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      11-14-2014, 03:44 PM   #16
128Convertibleguy
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Quote:
Originally Posted by bbbbmw View Post
Something is wrong with that news story. The policies I know (including BCBS policies) all have an out-of-pocket maximum - that's the most that you will pay before insurance starts paying at 100%. And that maximum on a typical policy is $3,000-$5,000.
There's nothing wrong with the story.

Your scenario only applies if the hospital is one that's on Blue Crosses "in network" list. "Out of network" is different, and that's where the 911 crew took her. She was incapacitated at the time.

It also affects the hospital's charges. "In BC network" hospitals have an agreement with BC to accept the BC reimbursement. "Out of BC network" hospitals don't have any agreement with BC, and can charge a BC subscriber anything they want. BC has no obligation to pay anything but their listed "out of network" reimbursement.

A real mess, that leaves her with a surprise, a $40,000 debt, after negotiations with the hospital and BC. Her original bill was $300,000. It could happen to you, your private insurance coverage may not be as good as you think. Surprise.

Among major Western democracies, only in America does crap like this happen.

Last edited by 128Convertibleguy; 11-14-2014 at 04:17 PM.