Alison and her family are not the only West Virginians struggling to understand the exorbitant costs and complex billing process of health insurance. Her family is a well-off WV family with a two-income household and both occupations are in the health care sector, respectively.
While as a Physical Therapy Assistant (PTA), Alison has been laid off due to the COVID-19 crisis, but her husband still works at the local regional hospital in the Cath Lab in Charleston, WV (essential employee). Now, like many other employer sponsored health insurance individuals, Alison was “covered” by her company’s health care insurance company until the end of April (as it covers a one month from time of lay-off of coverage).
“It’s been kind of a crazy battle.”
During this time, the bills from the medical center in which she and her son received their care, also the same center in which her husband works “You think your husband being an employee the would give you a discount or something,” have been put on hold due to the COVID-19 crisis. That helps Alison immensely considering she lost her job, “Thank goodness, the last thing I need would be a late fee,” but the questions and concerns still remain for her and many others like her.
“I’m happy to pay them by they are just SO much. I’m kind of dumbfounded.”
Sharing her story via a phone call, Alison encouraged us to find the medical center’s document of costs of services, as she was told “we don’t break down the bills” meaning the center does not itemize the bills for it’s patients. During our 25 second search we found the PDF which included 625 pages of costs.
The concern of costs started when a nurse practitioner said baby Tommy’s hip was clicking and they ordered a hip ultrasound. Working in physical therapy Alison knew the costs of an ultrasound could cost a couple hundred dollars, but when she got a bill for $1,400.00, “I thought, oh my god.”
“I pay for something here, then something there, and another one comes in.”
Alison even paid off the $160.00 circumcision bill for Tommy and asked if there were any more bills and the administrative billing specialist said, “No, that’s it, the rest is insurance.” Well, during the month of March 2020 she received over $6,000 in bills related to the birth of her eight-month-old son, “I asked, hey, did I owe you anything else? – The answer was ‘No’ – obviously not correct.”
The bills for Tommy’s birth and the labor/delivery procedure for Alison are in both Tommy’s and Alison’s names, which is not an uncommon practice. The medical center said she did not meet the deductible amounts for her and her son (both have $5,000 deductible policies) during 2019, “That’s just not right.”
As we continue to look for answers with Alison, as she needs to navigate the COBRA/Obamacare/Medicaid/CHIP options since she lost her employer sponsored health care, advocates like her are pursing open access and transparency in the medical billing process.
West Virginians for Affordable Health Care and other partners in the 2020 Healthcare for All campaign are working hard advocating for policies which would protect health care consumers, provide lower cost prescriptions, and ensure affordable health care for all West Virginians.
West Virginians for Affordable Health Care, thanks Alison for sharing her personal story. Please note, it was requested the names of individuals involved are changed for privacy purposes in this story.
If you are interested in sharing your healthcare story, reach out to us on Facebook (https://www.facebook.com/WVAHC/) or Twitter @WVAHC by sending us a direct message or give our Story Collection Coordinator, Lara Foster, a call 304-702-6708. Your story can help more West Virginia communities feel supported, understood, and protected by affordable health care.