Quote:
Originally Posted by Tbear
I am the author of " The Diary of a Partial Knee Replacement " on this forum and I continue to update it weekly for those that might have to go through a similar procedure as I did.
My next post was going to be on the cost of my partial knee replacement. Prior to my surgery, I had no luck trying to find out how much I might have to pay or how much a typical procedure like this is actually allowed by Medicare. All I knew was that I had insurance and it would be covered with a maximum out of pocket for me of $1900.
I currently have the United Healthcare Medicare Advantage insurance plan.
Although there were lots of smaller charges, the hospital bill in round numbers was $84,000. My hospital stay was technically one day with an overnight stay ( as required by Medicare ). The hospital was paid by the insurance company $8,500 as a total settlement.
I paid a $150 hospital stay co-pay.
The doctor bill was $2,800. Insurance settled that bill for $1,200.
The only other costs I've had to pay were the minimal copays for the pain meds I had to get as well as $15 copays each time I visit the physical therapist.
Needless to say that if I did not have insurance, I never would have had the operation...
Tbear
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And therein is one of the huge inequities in the system. Providers can "charge" way more than they will collect from insurers, and hospitals are by far the worst offenders. But they only get what the insurance pays, unless the patient is uninsured, in which case they need a bankruptcy lawyer. VERY, VERY unfair
It is also getting unfair for those under 65 WITH insurance, when you consider that many of these "Obamacare" policies have deductibles of 8,10, 12 and even $14,000. Hopefully, whatever emerges as the final version of the new health care act will address this, but I'm not holding my breath.