• Income-related Employment and Support Allowance, or
• Pension Credit Guarantee Credit
• Universal Credit and meet the criteria

regards Brian

That's it. I'm moving. Do you have an extra room, Brian?