Following the NY Times article “When Health Insurance Is Not a Safeguard“, here’s very good advice regarding gamma globulin infusions I received via email.
Gammaglobulin prices vary greatly depending on how much insurance pays, the number of grams used and the place of the infusion. The least expensive option is to have the product shipped to your house and do the infusion yourselves. For blood work there are some parents that ask the doctor for a lab slip and they either do it themselves and drop off the blood or take them to a lab. Hospitals charge the most followed by clinics and lastly home care. Many insurance companies have a set fee of what they will pay. So even though the charge may be $120 per gram the payment can be $80 to $90 per gram and be considered paid at 100%. The rest is written off by the provider. Some insurance companies pay 80 to 100% of the bill. It is not uncommon to see higher prices in those cases. Yet another variable is supplies such as tubing, pumps, needles etc. Because reimbursement rates are declining some providers will now charge more and seperately for the supplies to try and recoup that loss. Then of course you have a nursing fee and or the newer term “administration fee.” Insurance allows providers to collect
that whether or not you use a nurse. Not all companies take advantage of that but many do. Don’t be afraid to ask for a detailed statement. Know where the money is going. You are the consumer and like it or not healthcare is a business. The main thing to know here is to know what you are being charged and for what. Hospitals get to charge a room fee, paid by the hour, in addition to supplies, nursing, doctor visits, lab work etc.
Figure out what you really need and what is over kill. The money you’re spending may not be yours directly but it will most definitely affect you at some time. Know what the life time cap is and where you stand in relationship to it. Be a wise consumer. Don’t forget healthcare is a business. Like any business providers will charge what ever they can get away with, especially if no one is keeping an eye on it.
I’ve never done blood work for Andy…I don’t do well with veins… I’m ok with NG tubes and G tubes…