Ruthellen, St. Louis County

Last April, Ruthellen went to the ER for pain in her abdomen. She picked an ER that was in her insurance network. Ruthellen was admitted after finding out that she needed her gallbladder removed. She had surgery and was released the following day. She knew she would have to pay some out-of-pocket costs, because she can only afford a high-deductible insurance plan. Everything was as expected, until she received a bill from an out-of-network lab service that provided a pathology report on her extracted gallbladder. Her insurance offered to pay a fraction of the cost for this out-of-network service, but only brought the bill down from $411 to $323. Ruthellen called the insurer, stating that her surgery was an emergency situation, and she was not in a position to verify that every single thing was in-network. She even called the pathologist to see if she could get a cheaper rate directly, but they were no help. Ruthellen filed for an appeal through her insurance company but hasn’t heard anything since. After already paying $5,861 out-of-pocket for her surgery, she shouldn’t be held responsible for an extra out-of-network service that she had no control over. She says,

“That $323 is better in my pocket than in the pocket of the insurance company. Insurance companies as a whole are in it for profit and don’t care one iota for their customers.”