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Health Insurance Trauma

One fine afternoon, I was working at my office and I received a call from this guy about the huge medical bill he had received. Apparently, he had heard me talk about insurance on the radio and he wanted my help with his bill. He explained that he had just come from India 6 weeks ago on H-1 visa, his employer had enrolled him on the medical insurance plan but he still got a huge bill.

What has happened is it was a Sunday and he was suffering from Fever. Due to lack of knowledge about health care system in USA, he decides to walk into an emergency room of a well-known Bay Area hospital. After waiting for 2 hrs, doctor sees him and prescribes him a medication. While he was with the doctor, he asked the doctor to do a complete medical exam so he does not have to come back again. I was shocked and asked him, are you serious? Did you just do a medical exam at the most expensive hospital? Well long story short, he got a bill of $2500 from hospital in few weeks for his fever and exam visit. He could have done an annual medical exam by going to a general physician for probably less than $300. Interesting thing is that his employer never told him that there was $4000 deductible on his plan and how it worked, so he was responsible for the whole bill.

Being so new in the country and got hit by such a huge bill, he was upset and angry with the health care system here. His main complaint was even after having coverage through his employer, he has to pay this much. Unfortunately, these cases happen quite regularly within our community. Medical bills are among the top reasons for bankruptcy. Health care system is completely broken. Doctors are so afraid of lawsuits that they prescribe unnecessary test just to cover their back and I don’t blame them. Insurance rates keeps increasing every year.

Here is what you should do if you have to see a doctor. My suggestion is to go to your regular physicians for most general and minor issues unless it’s an emergency. It could be quite difficult to find your physicians over the weekend so you need to find the closest urgent care center. Urgent care centers are fully equipped to handle most of the situations. You can save a lot of $$$ by going there instead of walking to an emergency room.

Here are links to some good urgent care centers:

Fremont : http://www.fremonturgentcare.com/
Santa Clara: http://www.santaclarauc.com/
San Jose: http://www.urgentcaresanjose.com/
Palo Alto Medical Foundation, Multiple locations: http://www.pamf.org/urgentcare/

Over the next few weeks, I plan to help you navigate through the complex world of health insurance. And by the way, we were able to get the guy some discount from the hospital to ease his pain. Till next time….

Sunny Sethi
408-986-8506
sunny@matrixia.com
www.matrixia.com