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Medical Cost Horror Stories: The Finalists

A couple who fall through the cracks face $10,000 in critical health care expenses precisely when a brief gap in their insurance coverage begins.

A man undergoes treatment for peripheral vascular disease and winds up with a $10,000 out-of-network bill.

These are the final finalists in the Costs of Care national essay contest, which offers a $1000 prize for the best anecdotes from patients and clinicians illustrating the importance of cost-awareness in medicine. The winner will be chosen this week. (Read the other finalists’ horror stories here.)

Kelly Cheramy, the wife of a man with a chronic illness from McFarland, WI writes of her experience “falling through the cracks,” that includes a COBRA nightmare, a case of pneumonia at the wrong time, and sheer panic:

The decisions before us were scary: suspend treatment for one month, potentially jeopardizing my husband’s health and setting us back even further in the long run, or find a way to pay $10,000 for his medications, hormone injections, lab work and doctor visits. We chose the latter.

In the case of the patient with vascular disease, his doctor, Grayson Wheatley, a cardiovascular surgeon from Phoenix, AZ, writes about the mind-boggling minutiae involved in “preauthorization” and how one out-of-network anesthesiologist can upset that delicate balance:

It is not customary to obtain pre-authorization for anesthesiologists since almost always the anesthesiologist is in the same network as the physician and hospital. We assume, incorrectly, that if an anesthesiologist is working in an in-network hospital and with an in-network surgeon, that they also have in-network status.

The bill ultimately gets resolved in this case, but the question remains: is this really the best use of a cardiovascular surgeon’s time?