Healthcare Cost Confusion Magnified for Seniors

One of life’s great mysteries is the cost of healthcare. In many cases, it can feel like giving a health provider a blank check and letting them fill in the amount. Only then does the patient know the price.

It’s confusing and frustrating. For seniors, concerns can be amplified. As age increases, so does the likelihood of needing extensive, expensive and ongoing care. That multiplies the number of claims and complexity of the entire cost of care picture.

“Cost of care” itself can be a confusing term. For example, there’s the amount billed to the insurance company and what winds up being the patient’s responsibility. Typically, these two amounts look quite different. Where there is no insurance coverage, the bottom line patient responsibility can be downright scary.

Seniors deserve predictable healthcare costs

When buying goods at a brick-and-mortar establishment or online, seniors know the price upfront. Why should healthcare be any different? DispatchHealth, a Denver-based startup, is bringing back the house call and offering affordable care in the home. The company is demystifying the entire process so that the “patient responsibility” portion of the bill can be estimated at the time of service, not when a bill arrives in the mail.

Right on the website, estimates and processes are broken out clearly. Based on nearly 30,000 claims in a three-year period, DispatchHealth average patient responsibility bills are: $44.03 (commercial insurance), $17.33 (Medicare Advantage), $5.44 (Medicare with secondary insurance) and $27.31 (Medicare without secondary insurance). Non-insured seniors pay a flat rate of $275 at the time of service. The exact final total depends on the specific insurance plan, but these numbers will be in the ballpark.

That’s it. No complicated jargon or gobbledygook will confuse or frustrate seniors already dealing with healthcare concerns.

Three numbers for seniors to know

There are three numbers in the DispatchHealth cost equation: medical charges, explanation-of-benefit (EOB) charges from the insurance company, and what the patient actually owes in the end. Medical charges refer to the amount billed to the insurance company. EOB is what the insurance company sends to the patient (usually 30-45 days after service) to show what was covered based on the specific plan and deductible. A bill from DispatchHealth generally follows, detailing the actual “patient responsibility” – what is owed out-of-pocket. The rest of it may provide helpful information and insights (e.g., how an insurance company covered the procedure), but that’s it.

Contrast this to a typical ER visit

For many seniors, a visit to the ER can be scary on care and cost levels. While insurance plans typically list deductibles for ER visits, the rest of it can be a maze of charges with extremely high numbers. Cost of an ambulance, a variety of tests and the involvement of specialists and others not part of the core ER team can make even the most savvy senior cringe. Only after in-depth analysis, often requiring multiple phone calls and inquiries to everyone from the providers to the insurance company, does the patient actually get a true picture of what’s happening cost-wise.

This is one reason mobile urgent care house calls are proving to be a welcome relief for overwrought seniors. In addition to getting care in the comfort of one’s home, uncertainty about costs goes away. This dual level of stress relief is both welcome by, and necessary to, seniors’ health going forward.

DispatchHealth house calls provide clarity

In most healthcare sectors, getting older means murkier and scarier healthcare challenges. Misinformation, misperceptions and changing rules all contribute to the malaise.

A December 2018 New York Times article details some of the issues: Half our lifetime spending on health care is in retirement, even though that represents only about 20 percent of a typical life span. Total health care spending for Americans 65 and older is about $15,000 per year, on average, nearly three times that of working-age Americans.”

The article continues: “Don’t expect Medicare to provide complete protection from these expenses. Traditional Medicare has substantial gaps, leaving Americans on the hook for a lot more than they might expect. It has no cap on how much you can pay out of pocket, for example. Such coverage gaps can be filled — at least in part — by other types of insurance. But some alternatives, such as Medicare Advantage, aren’t accepted by as many doctors or hospitals as accept traditional Medicare. On average, retirees directly pay for about one-fifth of their total health care spending. Some spend much more.”

A sense of comfort for seniors

While the overall healthcare picture gets murkier, an oasis such as mobile urgent care house calls with predictable pricing becomes even more comforting to seniors. Many have heard or experienced the horror story of leaving the hospital after a major health crisis such as a heart attack, only to get a humongous bill presented to them as they depart. Why would anyone in healthcare do something so stressful as to potentially trigger another health crisis?

woman explaining healthcare bill

It’s time to do it better. Connect with DispatchHealth by phone, online or through an Android or iPhone app. A medical technician and nurse practitioner or physician assistant will come to you in a timely fashion, provide extremely affordable care, and diagnose and treat everything from the flu, norovirus and nosebleeds to joint pain, fall injuries and pneumonia.  

Reach out to DispatchHealth to re-discover how healthcare can heal the body and provide peace of mind.

about the author
About the Author
DispatchHealth Staff The DispatchHealth blog provides tips, tricks and advice for improving lives through convenient, comfortable healthcare.