So sorry your mother has to deal with this after being diagnosed with renal failure. Since she is freaking out about the bills, are you able to make a few calls on her behalf to help sort things out? You could call with her sitting next to you, or via 3-way calling if she isn't local.
Agree that the first step would be to call the billing department and ask if her Medicare coverage and supplement are being applied correctly. Next would be to call the supplemental insurance company to confirm that they don't cover these bills. Sometimes the problem is a mix up with the billing department.
She says she doesn't want to apply for Medicaid after the humiliating experience she had in the past. But, depending on the state she lives in, applying for Medicaid has gotten a lot simpler in the age of Obamacare. In many places, you can apply online, provided you meet the income guidelines. (For seniors on Medicare, this is ~100% FPL, or about $1000 a month, lower than the 133% FPL for working people in the states that have expanded Medicaid.)
Also agree with talking to the social worker in renal clinic: they want to be reimbursed, so they're motivated to help.
I can't stress the importance of this enough.
it's NOT just your mom. It's EVERYWHERE. Even with private insurance.
- 10 years ago, I had my first kid. I got a bill from the hospital for $3000. I was sleep deprived new mom. I asked for an itemized bill. I compared it to my insurance EOB. Nothing matched. No names, no codes, no $ values, no combination of any of the 100 line items. I called the hospital, confused. They said "let me take care of it". They re-submitted to the insurance, re-coded. My bill was now $700 ($350 each deductible - mine and the kid's). How many people would just pay the bill?
- 2.5 years ago, my second baby had surgery. They don't do the surgery in our home clinic. So the ped referred us to the specialist, the specialist referred us to UCLA. We got the pre-approval and the code for the surgery, which was done at 9 months. Then, the bills started. Now note: my kid was double covered: HMO from my work and backup was PPO/ HSA from my husband's work. The surgery was about $20,000-$25,000 (combo of hospital and doctor). I don't even remember what the bills totaled. But the very first paperwork we got was from my HMO, a letter saying that they would not pay for the surgery because it was not an emergency. No shit, sherlock, that's why we got PREAPPROVED. In the end, it took 18 months!! to get it all paid for. At around 9 months we had our open enrollment, when I realized that my out of pocket cost for an outpatient surgery is $125. After dozens of phone calls, eventually the HMO said "oh, you are right!" (I have no idea how screwed my husband's insurance was over this, because they paid right away. Funny thing, BOTH were BCBS).
Then of course the doctor bills started. 18 months. Out of pocket cost: $0 because of the HMO/PPO/HSA. Tens of hours on the phone. (Some of this was because the insurance company will only pay if they are billed from our home clinic, so UCLA needed to bill the clinic, who would pass it on).
- My old boss just had to have a procedure that was pre-approved and $30k, and he's getting the same go around.
In any event, I know that she is stressed out, but I think you should help her out and call the insurance company and the hospital (or whatever). It may involve digging in to the actual coverage and pointing it out. I swear that insurance companies and hospitals, etc. just bill people in the hopes that they can get their money.