Out of Network Medical Expenses
Paying off medical bills was practically the last thing on my mind when I was hospitalized prior to my cancer diagnosis last summer. I did what I could to make sure the hospital was getting pre-authorization from the insurance. However, the reality is that I was too sick and weak to really think about much more than the blood transfusions and diagnostic testing I desperately needed. The doctor who arranged the hospital admission assured me that no insurance company would deny the medical necessity of my hospitalization, but he didn’t warn me attending physicians and other medical providers were essentially independent contractors, rather than hospital employees, who may or may not be part of my Preferred Provider Network.
Appeals and Discounts
I learned the hard way about this reality. Unbeknownst to me, the group of doctors who served as attending physicians in the hospital were not part of my PPO, which meant that not only was the bill paid at only 60% by the insurance, but there was an additional $250 out of network deductible. These surprising charges forced me into another unknown realm: appeals to the insurance company and requests for discounts directly from out-of-network medical providers. Although the insurance company rejected my appeal for in-network level coverage, my requests directly to the out of network medical providers proved much more successful. Both of the providers I contacted wrote off part of the total and the billing department for the attending physicians also offered to put me on a monthly payment plan because of the size of the bill. I am pleased to say, I finally paid off that balance last month!
Paying Off Medical Bills: Miraculous Provision
While I was on medical leave for chemotherapy, the San Jose Teachers Association (SJTA) granted me sick leave through their Catastrophic Leave Bank. Essentially, sick leave donated by members of SJTA carried me through all but eight days of my medical leave. Because teachers in California do not pay Social Security Disability benefit Insurance, we cannot receive those benefits. Consequently, the provision of these days from the Catastrophic Leave Bank averted what otherwise could have quickly become financial catastrophe.
Unexpected generosity also came from long-time family friends, who with their personal insight into the overwhelming challenge of paying off medical bills, chose to help me pay off those bills. Their benevolence came just as I was facing the month with those eight days of unpaid leave, which was literally just in the nick of time. I was completely overwhelmed to be the recipient of their philanthropy.
Thankfully, I can see the end of my medical bills within the next couple of months. I am grateful for those who have helped me financially, for the medical insurance that covers the majority of my costs, for the job that enables me to continue meeting my financial commitments, and for a summer school teaching job helping me recover financially from the burden of months of medical bills.