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Blue Cross and Blue Shield of North Carolina invites you to learn how we’re fighting to rein in medical costs, and how you can too.
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Blue Asks You
from Blue Asks You 2011
in Health Care Navigation
February 4, 2011
myvoice commented on February 4, 2011
I've never questioned the price of medical care since I've always had the blessing of wonderful insurance. I've blindly known what my copay or deduct/coinsurance portion is and left it at that. I think we could all be made more aware of the costs.
kim c. commented on February 6, 2011
Now that I am on a plan with a deductible, I am more likely to ask about costs.
mav13 commented on February 7, 2011
I would like to see a follow-up question for anybody who answered YES to this one... "Was your Health Care Provider able to give you an adequate answer?" In my experience, the provider them self almost never knows the answer. I'm usually referred to the office staff, and the first response I typically receive is "your insurance will cover it?". To which I then have to respond, "I'm on an HSA with a high deductible, so I need to know how much it costs." This is usually met with consternation (mostly because the staff doesn't know how to deal with this kind of request), but eventually I'll get an approximate answer or price range. These kinds of answers are far from satisfying, and the responses from providers and staff alike are very disconcerting. I can only hope this type of patient behavior becomes more prevalent, and as a result the behaviors and responsiveness of providers begin to change to meet this need.
tr7dul commented on February 7, 2011
I usually don't bother since there are automated prompts to go through just to get to someone or you are left on the phone listening to a recording that says they are busy and will be with you in a few minutes and then it turns into 5, 10 or more minutes. My experience with getting to an actual person has been quiet frustrating.
EmilyB commented on February 7, 2011
I ask my provider and she gives me an estimate to the best of her ability. I'm usually asking about prescriptions and she pulls up bcbsnc.com on her laptop and we look at the average price of the drugs. The first thing I do when my doctor comes in the room is say "Remember, I'm on a high deductible health plan". She works with me to find less expensive medications and less expensive courses of treatment. She always give me all of my options and if it's not a necessary test or procedure, she leaves the final decision up to me. It works well for us!
RETROGIRL commented on February 7, 2011
$4000 to fix one tooth at the dentist office. Not even an oral surgery. Less than a decade ago I bought a car that cost me $500 and lasted about 8 years. Mexico offers dental vacations to US citizens at half the price of what it would cost in the US. The kicker is they advertise that they are US doctors who can do it for less over the boarder. Something is so wrong in this country.
CaryMomNC commented on February 7, 2011
The doctor didn't know and asked me to set up a meeting with another member of the office.
Suzanne B. commented on February 7, 2011
I have asked my dermatologist about a specific cost, and he said that he could only remove one mole per visit, because he got paid less per site, and he wouldn't get paid much. I though that was an honest answer, but I wanted to get all of the moles cut off at one time, so I wouldn't have to take time off from work. His response was flippant, but he was able to talk about the cost of moles. Sad.
jerseyblues commented on February 8, 2011
Since I have been on the HSA- yes I now ask a lot of questions including what things will cost. I let my providers know I pay first dollar of my care and that i need to spend my money wisely. I always ask: What will the test do for me? What could happen if I do get the test? What could happen if I dont get the test? And how much will this cost me? Then I use my resources at bcbsnc.com to make informed decisions on my care. I have found that Doctors appreciate informed patients that ask questions and have wellness goals.
Mayur G. commented on February 8, 2011
No, but would be more inclined to ask if there was a way to compare the cost information from a few other providers before deciding the best place to choose.
MarkGlass commented on February 8, 2011
When we had my son, I had a different medical insurer. We were on a percentage pay plan, so when we got the final bill from the hospital, I asked them to itemize to justify my bill. After a lot of demanding, I was horrified at what I'd seen. They had literally just made entries up. There were days in the nursery, even though he went there for a couple of hours the first day for the initial check-up etc. She'd been charged $10 a pill for ibuprofen etc, even though she deliberately refused to take any (expecting they would charge so much). They'd asked permission for a trainee doctor to undertake a procedure. She messed it up 3 times, so finally the senior doctor did it. Guess what? We were charged 4 times!
That was just a part of what we found in the bill. I was livid and went back to one of the most respected hospitals in the country to complain. After a lot of fighting, they dropped our bill to zero (I'm sure just to get rid of us).
The next goal was to go to the insurer and tell them that the bill that they had been given by the hospital was several thousand higher than it should have been. I was told it didn't matter. The amount was in the accepted range for that set of procedures, so they'd already paid it. No need to investigate.
I had a vested interest to check how the procedures were charged, but seeing as most people never actually see, nor care the itemized numbers, I bet there are few complaints.
This to me is one of the reasons why healthcare is so expensive. Healthcare providers know the reasonable amounts to charge and often do that, regardless of the real numbers. Perhaps they figure that sometimes they win and sometimes they lose? I really don't know. However, to me, this is a little like going to the garage and being told I owe them $500 for whatever they did - just pay it and don't ask any questions, because that's what everyone pays. It's not going to happen. It shouldn't happen in medicine either.
Sweetsie commented on February 10, 2011
I have an HSA so I asked for the cost up front. The doctor was unable to give me an answer. He had to refer me to speak with the person in the office that handled the insurance.
Barbiecake commented on February 11, 2011
Yes I sometimes do. I know there are cheaper alternatives, but most people dont know that they can ask about cost. They just assume they have to pay whatever the provider says. I feel members need to be educated to be made aware that they can ask questions about cost and different alternatives to their healthcare. A lot of times doctors do not do the billing so they themselves are unaware of cost. If I am having a procedure done I ask billing to give me an estimate, they are usually pretty acurate.
Robert A. commented on February 19, 2011
I have asked before...especially with dental!
expatrefilioque commented on February 22, 2011
No one knew at all. In fact, the doctor, the insurance specialist, the billing dept., etc did not know and I left the doctor standing there waiting while I search around. No one knew because it differed depending on which insurance would pay what so basically I had to have it done and THEN they would figure it would.
Problem was, my insurance required preauthorization for anything over $500. In the end, it was a whopping $10,000 for one appt, and I was only able to get my insurance to pay because they had a one-strike rule.
After that every single time I went to any Dr., I called my insurance to pre-authorize and even then they would ask my why I was pre-authorizing if I did not know what they were going to do.
It was an endless circle that sent me out of country for care.
Ivan P. commented on February 25, 2011
I've never asked but have been told through statements from insurance. I've noticed that going through insurence gets them or you a much much better rate. Especialy for lab tests.
jaime5121 commented on February 28, 2011
alcat commented on March 3, 2011
i asked about a particular procedure (elective) I wanted to get becuase I was trying to figure out what my co pay would be (i pay a percent of the cost up to x dollars). No one could figure this out for me so I did not get the procedure becuase I didnt want to get a $1,000 bill I couldnt pay. This is insane. They literally had no idea what it would cost and no way of figuring it out in a reasonable amount of time. In the mean time, i am still in pain.
lindi commented on March 5, 2011
yes and frequently they dont know because it depends on the reimbursement
BILLIE commented on March 16, 2011
Of course, just asking doesn't mean you get a real answer. It is usually quite ambiguous: what codes will be used, etc. How do we know what codes the provider will submit? Ask them, and they may not have the right answer,either, and then you get a REAL surprise when you get the actual bill.
zestyherrmann commented on April 7, 2011
Yes, and no one can ever give you a straight answer because there are so many possibilities that could happen. I am not looking for an exact cost, but an out of pocket estimate so I know how much to plan for.
There just seems like there ought to be way to make it easier or clearer.
Judy B. commented on October 1, 2012
I feel it is irresponsible NOT to know the cost of expensive tests. We have a LOT of medical bills due to five of our family members with serious health challenges and I NEED to know what the costs are upfront...and often you CAN negotiate them on your own, even with insurance!