Health care prices often have very little to do with the actual costs of providing the care and its quality. Too often, patients are on their own to figure out high prices and complex benefits.
, which analyzes health care prices for employers. “The hospital charged three to four times the amount of what this surgery typically costs, which is around $3,000.”If Manimtim had opted for Medicare Part B, the part of the Medicare program that covers outpatient care, he likely would have been on the hook for only, a Medicare cost comparison tool shows. Medicare pays a set amount for procedures regardless of where they are performed.
After inquiries by KHN, Anthem contacted the hospital, Saint Agnes, seeking help for Manimtim. Although the doctor is responsible for requesting an exemption from CalPERS’ $2,000 limit on payments for cataract surgery under Manimtim’s plan, that didn’t happen before his surgery. Anthem asked the hospital and doctor to consider the request post-surgery, said Anthem spokesperson Michael Bowman.
And that high payment, like all high payments, contributes to rising health insurance payments for all. “We never want to cause harm or create hardship for our patients, and that extends to our billing practices,” Sanchez said in a prepared statement.
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