Dear Mr. Capsis:
First of all, I very much enjoy your newspaper, look forward to reading it every month. I have lived in the Village for 57 years and almost every article interests me. Your writers are great and your layout and editing are impeccable. I was especially struck by your piece about your recent hospital experience. Be grateful that you have Medicare! I had my knee replaced at Hospital for Special Surgery by the same surgeon, Geoffrey Westrich, in 2011! Like you, I thought both Westrich and the hospital were superb, and my knee today is as good as the one I was born with eighty-one years ago. But I don’t have Medicare, since Columbia University, where I taught for many years, never deducted SS from my paycheck. I was young then and didn’t know or care about such details! After my retirement I used Blue Cross/Shield for medical expenses and by 2011 my annual premiums had reached $18,000. Outrageous. Yet Blue Cross would not pay for HSS, even though HSS accepted both Medicare and Medicaid. So to use Westrich I had to go “out of network” and pay all expenses myself. After the operation Westrich sent me a bill for $25,200. Since I am not Medicare I did not have the option— which you note—of paying what I wanted, so I had to pay in full. Since I was very happy with the outcome of the surgery I didn’t mind too much. Thanks to Denise Palacios (my heroine!) Blue Cross reimbursed me for almost everything else, which totaled over $100,000. Despite its cost, Blue Cross wouldn’t let me keep my PCP of many years, so with the Affordable Care Act I switched to Oscar insurance. My annual premiums are now about $7,000 and I still have my PCP. But Oscar doesn’t accept HSS or its surgeons, or numerous other hospitals and surgeons, in network or out. It’s a rat race, even when one can afford it. Medicare is surely the best way to go. I am glad that it treated you so well.
Thank you, Allen, for your superb recounting of the horrors of medical billing.
I had one surprise last week when I received a call from Lenox Hill Hospital that I still owed $1260.30 because my AARP insurance did not cover it.
Paying for medical services is indeed a rat race and we have no voice that is articulating the need for intelligent change.