Fridays (with Benefits) - 3/29/19 - When doctors take advantage of trust and convenience

"Ow, that's gotta hurt." These are words we expect to hear after leaving a doctor for a sports injury. But it's not what we expect to hear when getting the bill for that treatment. Obviously, medical treatment is expensive -- that's why we pay those hefty premiums, after all.

But when the treatment and products we receive are more expensive through insurance than they are out-of-pocket? Well, let's just say it's eye opening. And this week's article might just be the most extreme example we've heard in a while.

Price Of A Brace Brings Soccer Player To His Knees - Paula Andalo, Kaiser Health News

Esteban Serrano didn't go play soccer expecting it to make a major dent in his finances. But that's exactly what happened when he injured his knee during a friendly match in his neighborhood. And even though he attempted the tried-and-true "walk it off" method, the pain was too severe to ignore, so he headed to an orthopedist for a closer look.

Sure enough, Serrano didn't just "tweak" his knee -- it was a pretty bad strain of his medial collateral ligament (MCL). But thankfully, there was no tearing, so his recovery would consist of basic OTC pain meds and a standard knee brace for support.

Thinking that was the end of his struggle and that his insurance provider would handle the rest of the details, Serrano quickly put the incident aside and went about his life. Then the bill arrived, with some alarming numbers at the bottom.

His total bill for the office visit and x-ray, was pretty standard stuff -- a relatively conservative $315. But the sticker shock came from the $829.41 charge for a basic knee brace. Serrano's insurance provider only managed to cover $52 off the list price of $882 … again, for a knee brace.

And Serrano was being billed for the difference. Even though the brace (an item that's also FSA-eligible, we might add) is available for less than $250 from most retailers, Serrano was forced to pay this exorbitant price because his doctor provided it during the visit. We understand retail markup. We understand fees and costs. We don't understand how there could be a 300% markup on a basic neoprene and metal support brace.

We also don't understand how it wasn't clearly communicated during the visit that Serrano would be responsible for the majority of the cost. Sure, prices vary (and so do doctors, for that matter) but to casually leave that out of a 1:1 discussion? It's an oversight that we'll never understand, much less condone.

The article goes into more detail about the case, including what Serrano could have done during the visit to get ahead of these charges before they went through his insurance provider. For that reason alone, it's worth a few minutes to give it a read.


Fridays (with Benefits) is a weekly roundup of the latest headlines about employee benefits -- from FSAs to fitness programs and everything workplace wellness. It appears every Friday, exclusively on the Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.

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