18 Yr Olds Dr. Bills?

Updated on August 06, 2010
K.I. asks from Lindenhurst, NY
24 answers

Hi guys,
Ok, so my 18 yr old SS was sick recently. He started having stomach cramps at the end of June. His Mom is a PA (Physicians Assistant) and we sent him to her clinic to get looked at. She and the DR. she works for said it was just a bug and would pass. He stayed sick and we sent him back...several times...eventually they asked for some stool samples and said they think he has Ulcerative Colitis (which his Mom has too) and they said he would be fine and that he needed a colonoscopy to verify this diagnosis. In the mean time my SS kept getting more and more sick. Bloody bowl movements several times a day, all around fatigue and not wellness! Mom said she would set up an appt. for the colonoscopy but weeks went by with nothing...I called and she reassured me that he will be just fine, not to worry...and that she also has it and is fine. SS decided to spend the night at his friends house and while there he passed out and the BF(best friend) and BF's mom took him to the ER. The ER Dr. talked with us and asked why we have allowed him to be so sick for so long? I felt like a complete heel! It was terrible! SS was VERY sick and ended up staying in the hospital for 8 days!

My question is what should we do about the DR. bills? The Ex-wife sent me an e-mail telling me that she thought (with all her medical expertise) that the bill was going to be around $70 thousand dollars!!! $70,000!!! Oh my goodness...it would take him forever to pay this back! SS is on our insurance and I am sure it will cover some...but not all, that's for sure. Is there something we should do/can do to get them lowered some how? FYI, ex-wife also took that time to inform me that she will not be paying for any of his medical expenses ever...since he is 18 she is not obligated and neither are we...but to just be starting off in life and to be saddled with this kind of debt is terrible!...especially seeing how he was being treated by his mom...if only she had taken better care of him and gave him some freaking medicine...all this could have been avoided! He went to see her a half dozen times, if not more and they did absolutly nothing, nothing for the pain, no medicine of any kind. Hubby and I are besides ourself with guilt about trusting the ex-wife...we know she is crazy and mean...just never imagined she would endanger her own son this way...we should have known better!

Any and all help will be appreciated!

My sister said something about applying for state insurance? Would this help cover some of the hospital bills, even after the fact?

Thanks!

What can I do next?

  • Add yourAnswer own comment
  • Ask your own question Add Question
  • Join the Mamapedia community Mamapedia
  • as inappropriate
  • this with your friends

More Answers

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

L.M.

answers from Norfolk on

I would have your step-son contact a lawyer. His mother should not have been involved in his medical treatment, or lack-thereof. I believe there are rules about such things. She and the Dr. she works with were neglegent, causing unnecessary pain and suffering and much larger bills than if it had been handled properly in the first place. Lawyer up!

3 moms found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

R.S.

answers from San Antonio on

I am thinking 70K is way over what it should be...maybe 1 to 2K a day per day in the hospital so maybe 16K.

Most insurances...have either a 2K to 5K deductible then either pay 80 - 100% of the rest.

So my guess would be about $3,500, after the insurance works itself out...and double check every piece of paper from the insurance company verses the actual hospital bill...and then resubmit each bill from the hospital to be reviewed again and even call to double check it was ll processed correctly. I find mistakes all the time in verses what our insurance pays vs what they should have paid.

Don't pay anything to the hospital until it is determined that the insurance has covered everything, BUT do call the hospital billing department to let them know you are still working with the insurance and do intend to make payment...they will then extend you either 30, 60 or 90 days to finish working with the insurance company.

Then when the final total is determined...go with your SS and talk with the billing department in person and tell them how much he can afford to pay a month even if it is $20.00...he can pay on it for years as long as he pays it will not effect his credit or future prospects.

Don't panic...and keep all your paperwork on everything..start a notebook...3-ring binder and keep it all together.

I hope your SS is much better...and this is not going to hurt him in the long run.

3 moms found this helpful

L.M.

answers from Dover on

Unbelievable! I can't even image. You did say if when they saw him in the clinic if they actually processed him (as in documented anything in his file). If so I would think you would be able to get copies of those...then use that as proof that they were negligent/mal-practice. Since he is on your insurance, I have to assume that he is still your dependent (that may mean something different to me than it does legally but to me that means parents are still responsible but I don't know if that is true from a legal standpoint...check in your area). That said, I am sure the hospital bill will be huge but since he is on your insurance it will be less. Usually they bill one amount but have a contracted rate with insurance companies that are much lower (example is my daugters bill that was approx $4500 ended up being $2100). Your first step is to see how much your insurance is going to pay and how much the hospital will show as still due. Check w/ hospital and your insurance to see what your options are.

3 moms found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

N.N.

answers from Seattle on

So sorry to hear you and your family are going through this! Before I became a stay at home mom recently I actually processed financial assistance applications for several hospitals. Our office was here in Washington but the applications were for hospitals in California. If you check with the financial department/business office of the hospital you should be able to get an application. Although you will deal with the hospital directly it is a federally run program based on where you fall in the federal poverty guidelines and will be determined on number in household and gross income. Each hospital will have its own set of documents they will require you to provide (typically last year's tax return, paystubs, bank statements, utility bill, etc.). Let them know as soon as possible that you intend to apply for assistance and have an application sent to you. Be sure to read it thoroughly and submit all the documents as soon as possible. If you should have any questions let me know and I may be able to help.

2 moms found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

A.B.

answers from Corvallis on

I can't really add much to what others have said, at least in regards to the insurance issues. The one thing I would say is that it may be a good idea to report this incident to the state agency where you live that licenses PA's. She obviously demonstrated a big breech of professional ethics by participating in the care of her family member. You can probably file a complaint that way against her.

2 moms found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

H.O.

answers from Anchorage on

She is right he is 18 so she doesn't have to pay. It may not be right for her to say it..but it's true. However, usually parents that are physicians or P.As' do not treat their own children. It's a conflict of interest and she shouldn't have been seeing him in the first place. It makes me wonder if she ever did any actual tests on him. I would get the charts and paperwork from her office..he has a right to those records. Take him to another doctor, when you get a diagnosis of what's wrong..compare what the doctor that diagnosed did with what his mother did ..or at least what she wrote down. If there is malpractice..then sue her and she will have to pay. The insurance company will insist on it anyway..why should they cover a bill that should have never been? Good luck..poor kid..just getting started and having medical bills can really affect your credit.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

J.K.

answers from Phoenix on

Have him apply for medicaid. They will retro pay if he qualifies. Also, talk to the hospital about reducing the amount. They do it for insurance companies. Ask about any discounts and get a break down of the bill. When I took my son to the ER without insurance, they charged us $1200 just for rushing him in right away. Except, we waited in the waiting room for 5 hours. When I mentioned that to them, they took off that $1200... Good luck!

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

C.J.

answers from Dallas on

First off I hope you SS is feeling better. As for the doctor bills first thing to do is look at your insurance policy. For the visits to the clinic your SS should only be responsible for the co-pay if there is one, or the percentage of bill charges that your policy has set up such as 20% of the bill.

For the hospital your SS would be responsible for the deductible first, and any co-pays for days in the hospital if there is one. (Some policies have something like $100 a day co-pay for in-patient stays up to so many days). Then after the deductible is met your SS would be responsible for any percentage (such as 20%) that your policy states up to the max out-of-pocket (OOP) expense. Once that OOP max is met the insurance should pick up 100% of allowable charges.

I don't know the Medicaid and CHIP rules in WA, but it is something to look into as long as the hospital he went to is a Medicaid/CHIP provider. I would also call the financial counseling department to see if there are other programs he may qualify for. Once all of the bills are processed by the insurance and you get your first bill from the hospital call the customer service number to set up a payment plan. Most hospitals will set up a no interest or low interest payment plan. Show them that you are willing to pay the bill, but need some help doing so. If you need any help with any of the wording of your insurance policy I would be glad to help you. Good luck, I know doctor bills are no fun. Once again I hope your SS is on the road to a great recovery.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

L.M.

answers from New York on

I'm sorry to hear you SS was so ill. I hope he's on the road to a full recovery.

You really should find out what your insurance policy covers. When SS is better he should contact the hospital's billing dept. and request a reduction in the bill, and set up some type of payment schedule. Don't let them bully him into making payments that he can't aford, if he can only afford $40 a month and it takes him 5 to 10 years, so be it. As long as he makes the payments as agreed, they can not turn it over to collection and it will not affect his credit rating.

If you want he could get a copy of his medical files from his mom's office and speak to a lawyer about a possible malpractice suit.

State insurance ... That's for those who are uninsured, so he wouldn't qualify, and the whole purpose of insurance is "what if". Wouldn't it be nice if no one had to purchase insurance until after they had an accident, illness, or injury?

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

D.L.

answers from Seattle on

If he is on your insurance, even if the total claim is $70k, he won't have to pay the full amount. You should look into what your/his deductible is (you probably have a family deductible if there is a spouse and child(ren) on the plan) and then see if you have a annual cap (meaning, the most the insurance will cover annually). Also, look up the percentage he will have to pay for emergency care. Many times, all or most of this info is on your insurance card.

He might end up with a bill like $2-3k (which really sucks!!) but, it is doable. He can sign up for financial aid with the hospital and he might get most/all waived. Also, if he still has a bill remaining, then he can set up a payment plan.

I have to say, I cannot believe how absolutely shitty his mom is treating him. It sounds like he lives with her most of the time. (??) Is she always like this, or do they have a strained relationship. Is he still in high school or did he graduate this year? I wonder if she's liable at all. I'm sorry he (and you guys) have to go through all of this. Thank goodness he's finally getting the care he needs. Good luck to all of you.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

J.O.

answers from Corvallis on

Haven't read the othe answers so hopefully this isn't repeating things. Your son needs to contact the financial office of the hospital he was treated in and fill out financial aid forms. Most hospitals will work with patients who don't have money to pay the bill and will either write off all or part of the amount or set him up on a payment plan, even if it is only $25/mo. Applying for state insurance likely won't be of benefit particuarly after the fact. Good luck to you and your step son.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

A.J.

answers from Sacramento on

I sure hope your SS is doing better. Such a sad scenario that played out. As far as the medical bill is concerned rest assured he is not going to be responsible for the full $70,000. As the previous mom mentioned there are copay's and deductibles that he may be responsible for depending on what type of insurance policy you have for him. But I just wanted to let you know, its usually based off of the allowed amount from the insurance company, so It's not necessarily 20% of the 70 grand either!!

I say for what its worth and if you are really stressed about it. I'd recommend just calling the insurance company and have them go over the inpatient coverage on your policy...

Just to give you perspective (my visit wasn't an ER visit) but I was in the hospital while preggo w/ my first son for 2 wks. The bill was somewhere around 50 grand. I had an 80/20 policy and ended owing about 900, when it was all said & done....Not too bad considering what it could be.

Now as others have already mentioned Out of Pocket expenses, policy maximums are all different, but really you and his father did him a favor keeping him on your policy :) Depending on what hospital he was seen at, they do do payment plans and such. And non-profits should do it w/o interest as well!! It could still be a hefty copay/ded/coinsurance amt...but usually there is an OOP max that would put some limit and as I've already said it won't be anything near 70,000 :)

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

N.Z.

answers from Portland on

I'm not into law suits but, I think she has it coming. You can also get the bills lowered, there are many articles online about how to lower medical bills. Definately see a lawyer about this. Malpractice, is horrible, if she treated her own child this way, how does she treat her patients? Turn her in to the board, along with the doctor that backed her up.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

S.R.

answers from McAllen on

Im sorry to hear, hope he is feeling better. It's so frustrating that our healthcare system is ridiculously expensive, and confusing!!!!!.
Regarding your question, even if he has private insurance, he should apply for Medicaid and/or Chip he would be covered until 21 I think..., that way you would pay whatever your insurance covers, and Medicaid would help with co-pays and other things.
Good Luck!!

go to this website www.healthcarebluebook.com and it will give you a closer look at the cost of whatever procedures where performed and your possible expenses.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

A.O.

answers from Portland on

Ok, so here is what you do. Wait until all the bills have been processed and paid through the insurance. Then once you receive a balance bill call the billing department and let them know your situation. There is a strong likelyhood they will forgive the balance...or they will be able to process and discount and set up a payment plan which will not be interest bearing. You will only be expected to pay what you can afford, ie; 25.00 per month.

The important thing is that he is ok, all the other details will work themselves out. In situations like yours with a sick child always follow your instinct you will never be wrong. Good luck and try not to stress, it is definitely not worth it.

1 mom found this helpful
Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

R.K.

answers from Boston on

First I hope your step son is feeling better second I think he should speak with a lawyer.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

L.G.

answers from Anchorage on

I know we have been able to negotiate with the company that owns the clinic or hospital to lower the bills, most have a program to help out lower income families, maybe you should have your ss apply for one of those, but still help him pay it off. Best of Luck!

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

K.R.

answers from Spokane on

I didn't read all the answers so this may be a repeat, but I'll keep it short. Apply for the state insurance, some states will pay medical bills from the past (usually about 3 months past) - so it can't hurt to try!

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

L.L.

answers from Hartford on

You are a great woman for wanting to help your step son. He is lucky to have you in his life. I would wait and see what the final bill is and how much your insurance covers. Then you can decide what more to do. He may be able to work out a payment plan to pay off the rest. You can always offer to help with these payments. His mother is right about not being responsible for his medical bills now that he is 18, but that doesn't mean you shouldn't.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

N.M.

answers from Seattle on

Since your SS is on your insurance, you probably won't have to pay the whole $70,000. Most health insurance companies have an Out of Pocket maximum per year. Out of Pocket maximums vary widely - it can be $2000 or $8000. After that they usually pay 100%.

Check your policy and call the doctor's office and hospital to make sure the all of billing goes through your insurance.

Also, depending on your income, many hospitals and doctor will offer a type of hardship discount. Ask if this may apply to your SS. There is, of course, paperwork to fill out, but this may also save you some money. I did this when my husband had an emergency appendectomy and he did not have insurance. We saved about 20-40%.

Any type of insurance will not cover after the incident has happened. You may also check with the ex-wife to find out if your SS has State Insurance (Basic Health Care). If she is not cooperative then call DSHS to get the information. They often cover 100% up to the age of 19. I know my SD was covered this way and it helped out a lot.

Ulcerative colitis is often caused by extreme internalized stress. Your SS needs some type of counseling and/or healthy coping mechanisms to reduce the stress in his life, or he will be have a very hard road ahead of him. The UC will likely recur if he doesn't take care if it.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

J.W.

answers from Seattle on

You need to contact the finance office of the hospital. Seeing as how he was admitted through the ER, this was emergent care and he may qualify for some help thru their uncompensated care program. Getting insurance after the fact won't work. Compare it to having a car wreck and then running out to purchase insurance to cover the bill. Again, work with the finance office at the hospital. Was your husband not required to carry health insurance on his son as part of the divorce? Many policies will cover dependent children until they turn 19, 23 or 25 if they are students... the new health care affordability act provides for coverage until they are 26 and they don't have to live with you or be dependent, just not have insurance thru their employer.

It's unfortunate that this happened. I hope your step son is feeling better and on the mend. And don't be throwing the blame ball around. The thought of high medical bills is frightening and all consuming. There's more than enough to go around with both parents dropping the ball along the way. Focus on his health and working thru this issue.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

M.N.

answers from Yakima on

Wait and see what the medical bills are and how much the insurance pays. Since he is on his dads insurance you should get the bill for the balance remaining. You would have to pay the deductible if you have one on the insurance for a hospitalization. Check with your insurance carrier to see what you might be looking at as your portion to pay. You can try and apply for state medical for him and they would pay for the rest of the bill. If you qualify for that. You can also see if the hospital has a program to help in your situation. Some hospitals call it charity care.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

J.B.

answers from St. Louis on

First off state insurance is not just for people that are uninsured. I have insurance through my husbands work and through our state.
After you get your actual bill from the hospital I would then contact the hospital to see if they offer assistance/charity. Our local hospital does and it has helped us out in the past a lot of times.
Also, our state insurance does pay for unpaid medical bills when you are approved for the insurance.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

N.K.

answers from Seattle on

Wow, that is really scary for you and your SS. I am glad that he is on the mend. I wanted to give you a bit of my story as a little bit of hope so that you don't feel quite so underwater. I was paralyzed from the waist down from a rare spinal injury when I was 18. I jumped off of an 8" step in a Wendy's one night, and my legs turned into pudding. I had a very unusual condition that needed extensive spinal surgery. To make matters worse, there were some complications (errors made by others), and I required spinal fusion several months after the orginal corrective surgery. Nobody knew if I would be a normal person again. I shook uncontrolably from the pain, I used a walker or wheelchair, and my promising classical music career was in the toilet. I was also in a situation where I needed to pay for my own medical costs because I was 18. I had good insurance, but there were still bills rolling in for years. Not to mention, this would now become a chronic condition, The likelyhood that I would continue to walk past the age of 30 was poor (so far I am 32, but nobody can figure out how I still keep walking). I know it seems like a crappy start in life, but really I learned a lot about perserverance. I bought my first house when I was 19 because I was so determined to make something good for myself.

I have had 8 spinal surgeries, and I seriously doubt his 8 day stay will be 70,000$. I had a kid spend a week in the NICU and it didn't cost that much. Wait until you see what the insurance pays out. This will take time. Then be proactive about setting up reasonable payment plans with the hospital, the doctors, labs, and other professionals that you will owe money to. It will be several different groups. Just be realistic about your SS's earning power. Don't commit to payments that are 50% of what he earns. That isn't reasonable. Slow and steady wins the race. This really can be a great lesson for your young adult to learn now with help from a caring mentor. I know that I am a better person for having to work through that major hurdle when I was young.

Sincerely,
N.

For Updates and Special Promotions
Follow Us

Related Questions