Despite insurance, medical bills push family to bankruptcy (They had TWO insurance policies)

[Horse with no Name]

http://www.orlandosentinel.com/health/os-medical-bankruptcy-20110730,0,1539564.story

>>>snip
Ellie's birth on Aug. 30, 2007, began a 25-day, $74,000 stay in one of the most expensive places in any hospital. More daunting, it would launch a four-year journey of fear, hope, devotion and grief — a journey made all the more difficult by financial devastation.

Ultimately, it led two middle-class parents with good jobs, two major health-insurance policies and a house in suburbia into foreclosure and bankruptcy.

>>>snip
With two insurance companies — Marsha's was the primary coverage — "we were thinking that what one didn't cover, the other would," Simon said. "Instead, they were both pointing the finger at each other, and neither wanted to pay anything. It was a royal battle."

>>>snip
For the first trip to Johns Hopkins, for instance, Marsha had gotten preapproval from her insurer, only to have the company deny coverage when the bills came due. And though the policy had a $10,000 out-of-pocket cap, there were so many copays, deductibles and prescription costs excluded that the Sutherlands spent close to $20,000 the first year alone.

"I finally had to decide that a house wasn't important," Marsha said. "It was my family that mattered."

[saras]

1. They're doing what private insurance companies are DESIGNED to do, which is maximize profits.

[Curmudgeoness]

2. We don't need no stinkin' health care reform!

The system is not broken.

So....how do any of the assholes who made these statements explain what happened here? :mad: This is the kind of story that just breaks my heart.

[kath]

3. Only in America. USA! USA! USA!

[lonestarnot]

4. Woohoo. Fucking insurance!

[fredamae]

5. I just heard of a local widow who's husband

just died and left her with $200,000 in medical bills. They literally, were Millionairs with no Ins (pre-existing condition denial). All of their assets went to his medical needs. Today she is broke with $200,000 in unpaid med bills.

[sammytko]

6. If they are HIS bills and he is dead, she does not have to pay them n/t

[demodonkey]

7. Maybe. Maybe not. If she's sued for the bills and has no money for lawyer to defend the suit...

...she could well be railroaded into a very unjust (but "legal") default judgement.

And DO NOT say that there are legal services, pro bono lawyers, etc. available to help people in such situations; most only handle very limited types of cases and only for those who pretty much own nothing. If she still owns a home, a car, or any form of savings no matter how meager, she may not qualify for any legal help.

Indeed, it is hard to find a lawyer who will help in such situations even for pay, because few have experience or desire to go after medical predators.

[sammytko]

8. Why would she be sued for bills that are not hers?

The family in the article had the deck stacked against them. They both did not have stable jobs and if one lost a job, the other could not fully support the whole family.

One was a reading teacher and the other managed a pizza parlor. Their insurance policy probably sucked. Teacher insurance plans here in TX are super expensive - 600 or more a month for family coverage, but you know what - you practically have to work just for the damned insurance.

I consider myself lucky cuz I only pay 22 dollars a month for full coverage TriCare and can also use the VA medical and dental clinics. I wish everyone had this type of coverage.

[demodonkey]

14. You tell me why. I was sued personally for my mother's hospital "bill."

I put "bill" in quotes because neither my mother nor I ever saw any bill, let alone had any chance to have it audited. The first we knew of this "bill" was when a Sheriff showed up at our door to serve us papers that we were being sued. My mother is a retired Pennsylvania teacher who had -- and has -- excellent, extensive supplemental insurance beyond her Medicare. This insurance should have covered all her needs, but as we later found out, it was never billed either. It's not that her insurance refused to pay, they were never even asked to pay.

The hospital simply said my mother owes them a huge sum, then hired a medical predator to sue us for it. By medical predator I mean an ambulance-chaser type contingency fee lawyer who "recovers losses" for the hospital by seeking out and suing patients (and their families) who own ANYthing that could possibly be seized for whatever a hospital claims it's owed, apparently regardless or whether the claims are legitimate or not.

Remember, anyone can sue anyone else for anything. Defending against a lawsuit is incredibly costly, and as I said in previous post reduced cost or free help is pretty much not available to most people. If someone is sued and does not (or can not) respond and mount a legal defense within a very short span of days, the plaintiff (party who is suing) can go into the court and "legally" get awarded a default judgement, no matter how totally unjust their claim.

Apparently, this hospital and/or their medical predator has an eye on grabbing our three-generation small family farm. My mother is 93 years old, and a stroke survior, with chronic pain from an unrepaired broken hip that this hospital did not care to treat. She does not need to be worrying that she and I are going to be unjustly thrown out of our home, and end up "living under a bridge" as she puts it. But she does worry about this, constantly, thanks to the medical predators.

We have been fighting this stinking hospital for almost three years now. We owe a lawyer way over $5000 and that rises every month. I guess we are going to have to start a medical expense/legal defense fund to try to get some help and publicity about our situation, or we will end up under that bridge.

And I am sure we are not the only family in America facing a unjust lawsuit over medical "bills" that should have been paid by insurance.

[SoCalDem]

17. Whomever "signs in" a patient probably accepts "responsibility"

somewhere in the pages of microscopic fine print.

and when a couple is married, the debts of one, are assumed to be the debts of the other.

If one is the executor of the estate, the bills of the deceased are assessed against that estate ..if the estate is not large enough, they will try to get more from the family. but unless someone signed something agreeing to be responsible, it will not stand up in court...but they can make your life miserable as their 'retainer' lawyers drag you though the courts trying to make you pay..

When my friend's son died, they tried to get her to pay his bills (he was 24), and she just told them no. He was brought to the hospital by ambulance & she deliberately signed nothing except when it was time to donate his organs. (he never regained consciousness)..One particularly odious person kept writing with demands for payment, so she just sent them the address of the cemetery where Jeff is buried..

[demodonkey]

18. No. I was very careful that I did NOT do this.

I never signed anything whatsoever agreeing to be responsible for my mother's medical expenses. It is mean and irresponsible of you to post an assumption that I "probably" did.

O yes, the victim is always at fault.

Also, again:

1) To this day, years later, neither my mother nor I ever received a full statement for what this hospital alleges they are owed.
2) No bill or claim was ever submitted to my mother's very substantial insurance.

I am not a lawyer, but as far as married couples assuming the debts of each other (assuming there actually IS a legitimate debt owed) I believe that this varies by state and possibly by the terms of prenuptial agreements. Same with estate law. Consult a lawyer in your own state to find out what applies to you, if you are among the lucky few who can afford one.

[SoCalDem]

22. I SPECIFICALLY worded my response in a nuanced manner to NOT ascribe "blame"

to anyone in particular.. I am sorry if your distress read more into it than was ever intended.

One thing is for sure.

when we deal with insurance companies "WE" usually lose.

I am sorry you are having difficulties with this issue, and I am also sorry that I bothered to even comment..

I hope the rest of your day is pleasant:)

[demodonkey]

23. Well sorry but IMO the way you followed my post looked pretty much that you "probably" meant me.

And again please note, as of now this is not -- repeat it is NOT -- an "insurance" problem. IT IS A HOSPITAL PROBLEM, and a lawyer problem. My mother's insurance has actually been helpful so far, but they can't do much because they NEVER RECEIVED A CLAIM OR BILL from this hospital.

Nor did we. We have never seen any bill or statement justifying the amount the hospital claims it is owed. All we got was a Sheriff at the back door, there to serve us with papers stating that we were being sued for over $100,000.

Thank you, but it's pretty hard to have a pleasant day when one lives in constant fear of unjustly losing everything one's family has worked for for three generations. Nonetheless, again, thank you.

[vi5]

10. Really? Even if she has his "estate" now?

I mean if they had shared assets or if the money, house, etc. were primarily in his name, and she becomes the executor of his estate/will then wouldn't she have to use his money to pay for the bills?

I'm not entirely sure, but this is just my thinking. I could be wrong.

[steve2470]

9. Well ya know, if they had SAVED MORE MONEY, that would have never happened to them !!!

:sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm: :sarcasm:

[katnapped]

11. Not to worry...

Obama got this!

Yes we can!!!

[Missy Vixen]

13. It makes me want to weep

Those who believe anyone charging up to help us in 2014 are deluded.

Families all over this country will be filing medical bankruptcy even AFTER the vaunted "health care reform".

:cry:

[sarcasmo]

12. Give me the Canadian system any day over our shitty health care.

[Horse with no Name]

15. Me too.

Or that of France, the UK, Germany....hell, I would be proud to have what Cuba has.:(

Our "healthcare for profit" system is broken model.

In fact, just about everything about our country these days is broken. Historians will have a field day with our society. The one GOLDEN lining is that we will be a shining example of how NOT to do it.

[indepat]

16. Only in America: oh the joys of living in a RW society wherein the uber-wealthy

and large corporations will continue to slop mightily at the public welfare teat even if such as this were to reach a pandemic stage. :patriot:

[Shagbark Hickory]

19. And to think Elle was just ONE of 120 other people who died that day because of the lack of a

healthcare system

[Dappleganger]

20. I guess the solution is just don't get sick.

[Lone_Star_Dem]

21. This is the horrific reality many, many of us now face.

If we get sick we're at the mercy of the system. Since they're bigger than we are, we're all too often being screwed over in the name of someone's profit.

[bvar22]

24. This IS the "Uniquely American Solution".

Did you know that in civilized countries, and in many uncivilized countries,
the term "Medical Bankruptcy" is unknown?

Even after ALL of the provisions of the "historic" Health Insurance Reform Bill are enacted in 2014,
Medical Bankruptcy will STILL be Big Business in the USA.
Probably even BIGGER as those MILLIONS (50?, 70?, more?) currently uninsured are forced to buy Junk Insurance with High Co-Pays and High deductibles?

This IS the "Uniquely American Solution".


Thank GAWD it passed!!!