Nope. They would pay their contracted rate for service codes. That's why the hospital has to hammer others to make up for the shortcomings!
Nope. They would pay their contracted rate for service codes. That's why the hospital has to hammer others to make up for the shortcomings!
You're right, we would have paid the bill for her.
And if this lady had medicaid as well as her insurance would medicaid have helped pay what the insurance wouldn't?
"pays" to know what you are getting when you are purchasing insurance. if she would of had a private policy, not hmo or ppo, there likely would have been no in network or out of network differentiation. if i recall those private policy are very pricey, and would pay like 80% and you would pay 20% of the bill. I do not know if the private policy would have negotiated rates with the hospitals, since there is no network associated, and if not the billing could be at full hospital rate. So 20% of $83,046 would have been $16,609 or there abouts. Might be a break even deal considering she probably was not covered by or paying the pricier private policy.
You probably knew the answer to the question you were asking, but in case this was an honest question - yes.
My grandfather had Medicare and two health insurers when he retired (His railroad retiree insurance and his retiree plan from Sun). He would submit claims to all three and they would all kick in a share. Not sure how the order or pro rata was determined, but he usually only got billed for several cents if at all.
If her employer pays any portion of her insurance premium, she may have no other viable choice than to opt into her group plan. My employer pays nearly 90% of my premium cost; there's no way I could find a plan with a comparable premium (meaning, to my portion I pay).
Hmmmm, seems it was just last night that my quickness, accuracy, and keenness of judgment or insight sent a thrill up and down your leg.
Pretty typical pricing for CroFab. If administered, you start with 6 vials. For more serious envenomations, 12-18 vials may be needed. Very expensive. The antivenin for the Arizona bark scorpion (which can be deadly), could easily be more $$$ than pit viper bite.
I asked about Medicaid not medicare, which did your grandfather have?
Whoops, I totally misread that in the question - my mistake.
Here is my naive question - if she had private insurance, she would not have qualified for medicaid, regardless of income. Is that accurate?
