That’s so aggravating. My spouse and child go to the ent yearly for a clean out of ear wax as maintenance. Might be good strategy for your son.

It’s such a shit system, OP. Urgent care is often the only option on short notice, but their scope is so limited that they’re instructed to send anything that”might”be serious to the ER and then you get stuck with the bill. It’s such a racket.

If a medical provider tells you to go to the ER, that visit should be covered appropriately regardless of outcome. Otherwise, it places an unfair burden on the patient to try to determine the severity of their situation. It’s not reasonable for the patient to decide if it’s just ear wax or if he’s actually at risk of hearing loss, so, of course, you go to the ER but it feels like you get penalized financially for following medical advice!

[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Did you know he was going to ER? The Urgent Care doctor "recommended" right. It was your/your kid's call to go. [/quote]

I knew he was going where the guy recommended. My da actually asked about cost he said and the guy said it would be a copay. I’m not there so I was not going to tell him not to get medical attention after doctor said go to ER and he might go deaf! If he were home we’d have done things differently. In any case I still don’t get why this is not a copay because we do have an ER copay and I’ve never had a copay not kick in before deductible.[/quote]

I’d follow up with your insurance before paying 2k.[/quote]

Insurance are the ones saying it will be full pay bc we have not met deductible, which does not make a lot of sense due to copay.[/quote]

Right, it goes towards your deductible. I get it, but it’s really more of a problem with insurance companies and the high costs of healthcare. I had to get a breast biopsy this year because the doctors said I might have cancer. Turns out I don’t, but I still had to pay for the procedure (more than your son’s ER bill) because I hadn’t met my deductible. I don’t see how you’re getting out of this one. [/quote]

It’s just not clear to me how it’s not just a copay bc my plan lists a $150
Copay and nothing about having to meet deductible first. [/quote]

Do you know how insurance works? Sounds like you really don’t understand your plan. Every plan usually has a deductible.

Anonymous wrote:Why not pay for a lower deductible plan you can't have it both ways. We always pay for the lowest ppo

Some peoples employers only offer one plan? Also, for some people who end up having a lot of medical bills in one year, the high deductive plan can actually be the better deal. Why not MYOB?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would be more worried about why an adult is getting repeated ear infections! This is worrisome. Does he swim? Do the bacterial infections come on the heels of other, viral, infections like colds and flu? Are the infections usually triggered by wax blockage?

My son is prone to ear wax blockages and there is an oil he has to use regularly to keep the wax from blogging his ear canal. When he forgets for long periods of time, he can't hear, it gets painful, and he ends up needing to see the ENT to remove the wax, which isn't ideal.

even the cvs minute clinics remove ear wax for $50. urgent care wasn't needed OP.

I know it's not a hard thing to do, now that I know it was the issue! And he did first go to the little on-campus, college urgent care, very much like a minute clinic (there is no CVS/Walgreens minute clinic near campus) and same copay of $30. The issue is the doctor there did not take care of him, scared him and told him he needed the ER or might go deaf. At that time, based again on what the doctor said, he thought it was more than an ear wax issue. Since I am 8+ hours away from him, and he was very alarmed, I did not look into it as much as I should have, and the doctor told him that because the ER was another college hospital he should have just a copay. I should have double and tripled checked and made him try a different urgent care but honestly, in the moment I was not thinking beyond "the doctor told him he needs help stat or else, and he is far away and panicked". It's very easy in hindsight to think through things better. Had he been home we'd have just gone to pediatrician or ENT after minute clinic.

My colleague woke up with a “blocked ear”, assumed it was ear wax and is now deaf in that ear.

The problem with ear wax is the doctor can’t see through it to the drum. So there is no way to diagnose until it’s removed or images.

Urgent care maybe doesnt do ear wax removal because I expect it’s coded as “surgery” or some other nonsense.

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:Did you know he was going to ER? The Urgent Care doctor "recommended" right. It was your/your kid's call to go.

I knew he was going where the guy recommended. My da actually asked about cost he said and the guy said it would be a copay. I’m not there so I was not going to tell him not to get medical attention after doctor said go to ER and he might go deaf! If he were home we’d have done things differently. In any case I still don’t get why this is not a copay because we do have an ER copay and I’ve never had a copay not kick in before deductible.

I’d follow up with your insurance before paying 2k.

Insurance are the ones saying it will be full pay bc we have not met deductible, which does not make a lot of sense due to copay.

It probably wasn't in network?

It was!

Ah, that's so weird. Is this BCBS? Mine has copay plus coinsurance for whatever materials/drugs were used, but still 2k is a lot! Have you called the insurance company and have them walk you through this? They should be able to have you download the brochure and point you to exactly where it explains why you have to pay the deductible before the copay. For your peace of mind if nothing else lol.

It is BCBS! I have the brochure and it states right there that it is a copay and then 30% coinsurance but they kept telling me the entire bill would be my responsibility. It made no sense.

You probably don’t usually have to pay your deductible, this year you did so you feel it.

I think when you see an in network doctor you just pay copay, independent of deductible state — though that sounds wrong.

Anonymous wrote:

Anonymous wrote:Can't DS declare he has no income and get the bill reduced? That's so ridiculous.

He is under my plan. It’s so stupid.

Even so, is DS the one who is named on the bill? Is he the person that signed the paper that said he's on the hook for what insurance doesn't cover? If he, personally, is liable, he might be able to contact the hospital and get the out of pocket part reduced (after you call insurance and make sure it's been run through insurance properly and the billing is correct).

If told hearing could be lost unless the ER takes action, of course I would do the ER. Don't be too hard on yourself.

I have a high deductible BCBS plan as well. The bills at the beginning of the year can be scary but we've run the numbers and the cost across the year for our family's use of medical facilities ends up being lower than paying higher premiums.

I have called the hospital about high bills, like when I was told it would just be a copay and it was over $1,000, and gotten them to cut off 10-20 percent or so just by paying right away rather than using a payment plan, which honestly feels really shady, like the bills are arbitrary.

Anonymous wrote:

Anonymous wrote:Urgent care is useless. He needs a primary care doctor by the school.

this.

When are you able to see a primary care doctor same day? I’ve never been able to.

Anonymous wrote:Urgent care is useless. He needs a primary care doctor by the school.

this.

Anonymous wrote:I paid 2k total for my first child's birth. This seems off!

If you admitted to the hospital, the cost is significantly less. If they see you and determine it’s not an emergency, there is a financial penalty for using emergency resources for a non emergency situation.

I would ask their billing dept to run it thru insurance again to make sure. At any rate that gives you more time to pay.


On the other hand, is this Maybe a consolidated bill - copay, doctor fee, some kind of imaging test - alls separate items.

I paid 2k total for my first child's birth. This seems off!

I don't understand a 2k bill. Our bill when our kid had a seizure and hospital transport was less!

Yikes! I think our hospital co-pay is $200 for ER visit. My one kid had an emergency appendectomy- maybe the entire surgery was $400. Blue Cross