Menacing Medical Bills (2)


Today I received a follow-up from an earlier call related to outstanding medical bills.  The Hospital’s initial bill showed a balance due of $637. I had called and told them that my husband was enrolled in Medicare Part B as well as his Blue Cross Blue Shield Insurance (BCBS), an answer which satisfied all the other outstanding medical bills from the first calls.

My total emergency room (ER) Explanation of Benefits (EOB) showed two amounts not paid by insurance –

Copayment of $291

Coinsurance of $345.

The Copayment is a fixed amount charged whenever you use a particular service (like that $20 you have to pay each time you fill a prescription).

The Coinsurance is a percentage of the total cost of the service (in this case, about 10%).

Next I called the Human Resources Department of my husband’s employer (he was a State employee) and asked if his share of the ER bill at $637 was correct. The State provided the BCBS coverage.  I knew it had required him to enroll in Medicare Part A (it is available premium free if you have 40 calendar quarters of work in which you paid Social Security – my husband had 40 years with the State).

The HR department provided the “big picture” – Part A pays for inpatient hospital visits, Part B helps with other medical services, and Part D assists with prescriptions.  He had Part A only (free). The Part B premium is $105 per month, so he did not have that coverage.

Sooooo…it looks like the copay and deductible are “reasonable” at 10%, so I am pulling out my checkbook. I am very glad it was NOT twenty percent!