A 36-year-old woman has been charged nearly $18,000 for a breast biopsy despite having health insurance — only to find out she could have been billed just $2,100 if she had offered to pay the cash price.
Dani Yuengling, from Conway, South Carolina, went to see her doctor early this year after noticing a lump on her right breast. She feared the worst because her mother had died from breast cancer five years earlier.
The HR worker was referred to the Grand Strand Medical Center, in Myrtle Beach, for a biopsy — with a quick check of the hospital’s expenses calculator showing an uninsured patient would be charged $1,400. Yuengling hoped her health insurance with Cigna — one of the nation’s largest insurers — would help offset the cost.
But after having the procedure in February — and no cancer being found — she was billed $17,979. Yuengling said the mammoth bill left her struggling to sleep at night, distressed and suffering migraines. She secured a 36 percent discount after calling the hospital, but is now refusing to return for a follow up.
Experts said that patients should always ask health care providers for the cash price, as this is almost always lower than that offered to insurance. A spokeswoman for the Conway Medical Center, just 14 miles from the hospital where Yuengling was scanned, said they would charge $2,100 cash price for the same procedure.
Dani Yuengling, now 36 and a HR worker in South Carolina, was handed a bill totalling $17,979 (pictured) for an ultra-sound guided breast biopsy. After searching the hospital’s own website she had expected to pay around $1,400 for the procedure
Yuengling — who wanted to get a lump on her right breast checked — said she was left unable to sleep and suffering migraines by the bill. She has refused to return to the hospital for a follow-up
Grand Strand Medical Center in Myrtle Beach (pictured) said she was given the wrong price by its calculator due to a ‘glitch’ that they were working to repair
Yuengling has a $6,000 deductible with Cigna — an amount she has to pay before for procedures, she told Kaiser Health News (KHN).
The hospital refused to give her a price for the ultra-sound guided breast biopsy before the procedure despite multiple requests.
But their ‘Patient Payment Estimator’ suggested it should not be beyond $1,400, she said, while a Google search put the cost at around $3,000.
‘That’s fine, no big deal,’ Yuengling said she thought to herself after looking at the costs online.
TWO-THIRDS of Americans are putting off medical care they need because of the cost, survey finds
Two-thirds of Americans are putting off medical care they need because of the cost while half are struggling to meet existing debts, a survey revealed.
A poll by Kaiser Health News, laid bare the crippling price of health care many Americans facing for fractured limbs, dementia — and even cancer.
Doctors caring for low-income patients warned the system was ‘almost perfectly designed’ to force many families into debt.
Others said they had faced several cases where patients refused or gave up on the care they needed because of the time.
It comes against a backdrop of hospitals recording their most profitable year yet in 2019, the latest date figures are available. Current estimates suggest many continued to rake in funds during the COVID-19 pandemic.
But when the bill arrived she was staggered to see it was more than 12 times the figure she had expected.
‘I could not sleep, it was driving me crazy,’ she said.
‘I was having migraines. I was sick to my stomach.
‘I hate having debt, I didn’t want to think about it at all. But obviously, that didn’t work because I’m still thinking about it.’
Her health insurance negotiated rate saw the bill cut to $8,424.14, with Cigna offering to pay $3,254.47. They lumped Yuengling with the remaining $5,169.67 — or the amount left of her deductible.
After calling the hospital to complain, she secured a 36 percent discount — taking the bill to $3,306.29. She put this on her credit card, and says she now wants nothing more to do with the hospital.
Experts warned it is common practice for hospitals to charge extortionate prices for procedures when they are covered by health insurance, rather than someone paying in cash or privately.
For comparison, people on Medicare would only need to pay about $300 for the procedure — or 11 times lower than the bill handed to Yuengling — accounting for about 20 percent of the hospital bill, the federal website says. Medicare would pick up the remaining $1,200.
Those with private health insurance who tried other hospitals in Conway would only be charged about $3,500 for the procedure, according to FAIR Health Consumer website.
And those who offer to pay cash prices would be left needing to pay even less.
A spokeswoman for the nearby Conway Medical Center told Kaiser Health News they would be charged about $2,100 cash for the procedure.
Dr Ge Bai, an accounting expert at Johns Hopkins Bloomberg School of Public Health, warned it was common practice for hospitals to charge lower cash prices.
‘We can very confidently say this is very common’, she said after hearing about Yuengling’s experience.
‘It should be a norm’. She called on all patients to ask for the cash price for a procedure.’
Grand Strand Medical Center blamed the low price shown to Yuengling on a ‘glitch’ with their system, and said it would now be updated.
Shown above is the first page of Yuengling’s bill from the hospital. She is insured with Cigna, which reduced the price to $8,424.14. But she had a $6,000 deductible
Experts said it was always best to ask hospitals for the cash price for a procedure, as these are regularly lower than that charged to insurance
When DailyMail.com used the calculator today, it gave a price of between $8,000 to $11,000 for an uninsured patient to have a breast biopsy.
It comes after a new report found Americans over 75 years old are most likely to be in medical debt, while residents of West Virginia are the most likely to still owe money to their doctor.
Analysts from online pharmacy NiceRx said the oldest Americans average $17,510 in debt each — the highest rate in the county and double the $8,995 owed by the average 35 to 44-year-old.
But when asked whether they still owed their doctor money nine in ten said they had already paid it off.
It suggests that many over-75s are being forced into tens of thousands of medical debt as they try to pay off costs for eye, ear and teeth treatments which are not routinely covered by Medicare — the U.S.-backed health insurance for over-65s.
Many of those in the most debt may also have previously put off care due to costs.
Breaking the figures down by generation showed Gen Z — aged seven to 22 years — had the most debt per person at $19,890. It was unclear why this was the case, although it may be linked to parents putting off paying medical bills.
The report also found that a quarter of Americans in West Virginia were in debt to their hospital, the highest level in any state. For comparison, in Minnesota — where the fewest number of people are in debt — it is an ‘impressively low’ two percent.