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When You’re Still in Sticker Shock
If you were involved in an automobile accident, and if you have no medical insurance, you had better hope the accident happened in a no-fault state, where accident costs fall equally on both parties’ auto insurance policies. If it didn’t and you actually opened the hospital bill, you may need to go back to that same hospital to be treated for a heart attack!
Hospital bills in August of 2013, on the cusp of the Obamacare act – formally known as The Patient Protection and Affordable Care Act (PPACA) – are unbelievably high. It is almost a case of your entire fortune and your first-born, with coverage for critical care costing more than $3,500 per day.
Under no-fault, it’s easy to get insurance companies to pay up: in fact, they are mandated by law to do so. Unfortunately, if they don’t pay all the bills, deeming some the insurance owner’s responsibility – did you ask for and receive PTSD therapy, a home-care nurse or outside caregiver, or an at-home heart monitor? – you will be unable to sue your insurance company for full restitution.
During Sticker Shock Recovery
Sticker shock recovery may be more difficult and prolonged than actual physical healing, depending on not only the kinds of care you need in the hospital but the geographic area where you live. Costs for Florida-based treatment of COPD (chronic obstructive pulmonary disorder) run almost $63,000. The same treatment in a Minnesota hospital runs about $21,000.
In spite of such disparities, it can be said that, in the northern tier of states – except Washington, New York, Pennsylvania, Connecticut and New Jersey – hospital costs are lower than the southern tier. The exceptions noted above are not only populous states, but states where workers make very good incomes; two factors which make costly insurance self-explanatory.
Along the southern tier, Florida and Texas are expensive. Another Pacific Coast state, California, is equally expensive. But there are exceptions, and in general, hospital costs across the U.S. form a crazy quilt of medical expenses for inpatient hospital care that make little sense at first glance. For those interested in delving deeper into costs, a visit to the electronic pages for the Centers for Medicare & Medicaid Services, or CMS, has a wealth of information.
What You Can Expect in Fault Auto Insurance States
If your auto accident is very expensive, both in terms of property damage and bodily injury, and you live in Michigan – which mandates Personal Injury Protection (PIP), Property Protection (PPI), and Residual Bodily Injury and Property Damage Liability (BI/PD) – you will eventually end up with a fat folder of bills from hospitals, doctors, medical professionals and even some people you never heard of.
For example, if you had an MRI (Magnetic Resonance Imaging), you will get one bill from the hospital and another for the individual or group that “reads” the test. In a blessedly few cases, you may get separate bills from the technician who performed the MRI, the individual who examined the scan, and the company or division in the hospital which owns the device. Good luck sorting that out!
Michigan’s minimum coverage limits for the various aspects of auto insurance. PIP pays all “reasonable and necessary” medical bills up to three years, including lost wages. PPI pays up to $1 million, which may seem like a fortune until you add up the medical bills. The BI/PD portion of that policy indemnifies the driver or policy holder for any out-of-state property damage; the limit is $10,000. The minimum amount you are required to shell out – which varies from one insurance company to the next (welcome to free enterprise!) – will pay $20,000 per each person injured or killed, and $40,000 for each accident where several individuals are hurt or killed.
What about All Those Bills?
Your insurance adjuster will love you if you start a tabbed file for every kind of bill you receive after a fender-bender. If you don’t, and he or she has to wade through the paper tsunami you have created, you may not get the same kind of fast, generous service settling the bills as someone who has will.
If you’re not a paper-pusher and your main job is making sure the plastic bubble in the bag-making machine doesn’t collapse, let your wife help. You might even drag in your teenagers to give them first-hand experience with the way insurance works.
At the beginning, you should send a note to every provider who sends you a bill explaining that the services are the result of an auto accident, and that your insurance provider is handling the bills. Use your insurance-generated claim number and the name of your adjuster in every piece of correspondence. If your letter or bill is more than a page, carefully staple the pages or – if your adjuster says don’t – preface every document with a fax-cover page (your name, fax number, telephone number, claim number, adjuster’s name, and a line item indicating how many pages you are submitting including the fax cover page). Copy every piece of outgoing mail relating to the accident.
Make copies of the prescriptions your doctor orders, and get receipts for every single item you purchase in relation to your injury. As long as you are careful about filling in the appropriate subsections on claim forms, your adjuster will see your behavior not as OCD (obsessive compulsive disorder) but as the sign of an organized mind. After all, that’s what he (or she) does in the office.