Aetna Insurance Drama - Help me
Hi Everyone, Series of events happened recently with my insurance company, AETNA. I have an HSA plan. 1. I fell sick couple months ago. There were no appointments available in nearby hospitals so I called to primary care little far from my place and asked if they accept Aetna to which they said 'Yes'. 2. I visited the hospital, doctor asked me to undergo series of Covid tests (which I think was very unnecessary as I had no symptoms and I told them so) rapid and RTPCR both. Rapid came negative obviously. 3. I got cured in next 2-3 days. And after 6 days I got the results of the RTPCR test - obviously it was negative too and of no use. 4. I got the bill from insurance company which was huge. I don't have issue with consultation fees. Which was $140. However my covid tests cost is $500 (200 + 300) combined, which is just insane and I am furious now. While at many places the covid test is free or rapid and rtpcr lab test hardly cost $40-60. 5. I appealed and got to know the hospital was out of network and insurance company is charging 140% of maximum permissible amount for the tests. I have appealed it twice till now but appeal has been denied. Is this very normal scenario with insurance companies or What shall I do to avoid such expenses in future? What if I dont pay any these lab test expenses? I feel its very unethical of the hospital and doctor to conduct these tests and also my experience in the hospital was very bad as many of their basic equipments were not functioning properly like thermometer and blood pressure machine etc. I am furious with all of these things, considering if I would have not used my insurance card I would have been better off. Also the learning for me is I am gonna take an appointment 2 days in advance from now on as soon as I start feeling changes in my body to avoid these unnecessary spends. What are your views on this? PS. - I am sorry I was calling it a hospital but its a Primary Care to be precise. #insurance
Exactly: accept!=in network
Welcome to the US. The world, where you sign up to pay the bill, but you are not allowed to know what the bill is.
So true ? They say shop for medical care just like u shop for anything else The catch .. u cannot know the price upfront
Your problem: all insurance apps give you the option to check the provider. Your fault for not checking. Call labs, ask for any cash discount(totally off insurance). If not get on payment plan, pay off and move on. No matter how you crib, you can't win and sorry but it's not that big amount too knowing the ludicrous medical bills for minor things in this country.
Definitely its not that big amount but I am glad they didn't do any other costly tests right ? One should be aware and consent must be taken before conducting the tests along with mentioning the estimated costs? I just want to know some good practices and how a person in US deals with hospitals and doctors.
1. Don’t go to the hospital for trivial things. Go to your doctor. Hospitals charge extra for everything. You did the equivalent of ordering room service, then are complaining about the additional cost. 2. Next time, call your insurance company and get pre-approval. They are the ONLY ones that can tell you what is actually covered. 3. Switch to a PPO, if you don’t want to take on the extra work yourself to minimize your healthcare costs. HDHPs have lower premiums for a reason.
Next time go to a Minute Clinic or Patient First instead of a hospital. Unless you are literally dying check the website to make sure you are using an in network facility. Keep a list of in network urgent care centers and hospitals handy. You are likely going to have to pay the bill. You can try balance billing arbitration but since your situation was not life threatening you don't have much recourse.
Always ask them if they are in network