$300K Bill Charged by Out-of-network Hospital

Megan Rothbauer nearly died from a heart attack last September. After being picked up unconscious, EMT’s followed procedure and rushed her to St. Mary’s Hospital in Madison – the nearest hospital to their location.

Megan Rothbauer received the very best care at St. Mary’s Hospital as doctors and nurses saved her life. She immediately praised the EMT’s (Emergency Medical Technicians) and hospital that saved her life. It seems like a happy ending. She nearly died, but the instant health care facility saved her.

But the story doesn’t end here. Megan was hit with $300K in medical bills, even with the health insurance. Afterwards, St. Mary’s officials revealed that our hospital is out-of-network for her health insurance plan, directed by Blue Cross Blue Shield. Like other hospitals, St. Mary also treats the patients without knowing their insurance status or the patient’s ability to pay.

Also, the St. Mary hospital was only 3 blocks away and if you will estimate the cost of her arrival at the hospital, it might be $1500. Instead, the hospital’s bill was amounting $300k. Blue Cross did agree to pay what they would have paid the in-network hospital, which was $150,000.

St. Mary’s walked to the plate and covered 90 % of the hospital expenses, taking the bill down to $40,000 compensated to the doctors involved with her care. Which has her close to bankruptcy, because of her lack of preference within the matter.

Using the Affordable Care Act, individuals are discovering that choice continues to be sacrificed to what was said to be affordable prices. For everyone that saves money under the plan, another will get socked with costs.

In the case of Megan Rothbauer, it’s the frustration of getting no choice. She’s fortunate that the hospital and the insurance provider will work together with her, but ultimately, it exposes a harmful flaw that continues to be within our medical health insurance industry. Option is being restricted.

You are able to blame the ACA, profit chasing after by companies or whatever. Despite, the concept behind the ACA ended up being to prevent precisely what happened above. If you’re covered under a good health insurance plan, this will never happen. If it means the ACA needs a change, then so whether it is.