I just spent four months in hospital in the UK. How screwed (financially) would I be in the US?
I spent half that time in Critical Care (much of that on a ventilator, a small amount sedated), and most of the rest in a specialist neuro-rehab unit. I would have died otherwise.
Fortunately it cost me nothing - Thank Bevan for the NHS - but if I were in the US I imagine I would be financially crippled!
You would have lost your job and likely be on medicaid and disability and it would be very unclear if you have or lost your house and possessions but keeping hold of them moving forward would be almost impossible unless you could find a new job which is also highly unlikely.
Also, at some point you couldn't afford care anymore. So you would have stopped treatment and died.
maybe. the us is odd in that if you literally cannot walk out on your own they usually keep you while the bills rack up.
Hm, would you though. There is short and long term disability. Some states require some amount of it. And salary type jobs often include more of it. You may get replaced after a bit, but you technically would still be employed until after. That might mean you would have to pay the insurance premiums out of pocket, but assuming you could afford to, that would be well worth it.
Not saying that is how it "should" be though. Just that there is probably more nuance.
Im talking about the concept of insurance in general. Im just comparing it. You pay more to handle and event that you can't economically handle at the time. Like losing your house to a fire. Im just saying the value is worth the cost much like generally these things are.
Your first stop would be a bankruptcy lawyer.
if you can afford one lol.
This is too hard to answer because of the number of variables at play like, do you have insurance, does your condition/issue qualify you for Medicare, does your job offer disability leave, are you FMLA eligible, do you meet requirements for SSA disability etc.
Anecdotally, in 2017 I spent two non-consecutive months in the hospital. The first visit I came in through the ER, ended up in the ICU intubated and worked my way through each section as I got better.
My second stay I skipped the ICU but had a transplant halfway through. I also was on dialysis for the ~6 months in between.
Dialysis was billed at $7k a visit, roughly $500k in total. The transplant surgery alone was ~$750k. The hospital stays came to about $5k a day on average for roughly $300k in total.
So straight billed amount I was somewhere in the $1.5-$1.7 million range.
Jesus fuck. I hope you are doing better now. Did any of the bills go away or you just paying on in it forever?
I am doing better though it's looking like I'll need another transplant at some point.
Fortunately, I had good insurance through work and because I ended up in renal failure that makes you automatically eligible for Medicare (one good thing Nixon did). Also, the billed amount gets discounted based on whatever deal your particular insurance has with the provider, so billed amount ≠ paid amount. Unless you're uninsured.
I did ended up going through bankruptcy anyway but that had more to do with my choices and lifestyle leading up to all of this. It did wipe out any portion of that bill that would have been my responsibility though
you will also be on immunosuppresants long term, because organ transplants too. only some of those medicines are probably cheap.
The average cost of a hospital stay in a U.S. hospital is about $3,000 per day, but it varies significantly by location. So long stays like yours might cost between $250,000 and $500,000.
If your insurance covers it (and about 92% of Americans have health insurance), you'd be looking at your annual out of pocket max, which the law caps at $18,000 for family plans or $9,000 for individual plans, but which most people on employer sponsored plans (around 60% of Americans) have out of pocket maxes around $4,000 to $5,000. Source
So for most Americans, your hospital stay would've probably cost the individual patient about $5,000. Insurance would've paid another $350,000.
But for some Americans, they'd be looking at a $360,000 bill and then would just file bankruptcy, start over with close to a net worth of zero, at least for non-exempt assets (people generally get to keep their homes, cars, and retirement accounts in bankruptcy so it won't actually be starting from zero if you're well into a middle age in the middle class).
Or worse, the hospital would realize they're not getting paid, and then would find a reason to kick you out as soon as you're stabilized. They have to keep you alive even when you can't pay, but don't have to treat you beyond that for free.
And if you do have insurance and get a bill over a few thousand, there are pretty good odds insurance will deny paying for it and drag you through many levels of confusing and auto-denied appeals over the course of 6+ months! Even if your procedure is clearly covered in your summary plan description or required by law.
And this is why Brian Thompson got what was coming to him.
Agree 100% except one thing to be a little picky, the insurance doesn't pay the full 350k like ever, that's the list price they have negotiated prices with the hospital that differ, and if your ask the hospital bursar/collections you can get a cash price that's usual less as well.
Excellent answer
With the recent changes to the medical insurance landscape in America, and thousands upon thousands of people losing their jobs due to various factors, your 90% figure is pretty generous. Add in the fact that most insurance is tied directly into employment, Americans have much less options than the rest of the free world, unless you are filthy rich.
do you loose your house if you file bankruptcy?
generally, no
That depends.
Are you wealthy? If yes, you're fine. If no, you're fucked.
Are you a veteran? Same answers.
Are you poor? You probably died in the waiting room.
Haven’t seen anyone mention maximums. Sometimes insurance plans will straight up stop covering you after a certain price. Like, for the rest of your life. Imagine running up a cancer treatment bill in your teenage years and being cut off until you either die or somehow live long enough to get a job with different insurance.
Holy fucking shit just burn the whole industry to the ground at this point.
Honestly, it would depend on what kind of insurance you have in the US. Each employer has a different set of plans.
No insurance? Absolutely screwed. With insurance?
End of 2018 I had a heart attack and open heart surgery with really good insurance.
Emergency Room - $150
8 days in the hospital + open heart surgery from the head of the cardiac department - $100
Drugs and all the oxygen I could carry - $100
Roll forward to January 2019... my company has been bought by a giant company. Health insurance changes. I lose my existing hospital and all my doctors and have to start over in a new system.
7 days in the hospital draining fluid from congestive heart failure - $6,500 - the annual out of pocket maximum for that insurance.
Good news though, hitting the out of pocket maximum on Jan 15 meant all my other medical care the rest of the year was covered at 100%.
Yeah, I can't imagine that, $6500 would RUIN me, like I legitimately would not be able to pay it
Most of the time you can set up a payment plan but that’s still brutal
Fortunately (?) the reason for the insurance change was my company was acquired by a giant company. Bye bye signing bonus...
alot of doctors are also being bought up by equity firms too, which adds another layer of cost.
That is bankruptcy, pure and simple. There's no way you'd financially recover from a four month stint in the hospital.
People have literally unalived themselves here over hospital bills like that.
Thank God you weren't in a shit hole country, like the US.
This is not YouTube, don't make it so. You can -and in my opinion, should- say suicide, kill, etc.
Dont say unalived. Say "suicideded" or killed themselfs. Stop censoring yourself
So much of this
I don't understand the need to find alternative words for words we already have. What, in 20 years we need to find alternative words again because the next generation feels insulted by the words this generation came up with?
Just use the words. Suicide. It is what it is. Its ugly, it's sad, it shouldn't be needed, but here we are. Don't make it more palatable by censoring yourself
America needs to be thrown into a volcano
Or get insurance and then the bill is significantly smaller. The much smaller amount can be put on a payment plan if needed or even haggled down to something you can pay.
How marketable would you say your illness was?
Your options would be: begging strangers on the internet for money and going viral, being rich enough to pay out the ass for really good insurance when you were healthy, declaring bankruptcy, and playing Luigi's Mansion.
I spent six weeks in the hospital in the US, and my bill (before insurance) was over $400k.
But surely your out of pocket maximum was much less. The "before insurance" numbers are a fiction to make your insurance company look like they're doing more for you. They don't pay the hospital anything like that amount, and if you had no insurance, you could negotiate a lower amount from the hospital as well, since they'd rather get something over time than have you go bankrupt on them.
my insurance paid $100k for 5 days in critical and 3 in regular room in 2014, 4 months should be 12 times that, plus add inflation
I'd bet, although the hospital billed that amount and insurance covered it, they actually paid less to the hospital. Because they negotiate lower "allowed amounts" in exchange for keeping the hospital in their "preferred provider" group.
Unless you got a couple of million bucks in your bank account…. Super fucked
Or have good insurance.
Even then how whats your deductible or your out of pocket cost before insurance kicks in and then your doctor will have to prove you needed it they might stick you with a bill anyway and 4 months in IC will likely be $5009-15,000 per day maybe more depending on any surgical procedures. The land of the free run by the POTUS- Pedo of the United states, what a great time to be dying
Also don't know the answer, but another anecdote.
I was admitted to the ICU where I stayed for about a month, not on any ventilator or any other machines except an IV drip (the medication was very dangerous and needed that level of surveillance). However, I was taking up space, so I was transferred to the next level down, where I spent another month on nothing but just that one IV medication. In total I had two non invasive heart surgeries during my time there.
For basically just room, board, babysitters, and the medication, I was billed over $650,000. I was 26 at the time, in college, no job, living off savings I'd accrued in the military....
Yeahhhh.
Jury Nullification
You'd be fine, aside from the attorney's fees for declaring bankruptcy.
...Oh, and probably losing your housing.
So basically, you declare bankruptcy and sell everything you own?
I mean, I guess I kind of knew that'd be how it would work, unless there's some kind of protected assets, but it's crazy people put up with that kind of life-ruining.
My hospital stay billed insurance like $300k for a 5 day stay. It was not critical care but it was specialized. Insurance covered all but like a thousand, I also have a $5k out of pocket max that goes into effect in some situations.
So if my hospital stay was 4 months and I didn't get a bulk discount we're looking at like $7mil USD but with insurance I'd instantly hit my out of pocket max and only be out $5k. Because there are lots of ways insurance can fine print you from actually hitting out of pocket though I don't know
Unless anything was out-of-network and that bumps you up into a much larger out-of-pocket max.
But you planned for that. You went to the hospital you specifically knew was in network before you entered your coma.
Problem is they brought in a doctor they knew was out of network. You didn't choose him, they did. Now pay up!
Or just not covered procedures, like organ transplants
If you spent 4 months in a U.S. hospital and didn't die, you would spend the rest of your life wishing you did.
There are a huge variety of factors but one I think people tend to forget: your state of residence
Massachusetts or Hawaii, you'd prob not be much worse off than your current situation. Most states, you'd likely owe whatever your insurance plan's out of pocket maximum. In most of the Southeast and Texas, you'd probably be launched into the sun
Hmmm. Probably like $500,000. It would be cheaper, but good affordable rates are only available to insurance companies. But with a GoFundMe plan you might save up to a $50,000. Best bet is to get on the evening news with you in total shambles. The good news is you can haggle hospitals here, no joke. Not acceptable anywhere else in the US unless you're buying something hot.
Buying something hot
Your mum?
My brother smashed and broke his thumb.x ray, er visit, blah blah blah. They call him a month later to talk about payment. I cant remember how much, he had shit insurance though. He said, I'd love to pay, but I can only afford 20 a month. I'm willing to pay 20 a month for the rest of my life. Hospital told him dont worry about it. We got a fund for that.
Yeah, that's good to hear
Almost all of these comments are talking about the total billed amount, which is correct. On most plans, you'd hit a certain amount, and they'd start covering a larger portion of the bill. But your out of pocket expense would definitely be in the hundreds per day, (thousands if bad insurance), while the insurance company would pretend they did you a huge favor.
Yeah, but a lot of insurance plans also have coverage maximums.
That's illegal under the ACA. That USED TO be the case, but now it's the opposite. Once you hit a certain amount per year, you're no longer on the hook for anything covered.
It depends on your insurance. You might hit a deductible and only owe a few thousand dollars, or you might be bankrupt.
Adding this for extra absurdity: going in no one knows, no one at all, how much your fees will be. Prices are negotiated between the insurance companies and health care providers. Until they send in the billing codes, pray they get them right, get proper authorization (from insurance, not your doctor) then go through with the treatment and finally issue a bill, which gets processed by the insurance company again - at that last step then and only then do you get a surprise bill for your share of the costs. It can take months. For a stay like yours, it would be anybody's guess.
Simple procedures planned in advance, you MIGHT get a price, but that will almost certainly miss things like incidental costs or direct fees from doctors or other practitioners who all invoice separately.
it is also reason why the fees are extremely high, they know insurance are only going to pay a percentage of it, and to make up for that doctors, hospitals, etc will charge alot.
some insurance can be nitkpicky enough to not cover things o.
I'm British just reading this thread and shaking my head. Can't fathom these stories.
And hope that the tories don’t get into power again and kill the NHS.
All the screwed. And now as of this month medical debt will be part of your credit reports, so good luck on getting a home loan or job
I don't know the answer to your question, but I will say that I'm glad you're still here with us, friend
More likely you just would not have been kept in hospital four months here. Somehow we have the combination of highest cost and also cost-cutting schemes.
To answer your question - $18,000 I guess, if I got lucky and the insurance worked correctly. That's the alleged max out of pocket for the insurance I pay for at work.
According to https://nchstats.com/average-cost-of-hospital-stays-in-us/ the average cost for inpatient care in the United States is 3,025 dollars.
4 months of 30 days multiplied by 3,025 is equal to 363,000 dollars without insurance.
That is an entirely believable number to me.
In Canada. A very good friend of mine who is around 70 but acts more like in his 30’s which kept him feeling good. Hey we only have one life let’s enjoy it.
Unfortunately it caught up with him a month or so ago.
He was in a vicious motorcycle (his) accident that took an eye, a leg, needed facial reconstruction and wrecked chest. He cannot speak as his jaw is wired shut. I am disabled and cannot get up north to see him. His daughter calls me once in a bit to fill me in.
I cannot begin to comprehend how much his operations, rehab, prosthetics and hospital fees would be in the states. I assume he won’t be getting out for a few months (I am not very knowledgeable on medical stuff) then a ton of therapy. I was told he also has insurance on top of his Ontario health card so hopefully he is in very good hands.
similar story about a former classmate when i was in college, when her cousin had a motorbike accident, the insurance, kaiser refused to pay for a 60k surgery because he needed some major muscle reattachements, they had to switch to an insurance that would do the procedure for lower cost. some insurance providers can outright refuse to pay for procedures just like that.
On the order of hundreds of thousands to over a million dollars without insurance, on order of $50k-$100k in copayments with insurance. Either way will wipe you out financially, effectively forcing you to go through medical bankruptcy and resetting any savings you have to $0. In addition, the equity in your house and car can also be seized, above some personal homestead exemption ($250k in New York for example, where the average house price is $2M, and $5k for vehicle). Not sure if they kick you out of the house immediately, or put a lien on it that comes due when you die/move out and house is sold. The only savings that are safe from bankruptcy are retirement savings in IRA and future social security payments.
If you’re on a plan that qualifies for the ACA (basically any real health insurance plan), your out of pocket max per year is capped at $9,200 this year.
Good to know! Still have to watch out for that every service you receive is counted as "in-network". I've read horror stories where somebody with an emergency goes to a hospital that their insurance promises them is "in-network", then later receive a surprise bill because one of the doctors that attended them at that hospital was "out-of-network". Why was the doctor at that hospital then? It's just something they do apparently.
In the U.S. with insurance you would have easily hit the deductible and out-of-pocket costs though that does mean you would have been billed a few thousand dollars easily (on top of the regular monthly insurance costs). Everyone has slightly different health insurance plans so the actual amount would be hard to predict for a hypothetical question.
One thing you got me thinking, I'm not too sure how often U.S. insurers would actually cover someone to literally stay 4 months in a hospital, maybe in rare extreme cases? Insurance companies typically only approve x amount of days/weeks in hospitals or rehabilitation facilities so once you use up those approved days the hospital has to figure out how to get you out or start billing you directly at a few thousand per day.
According to https://nchstats.com/average-cost-of-hospital-stays-in-us/#google_vignette the average is $3.025 per night. 4 months = 120 days = $363,000 = €313.307,21
Depends.
My dad went in the hospital for like probably 3 months, and afiak, their small bussiness is still running. They have insurance.
For everyone else who don't have insurance and don't have any assets, just refuse to pay the bills, like what are they gonna do? Confiscate your organs? (Inb4 they pass the "USA Repossess Organs Act")
Don't give them ideas, they're already trying to control women and negate body autonomy.
If you don't have the money on hand to pay what it would have cost out of pocket, then you're better off dying.
If you don't have the money at all, you're probably in the clear.
I'm not from the US, but I've heard someone from there explain the system.
When you go to hospital, and get a bill of $250.000 your insurance company will cover let say $50.000. You will get a bill for $1.200 and the rest will be declared by the hospital to their insurance company as damages.
It's super weird, I still don't get it but apparently this is how it works in most cases, or as I'm told.
Great thing about medical debt is you don't have to pay it.