Private Pay

Over the last year or so, taking care of Sarah's mom and dad, we have learned a lot about elder care and all the elements involved. It has been a learning experience to say the least.

Recently, after a long struggle, Mr. Holland passed away. It was a sad time but we know he is in a much better place now. Since he passed, Sarah has been working on all the issues that must be dealt with at this time. One of the issues raises a lot of questions.

In the last few weeks of his life, Mr. Holland required special attention for various medical problems and spent time in the hospital, a skilled care facility and in the end a non skilled facility. He was in the non skilled facility for fifteen days prior to his death.

The bill from the pharmacy for the various medications administered the last fifteen days was about $1,500.00. Studying the bill, that seemed a little high compared to other pharmacy costs we had encountered. We contacted the pharmacy just to be sure there hadn't been a mistake. We certainly didn't mind paying our bills but just wanted to be sure they were correct.

In the course of conversation with the pharmacy, they realized we were private pay rather than paying with insurance. They told us that since we were paying the bill there would be a reduction in the costs. Boy were they right.

The original bill for the medications for the last fifteen days was about $1,500.00. The reduced bill was just about $500.00. Don't get me wrong, we were happy for the reduction but it begs the question. Why would the bill be so much higher when the pharmacy thought the bill would be paid by insurance? Why charge the insurance company an extra thousand dollars?

This seems to me to be another window into some of the problems in the health care system. I just wanted to share this story with you in the event that others might find themselves in a similar situation. It never hurts to ask questions.