Need to know what you're going to pay for that medical procedure? Good luck getting the exact figure

January 03, 2019 05:32 PM

This week, a new federal rule says hospitals have to post how much their services and procedures cost. 

So, News10NBC decided to look into this.


What we found is that it is still nearly impossible for you, as a patient, to find out exactly how much money you'll have to pay for a medical service. 

Like 50 percent of Americans, Anna Ka is on a high deductible insurance plan. When you're on those, you're told to be a health care consumer. She wonders, how can you be a consumer when no one tells you the exact price? 

Anna Ka, Excellus BCBS customer: "I want to know what something is going to cost me before I choose to do it."

News10NBC met Ka at her apartment in Rochester. 

Here's her situation.

She's had a medical service that cost her $75 a session. She paid out of pocket. 

This year, the service jumped to $100 so, she wanted to know how much it would cost if she went through her insurance provider, Excellus BlueCross BlueShield. 

Ka: "And they told me they just could not tell me what anything costs."

So she filed a formal grievance and she read to News10NBC part of the Excellus BCBS response she received in December. 

"Our customer service representatives are contractually unable to quote or provide information from our fee schedule to our members," Ka read. 

Ka: "You have to buy it before they tell you how much it costs."

So on Thursday, News10NBC Chief Investigative Reporter Berkeley Brean reached out to Excellus BCBS.

Here's part of what spokesman Jim Redmond said in a statement: 

"It is difficult, for a variety of reasons, to give an exact member cost share amount before a claim is received: some benefit plans are insured; others are self-funded; deductibles and coinsurance may apply; and the actual procedure may differ from the proposed procedure, as there may be unknown health conditions or complications."

Excellus BCBS and other insurance companies have price estimators for customers on their websites.

Hospitals have them too. You have to be a insurance customer to log in.

Click here for Excellus BlueCross BlueShield.

Click here for Rochester Regional Health. 

Anna Ka is spending her money and she thinks its fair to get an exact price. 

Ka: "I know the information is probably proprietary but ultimately I'm the customer. I'm the one who has to pay it so it can't be proprietary to me. It has to be disclosed to me."


Berkeley Brean

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