When I was preparing for surgery, I asked DHMC’s financial office what it would cost. The bean-counters told me that the out-of-pocket cost for a Medicare patient like me would be about $1,700. That sounded pretty reasonable, especially since I had supplementary insurance that might pay some of that.
But, I added, what about the charges to Medicare? I cared about the bills I ran up for the government program. The answer was, “about $52,000.”
I went into shock. How, I asked myself, could they justify that kind of charge?
The answer was much less shocking, but lay tangled in the byzantine billing practices of modern American medicine. As it turned out, the hospital billed a little over $45,000; but after Medicare got finished disallowing about half of it, DHMC collected less than $21,000, mostly from Medicare. My supplement plan chipped in about what the hospital said I would owe. Another $1,200 was billed by my physical therapist; but he got only a little over half that in payments from my insurers.
So my advice to patients is, be prepared to see big numbers. The hospitals know their charges will get downsized by Medicare. They accept the bill-trimming as part of the game.
I have no complaints. When the financial smoke cleared, I realized that I personally had paid about $30 for my new hip. I had just paid our veterinarian five times that much to treat Hyper Piper, one of our border collies, for a cut on her paw.
Also, see WSJ story: https://www.wsj.com/articles/what-does-knee-surgery-cost-few-know-and-thats-a-problem-1534865358?mod=searchresults&page=1&pos=1
GetHip! 