Even the insured can’t afford their medical bills

A startling trend is outlined in Helaine Olen’s article “Even the Insured Often Can’t Afford Their Medical Bills”, and we see it everyday in practice. Americans are paying out more every day for insurance then they have ever before. The drawback is that their is a severe shortage of benefits, we see astronomical deductibles and services that were once covered no longer are. Compound on that insurance companies are becoming stingier and requiring more notes along with pre-authorization for services and you can see how the doctors are becoming captives to the insurance companies. Patient Payment Solutions allows you to give your patients access to care that they would not be able to afford otherwise. The great thing is you can still get paid upfront with our pre-funding but also overtime with no credit check.

The article outlines the shortfalls of when you are paying over $2000 a month for insurance, more then a mortgage on a decent home, with no real coverage until your bills are over $6,000 means that that patient is spending over $30,000 before they get any benefit from their insurance. Add to this the in and out of network fiasco along with pre-authorization and people are looking at some seriously large bills and in some cases bankruptcy.

Let’s look at some choice excerpts from the article:

“A chance trip to Long Island’s Adventureland amusement park just might have saved Cassidy McCarthy’s life. After Cassidy—whose family calls her Cassie—then 4, complained about pain and nausea following a ride on the Ladybug rollercoaster, her dad, Daniel, a registered nurse, felt her stomach and discovered a small bump. A CT scan ordered up at a local hospital’s emergency room revealed a kidney tumor.

It was another seemingly chance decision by Daniel McCarthy to sign on as a volunteer firefighter more than a decade ago that saved the family’s finances in the wake of Cassidy’s diagnosis with cancer. As it turned out, that activity allowed him to ask The Heather Pendergast Fund, a foundation set up in 2009 to help out the families of Long Island’s volunteer firefighters and EMS workers with their children’s medical expenses, to pay many of Cassidy’s medical bills.

McCarthy says the charitable foundation was a financial lifeline. Cassidy quickly racked up more than several thousand dollars in out-of-pocket medical expenses—for the surgeon, the anesthesiologist, radiologists, chemotherapy, you name it—since the family’s insurance policy had a $6,000 deductible. A few months later, Pendergast came through again when McCarthy lost his job at a local nursing home and rehabilitative center and the family suddenly had to find money for COBRA payments, which, at $2,100 a month, were more than the monthly mortgage payment on their West Babylon, Long Island, home.”


“The current debate over the future of the Affordable Care Act is obscuring a more pedestrian reality. Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders faced a deductible, the amount people need to pay on their own before their insurance kicks in, of at least $1,000. For people who buy their insurance via one of the Affordable Care Act’s exchangesthat figure will be higher still: Almost 90 percent have deductibles of $1,300 for an individual or $2,600 for a family.”


“This spending is most pressing for households with the highest medical bills, the 5 percent of Americans who make up 50 percent of the country’s healthcare costs. Medicare, Medicaid, and private insurers will spend $40,375 on average per patient for someone in this group. Their out-of-pocket spending will be much less: on average, $2,582.90. This isn’t, in the scale of things, a lot of money—but given Americans’ straightened personal finances, it’s more than many can easily access.  ”


“A paper published by the journal Health Affairs in 2013 found cancer patients are more than twice as likely as their peers without the disease to declare bankruptcy. The consequences of this expense goes beyond the patient’s checkbook: Last year researchers writing for the Journal of Clinical Oncology found that cancer patients who declared bankruptcy were significantly more likely to die than those who did not need to ask the courts to discharge their debts. The reasons for the increased mortality are unclear: It’s possible people with shaky finances are less likely to receive adequate treatment, but it’s also possible stress is a contributor.”


You can see how the realities of healthcare costs are quite a burden for many fellow Americans. Help each other out and keep your collections high with patient payment solutions.


Thanks to The Atlantic and Helaine Olen