What is the most nightmarish medical bill you ever saw and how did it get payed?

Published

Specializes in retired from healthcare.

In times past I have heard of people who lost their homes because of medical bills.

The Affordable Care Act offers a plan that would reimburse a patient for 90 percent of their bill while they would pay the other 10 percent out of pocket.

I have heard of hospital bills being more than $1000 per day. I have heard of people who stay hospitalized for more than 120 days.

How much might this 10 percent "out-of-pocket" cost equal and isn't there still a risk that the sum of this might result in a patient losing their life savings unless county funding or other types of funding are available to them?

What funds are available to any patient if that 10 percent out-of-pocket cost is equal to everything they own? Could they really lose it all or is this just a paranoid idea?

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

2.5 million dollars. Biggest bill I ever saw. Yes, you could really lose everything you own.

Up Vote Up Vote ×

I had a 27 weeker in the NICU for 4.5 months, the medical bill was well over 1 million dollars, I had to pay a couple thousand bucks. Not a bad deal at all.

Up Vote Up Vote ×
Specializes in Utilization Review/Case Management.

I work in Utilization Review on the insurance plan side. I have seen bills over one million dollars for many NICU babies. I think the highest one was almost 6 million. Frequently I see bills that are well over $100,000. My company figures the "average" hospital stay at over $5,000 a day. I did not see the math they used to come up with that number, but they use it to sell their service, so it must have some basis that can be quantified. I am not sure how the affordable care act plans work, but many commercial insurance companies as well as private, self-funded plans have deductibles and co-pays. These rates can vary between "in network" and "out of network" providers. There are many other ways they can figure out the payments - it can be very confusing.

Up Vote Up Vote ×
Specializes in Home Care.

I worked for one of the large medical insurance companies as a high dollar claims adjuster.

There are complicated contracts to follow when paying those claims. I think the highest I paid out was close to $750k. That was scary.

And then I went into nursing

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I know of many who file bankruptcy against medical bills....however that is only every 7 years.

Up Vote Up Vote ×
Specializes in ICU.

Before my son passed away, we pretty much lost everything. He was 21, had BlueCross, but our part over the years was astronomical. His premium went to $1300 per month. He was denied disability the first time (stage 4 with mets to liver and lungs!) and had to reapply. Since he was only 21 at the time, he only got a little over $600 per month for disability. When he finally got Medicare, his premium was $98, taken out of his little disability check. He NEVER got Medicaid; was denied twice for it, and died without ever receiving any help from Medicaid. Food stamps? He got $90 per month for one year. Yes, medical bills will bankrupt you fast. I ended up quitting my job to take care of him, so I no longer had an income. Sold my house and rented. I am glad children can now stay on their parent's insurance for longer... there has been a huge gap for people in that age range. If you are under 18, there are places like St. Jude's and Ronald McDonald houses, but for those over 18 who never got the chance to work and make much money, there is a huge gap. At least that is how it was for us. He was still in college when he got sick, and had his own policy at that time, but the premiums were outrageous.

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Before my son passed away, we pretty much lost everything. He was 21, had BlueCross, but our part over the years was astronomical. His premium went to $1300 per month. He was denied disability the first time (stage 4 with mets to liver and lungs!) and had to reapply. Since he was only 21 at the time, he only got a little over $600 per month for disability. When he finally got Medicare, his premium was $98, taken out of his little disability check. He NEVER got Medicaid; was denied twice for it, and died without ever receiving any help from Medicaid. Food stamps? He got $90 per month for one year. Yes, medical bills will bankrupt you fast. I ended up quitting my job to take care of him, so I no longer had an income. Sold my house and rented. I am glad children can now stay on their parent's insurance for longer... there has been a huge gap for people in that age range. If you are under 18, there are places like St. Jude's and Ronald McDonald houses, but for those over 18 who never got the chance to work and make much money, there is a huge gap. At least that is how it was for us. He was still in college when he got sick, and had his own policy at that time, but the premiums were outrageous.

I am so sorry for your loss.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Before my son passed away, we pretty much lost everything. He was 21, had BlueCross, but our part over the years was astronomical. His premium went to $1300 per month. He was denied disability the first time (stage 4 with mets to liver and lungs!) and had to reapply. Since he was only 21 at the time, he only got a little over $600 per month for disability. When he finally got Medicare, his premium was $98, taken out of his little disability check. He NEVER got Medicaid; was denied twice for it, and died without ever receiving any help from Medicaid. Food stamps? He got $90 per month for one year. Yes, medical bills will bankrupt you fast. I ended up quitting my job to take care of him, so I no longer had an income. Sold my house and rented. I am glad children can now stay on their parent's insurance for longer... there has been a huge gap for people in that age range. If you are under 18, there are places like St. Jude's and Ronald McDonald houses, but for those over 18 who never got the chance to work and make much money, there is a huge gap. At least that is how it was for us. He was still in college when he got sick, and had his own policy at that time, but the premiums were outrageous.
((HUGS)) I am so sorry for your loss
Up Vote Up Vote ×

All the insurance plans I've had over the years had a "max out-of-pocket" limit that limited the amount I had to pay in a given year.

Last year my max out-of-pocket was $2,500 for in-network and $5,000 for out-of-network. My deductible was $1,250 and my co-pay was 20%.

I had 2 trips to the ED, multiple CTs, multiple ultrasounds, surgery and 7 days in the hospital. I had to pay the first $1,250 (deductible). Then I had to pay 20% until I had paid another $1,250. (In other words until I had paid a total of $2,500.) Then my insurance covered everything else at 100%.

Most of the people who go bankrupt over hospital bills are those who are uninsured.

Insurance plans used to have a lifetime cap on what they paid, so once you reached that cap, you had to pay for 100%. For most plans that used to be $1,000,000. If you had medical bills over that amount, you could end up bankrupt. The lifetime cap was eliminated with the ACA.

Up Vote Up Vote ×
Specializes in Med/Surg, Rehab, Case management.
Before my son passed away, we pretty much lost everything. He was 21, had BlueCross, but our part over the years was astronomical. His premium went to $1300 per month. He was denied disability the first time (stage 4 with mets to liver and lungs!) and had to reapply. Since he was only 21 at the time, he only got a little over $600 per month for disability. When he finally got Medicare, his premium was $98, taken out of his little disability check. He NEVER got Medicaid; was denied twice for it, and died without ever receiving any help from Medicaid. Food stamps? He got $90 per month for one year. Yes, medical bills will bankrupt you fast. I ended up quitting my job to take care of him, so I no longer had an income. Sold my house and rented. I am glad children can now stay on their parent's insurance for longer... there has been a huge gap for people in that age range. If you are under 18, there are places like St. Jude's and Ronald McDonald houses, but for those over 18 who never got the chance to work and make much money, there is a huge gap. At least that is how it was for us. He was still in college when he got sick, and had his own policy at that time, but the premiums were outrageous.

I'm so sorry for your loss.

I think this is the worst disability denial I've ever heard and I've heard some doozies. Yet the frequent fliers I used to get on Med/Surg who would stop taking their meds to have a hospital vacation were on it... I've definitely taken care of some younger cancer patients who lost everything whether they had much to start with or not.

Up Vote Up Vote ×

Yes, there is a limit. My friend's child was stung by a scorpion and had a bad allergic reaction. She was rushed to one of two hospitals that carries the antivenom and had to receive two doses, at $20,000 each! No I am not kidding. That plus the other accompanying bills came out to a huge amt of $$. They had to pay 20%, but the annual deductible was $2000. They met that and then the kid didn't get charged anything for the rest of the year for all follow-up visits and other medical related bills.

Up Vote Up Vote ×
+ Join the Discussion