A Horror Story Averted!

Spring 2011 CSANews Issue 78  |   Posted date : May 06, 2011.Back to list

Bird talk - Le Jaseur
Dear Bird Talk,

Ross Quigley's article in the summer 2010 edition of CSANews ('Let me first say that Medipac is fine!') hit the nail on the head. I suspect that our personal case illustrates the need very clearly.

We went for a short, three-week holiday that included a one-week cruise out of Tampa last spring, as my wife had not been medically 'clear' for long enough to get regular insurance from you due to cardiac problems. In fact, in trying to get coverage, she was turned down flat by your competitors. However, Medipac elected to complete a further evaluation and offered coverage at a higher rate (which we accepted) and which included her pre-existing conditions. I might add that we also took the Holland America's premium insurance package, which includes some medical coverage for $99.

The first week in Bradenton was fine, then disaster struck. We both came down with a terrible flu, despite every normal sanitary precaution. After some 48 hours, my diabetic wife Helen appeared to be dehydrated and had a blood sugar of two − a serious situation. She 'blacked out', fell on the marble bathroom floor and was in a semi-comatose state. My glucose tablets did not seem to improve the situation.

We called 911, rather than the Medipac emergency line. Five emergency measures workers were at our door in five minutes. They were excellent…no complaints there. It was agreed to stabilize her in the local hospital.

On admission, I faced the usual questions - do you have any insurance? "Yes, we have MEDIPAC."

"OK, we know MEDIPAC and they pay their bills," was the administrator's response.

However, that was only the start. I was requested to sign the usual waivers and permit them to carry out whatever needed to be done. I crossed out two sections that indicated all of these extra tests. Within 15 minutes, an irate doctor was at the door of her room. "By crossing out those sections, it is impossible for me to treat your wife, I cannot do the necessary tests."

So, in true diplomatic Canadian style, I indicated that the Florida medical fraternity had such a terrible reputation for padding extra tests onto the bill to run it up, that I was not going to be a party to that. "Look," he said, "I just want to give her an X-ray and MRI as she hit her head."

I acquiesced. I also called MEDIPAC to tell them the story and bring them up to date.

In the morning, Helen was fine and was released with the admonition to monitor her diabetic condition more carefully. Actually, in hindsight, I don't think that we could have done much more, as her condition became pretty extreme quickly and she couldn't keep anything, liquid or solid, down.

However, that was not the end. Within a month, harassing letters started arriving, suggesting that we had better pay up. Some two months after returning to Canada, I called MEDIPAC and commented on the various letters. They checked our file and informed me that every bill had been settled.

On the whole, those Florida bills were reasonable - hospital doctors around $400. Ambulance services for the 10 miles - $600. But the hospital bill was outrageous and simply took the cake. Hard to believe but, for that one night of stabilizing, they charged us the staggering sum of $18,750. Oh yes, I know that even when MEDIPAC negotiated that figure, the sum is an example of pure egregious greed.

So, as Ross says - get your insurance before you head off.

Sincerely,

E. Peter McLoughlin
Rigaud, QC


Response:
Ed: Thank you for the textbook case to review. There are several things to be learned here, the first being that a simple overnight stay in a U.S. hospital can be $20,000! If invasive surgery is involved, $50,000 and $100,000 is certainly possible. "Egregious Greed" is an excellent description.

The need for travel insurance is obvious, but did you notice that Medipac was the only policy that would cover Mrs. McLoughlin AND we covered her pre-existing conditions. My insurance article later on will say a little more on that subject.

Next is the hospital administrator's comment that Medipac pays their bills. What she was really saying was that a lot of other companies do NOT pay their bills. This means lawsuits and collection agencies and possible issues at the border if a U.S. court orders you to pay a hospital or doctor bill, usually in absentia.

Some hospitals in the U.S. have lawyers who send out their bills to foreigners, as they automatically expect non-payment; Medipac is trying to change this losing strategy by working with the hospital systems rather than being confrontational. Medipac looks for a way to pay your bill, not for a way to deny it.

The call to 911 was made prior to calling Medipac. This is the proper decision in an emergency! You can call us from the hospital, or while on your way to the clinic.

The last item is all those harassing bills, and often harassing telephone calls which you may receive AFTER your bill is paid. This is a type of fraud, in my opinion. The practice is called "balance billing." Essentially what happens is that a hospital issues a bill for $100,000 for a procedure; we have a contract which says that this procedure will cost only $75,000 and it is then paid for at that rate. The hospital, now having the insurance company money in hand, sends a "balance due" bill to the patient for $25,000; many times, the patient will pay it thinking that they were lucky not to have to pay the $100,000. This is illegal, but it is also a very widespread practice.

As a Medipac client, you can simply refer these letters and calls to Medipac and we will do our best to stop the harassment. Also, send any bills that you receive to us and do not pay them yourself. I have seen situations in which we have received 10 different bills for very different amounts for exactly the same thing.

The thing I liked best about Mr. McLoughlin’s letter - it had a happy ending!

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