Hospitals Demanding Cash Up Front
Fifty-three-year-old Lisa Kelly is fighting Leukemia. For the past two years, she has also been fighting to pay for treatment.
"It just wears you out, it just takes everything out of you," Kelly said.
She was underinsured. When she was still healthy, she purchased a limited-benefit plan marketed by the AARP.
With $37,000 of annual hospital coverage, she thought it would at least get her in the door at M.D. Anderson, a leading cancer center. But they told her it was not enough.
So Kelly cashed in some of her husband's inheritance and came in with a check for $45,000. When her tests showed she needed immediate cancer treatment, the hospital asked for another $60,000 to admit her that day.
Kelly's situation is not unique. Nearly 4,200 out of the nation's 4,900 hospitals are beginning to require proof of payment up front for non-emergency needs. Meaning: if it is care you can schedule, the hospital wants to know how you will pay for it.
They cite the costs of uncompensated care.
In 1997, hospitals provided $18.5 billion worth of care without pay. By 2007, that number has almost doubled to $34 billion, according to the American Hospital Association.
Rich Umbdenstock of the AHA says hospitals are in a very tough position. He sees lots of plans like Lisa Kelly's, which may be enough to cover the costs of a broken bone, but fall far short when it comes to catastrophic illnesses.
"The patients have purchased the plan, the insurer has issued the plan but a lot of times it falls to the hospital to explain that plan," said Umbdenstock.
Kelly paid $187 a month for a plan that severely restricted the type of care covered. That's instead of buying full health coverage that would have cost her two-to-three times as much.
The office of Sen. Chuck Grassley, R-Iowa, has been investigating how some limited-benefit plans are marketed. He asked Kelly to testify before Congress.
Learn more about Lisa Kelly's case and what's being done about the issue, including documents and video clips.
"Wouldn't you expect when you buy something that is referred to as "health security" that you were getting a pretty good product?" Grassley said.
The AARP stopped marketing the plan purchased by Kelly, but there are still an estimated 1 million people who are holding similar policies.
"Knowin' your insurance and what it costs you alone is just devastating," Kelly said. "Much less knowin' you have an illness that'll kill ya."
By using her family's life savings, Kelly has already paid more than $100,000 out of pocket. And she still owes $137,000 more.