Welcome to fifty: My first health scare as a middle-aged man

Three weeks ago today, I had a major health scare.

Because it was Monday, I was at the family box factory. I had just finished running payroll and had taken paychecks out to the shop. I exited the building and *bam* my chest just sort of seized up.

“Ouch,” I thought. But, being a Roth, my thought process didn't go much farther than that. (We Roths don't like doctors and we tend to deal with injuries for weeks or months or years before having them looked at.)

On the way back to the office, I stopped to talk to my cousin Duane. He was digging in the dirt, prepping a spot for his summer garden. We chatted about blueberries, tomatoes, and greenhouses. We admired the warm spring day. After a few minutes, I realized that my chest still hurt.

“I don't want to alarm you,” I said, “but I'm having chest pains. It's probably nothing. But just in case it is something, I thought you should know.”

I walked back to the office and sat down at my computer. Instead of going back to work, however, I googled heart attacks. I read the list of symptoms. I wasn't experiencing anything except chest pain but still…Every site said the same thing: Don't mess around. If you're having chest pain, have somebody drive you to a doctor.

Duane came in. “Are you feeling okay?” he asked.

“I'm still having chest pains,” I said.

“Do you want me to drive you to the doctor?” he asked.

I debated things in my mind. “It's probably nothing,” I thought. “Or maybe it's a panic attack like twenty years ago.” In 1998, I experienced two similar episodes that turned out to be panic attacks. I was under a lot of stress then. I'm not under a lot of stress now.

“Plus, if I go to the doctor, it could end up costing a fortune. My health insurance sucks,” I thought. “But if it is a heart attack and I don't go in, I could end up dead.”

“Well?” Duane said.

“Tell you what,” I said. “I know I'm not supposed to but I'm going to drive myself to urgent care. If you don't hear from me in fifteen minutes, come find me.” (There's only one logical route from the box factory to the nearest clinic.)

I gathered my stuff, hopped in my pickup, and drove slowly to the clinic.

Hurry Up and Wait

At urgent care, they expedited my case. Within minutes, I'd been hooked up to an EKG machine. While he worked, the doctor asked me lots of questions about my past and current health.

“Everything looks normal to me,” he said. “Your blood pressure is high, but the EKG is good. So is everything else. Are you still having the pains?”

“Yes,” I said. “And they're now in my back too.”

The doctor frowned. “I don't think you're having a heart attack,” he said, “but we should make sure. I want you to drive yourself to the nearest emergency room.” He gave me a printout that explained my situation and wished me luck.

Twenty minutes later, I was in the ER for the first time in my life. (I've been there for other people but never for myself.) A nurse ran another EKG. “Everything looks fine,” he said, “but we're going to do some more tests.”

Hospital Monitor

First, they drew blood. Then they ran chest x-rays. Then they ran another EKG. Then they ran a CT scan. “Oops,” the doctor said when he saw the results of the CT scan. “They didn't scan the right spot. That's my fault. I goofed up. I pressed the wrong button. I guess we'll do an ultrasound to check out your abdomen instead.” So, I got an ultrasound. Then more blood tests and another EKG.

Can you guess what I thought when the doctor admitted he'd run the wrong test? That's right: “I'd better not be charged for this!” In any other business, if the service provider makes an error, the customer isn't charged for it. Is that the same with hospitals? We're going to find out.

After five hours of tests and waiting, they let me go.

“I'm not sure what's wrong,” the doctor told me. “Your blood pressure is high, but you're the healthiest person I've seen all day. Follow up with a heart specialist. Go enjoy the sun!”

Paying for Pain

Since that heart-attack scare three weeks ago, life has been a whirlwind. We've been planting trees and bushes and flowers and seeds. We celebrated my birthday. Kim had knee surgery. Plus, there's all the rest of Real Life to take care of.

I tried to follow up with the recommended heart specialist but he's out of my network. “You should find somebody on your own insurance,” his office staff told me. I haven't done that yet.

Last Friday, two other things happened.

First, I had to go back to urgent care. (When was the last time I sought medical help twice in three weeks? Has it ever happened?) I have miserable allergies this time of year, but my throat seemed even more raw than normal.

Turns out, I have a simple canker sore…on the back of my throat. The doctor prescribed a numbing agent. “Your blood pressure is pretty high,” he said before I left. “You might want to have that checked out.” He suggested that I buy a blood-pressure monitor while I was picking up my prescription. So I did. (Nothing says “I just turned fifty” like browsing blood-pressure monitors at the pharmacy.)

When I got home with the meds and the monitor, there was an Explanation of Benefits waiting in the mailbox. I opened it to learn the initial cost estimate for my ER visit. (For non-Americans, the Explanation of Benefits is a statement we receive after health care but before we receive actual bills. My understanding is that it's an estimate of what is being billed to whom. But it's not always 100% accurate.)

According to the Explanation of Benefits, I'm on the hook for $6858.49. That's enough to give a person a heart attack! (Haha.) I'm under the impression that my insurance plan covers all emergency room visits, so this number could change. Right now, though, I assume I owe nearly $6900 for my four hours in the ER.

Hospital EOB

A Change of Heart

After-Visit SummaryOver the weekend, I tested my blood pressure several times. It's high. I haven't figured out my new blood-pressure monitor well enough to state definitively that I have hypertension, but it seems as if I'm pre-hypertensive at a minimum. In any case, it's clear that I need to make some changes.

Over the next few months, I want to:

  • Scrutinize the hospital bill. I want to know what I'm being billed for and why. (I'd better not be charged for the mistaken procedure in the ER!) As much as I hate phones and confrontation, I might have to use both. Good thing I just read this article on how to fight expensive medical bills. I'm curious to see what I'm actually billed for compared to the estimates on the Explanation of Benefits.
  • Look into health savings accounts. This is one of my financial blindspots. I've never read about HSAs, so I don't know the pros and cons. I don't know anything about them. From what little I do know, it sounds like an HSA might be a way for me to cushion unforeseen medical expenses.
  • Get serious about my physical (and mental) fitness. For the past few years, I've been coasting. I've been overweight and out of shape during most of my adult life. In 2010, I lost fifty pounds and gained muscle. I was the fittest I'd ever been. I maintained that for a few years, but have gradually softened. I've made occasional half-hearted efforts to change. It's time to give 100% effort again.
  • Find a primary care physician. I had a primary doctor I liked but when Kim and I left to explore the U.S. by RV in 2015, my doctor moved. I haven't had a regular doctor now for four years. This is enough of a passive barrier to keep me from seeking medical help. Dumb but true. I need to find a new doctor.
  • Find a therapist. Like last year, I'm struggling with depression this spring. It sucks. It's not as bad as it was in 2018, but it's still enough to sap me of motivation. I need to get some help.
  • Be proactive with my heart health. My family doesn't have a history of heart disease. We have a history of cancer. I've been worried about cancer all this time, but what if I should have been caring more for my heart? Fortunately, managing high blood pressure doesn't seem too onerous.

There's one other thing I'm going to do — especially if my final bills do amount to $6900 and I can't get them lowered.

My health insurance carries a $7900 annual deductible and $7900 annual maximum out-of-pocket expense. If I end up owing $6858.49, then there's only $1050 left until I reach the maximum I can possibly pay this year. That gives me a strong incentive to get as many medical procedures done this year as possible.

Final Thoughts

I'm glad that I didn't have a heart attack. I'm disappointed with myself for allowing my fitness to erode, but I'm trying not to beat myself up to bad. I can get back in shape. And I can lower my blood pressure. It'll take time and effort, but it's doable.

In 2012, I was worried about my lack of energy. I asked my doctor to run some tests. “You have nothing to worry about,” he said when the numbers came back. “You're one of the healthiest 43-year-old men I've ever seen. I'm serious.”

No doctor would say that about me now at age fifty. But if I apply myself, maybe in a few years my doctor will tell me, “You're one of the healthiest 53-year-old men I've ever seen.”

More about...Health & Fitness

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John
John
1 year ago

That’s a rough patch but it’s certainly a good motivator to get on top of your health!

Once you have an actual bill in hand, many hospitals / clinics will offer a discount for timely payment. For example, 20% off if you pay within 30 days. Sometimes this is stated clearly on the bill. Other times, you may have to ask… more phones and confrontation 🙂

Dr Don
Dr Don
1 year ago
Reply to  John

To JD Roth
Search for “Right Bundle Branch Blockage” a non-fatal common condition.

If it is RBB it may be useful information (due to the Dr’s “under-diagnosis”) to negotiate a reduced bill.

Petra
Petra
1 year ago
Reply to  Dr Don

Don, then why wouldn’t they have seen this on multiple EKGs, hmm?

Eileen
Eileen
1 year ago

JD — I haven’t ever really seen a difference in what the EOB says and what I end up getting billed. And with Hospital stays, I think you can also get billed by the Drs practices as well, but I suppose it all depends. We recently had a billing snafu for some treatment for my husband’s knee. They billed us for the Rx injections that we’d already paid for. So mistakes do happen obviously. I have a high deductible plan as well, but only preventative is covered 100% regardless of whether you’ve met your deductible or not. So my annual… Read more »

FoxTesla
FoxTesla
1 year ago

J.D. – Hope you are still feeling well! HSA – I didn’t think anyone was signing up for an HDHP without also setting up an HSA…that’s the whole point! I’m sure your reading with be studious but the short story is HSAs are governed by the IRS, allow rollovers year to year (unlike FSAs), are investable (depending on who the HSA holder/broker is), are maintained even if you stop having an HDHP (you just can’t contribute to them anymore) and contributions up to a certain point can reduce taxable income. EOB – As you go through the itemization, have your… Read more »

Eileen
Eileen
1 year ago
Reply to  FoxTesla

Right — I listened to a health reporter recently tell the story of a person who despite being in compromised health (I can’t recall if it was an auto accident or a health issue) asked every single hospital person she encountered to confirm they were in network (and they confirmed yes). IIRC, she needed surgery and found out that the on-call Dr was NOT in network. So then what are you supposed to do? His bill was many many 1000s. They claimed it’s related to using staffing companies to help cover ER services/hours, but that still doesn’t leave the consumer… Read more »

Betsy
Betsy
1 year ago

Welcome to my life during 2018 for its entirety. My chest pain was precipitated by a medical emergency in Colombia: a sudden onset pulmonary embolism from which I almost died, and the discovery of an old, quite serious injury to my aorta which had miraculously healed itself. For those who don’t know, an aortic dissection can be fatal within a minute or so. Subsequently, every twinge had me thinking this could be it. Chest pain episodes occurred quite frequently, and as you described, spread to the back. These became quite severe and had me writhing with them dispensing morphine, yet… Read more »

Becky
Becky
1 year ago
Reply to  Betsy

Yes!! I was also going to suggest checking the gallbladder. I had severe chest pains, but an EKG and chest X-ray both came back normal. ER docs decided it was indigestion and sent me home. Two months later, I was back in the ER after vomiting bile for hours and had a crazy high red blood cell count. My gallbladder had gotten so infected, it was too risky to operate right away and I had to wait 3 months, hoping I wouldn’t have another attack. The bright side is, if it is your gallbladder, you can have it removed with… Read more »

Donna Freedman
Donna Freedman
1 year ago
Reply to  Becky

Yes to this. I had one gall-bladder attack, and within a couple of weeks was scheduled for an outpatient surgery. Got there at 6 a.m. for the laparascopic procedure and they kicked me out at noon.

By contrast, my ex-husband was in the hospital for four (maybe five? I’ve blocked it!) days and they cut him wide, deep and continuous.

Hope you’re feeling better now.

HG
HG
1 year ago
Reply to  Donna Freedman

Maybe pancreatitis. I’ve had a few attacks and it’s chest pain radiating to the back. Was drinking a lot of energy drinks/caffeine at the time, suspect that may have been the culprit.

Dave @ Accidental FIRE
Dave @ Accidental FIRE
1 year ago

Yikes dude. First off glad you’re okay. Second – shame on you. At the risk of sounding like your Mother, you NEED to go to he Doctor!! You get one body, no replacements. My Dad died an early death because he didn’t. Just find a good one and go annually for a checkup.

Lastly, that $6800 is exactly why health insurance is the one thing that scares the bejeezus out of me about early retirement. That’s ridiculous. Good luck navigating the mess.

Sara
Sara
1 year ago

And yet, a 6800 dollar bill to be told nothing is really wrong is exactly what keeps people from going back to the Doctor the next time something doesn’t feel right. It just makes me grouchy about healthcare in the US.

Jess
Jess
1 year ago

Once you figure out/verify what you actually owe, don’t just go online and pay it either. Call the number on your bill and ask if there’s any discount for paying in full, because if not you want to talk about setting up a payment plan. In my hospital system, it’s always an automatic 10% off the amount I owe- which is no chump change with a big bill!

Mike in NH
Mike in NH
1 year ago

Getting my exercise in is by far my favorite way to self medicate the winter grumpy’s. I think you have a really good opportunity here to pull a two for one on that part of your to-do list JD.

*And before the internet mental health police come taser me, yes I am very familiar that exercise alone cannot be expected to handle severe conditions.

Sequentialkady
Sequentialkady
1 year ago

Hi Everybody, I’d just like to reiterate that high blood pressure can be a silent killer. In too many people the first major sign is sudden death due to a stroke or burst blood vessel. In other other group, it’s slow death due to congestive heart failure, which often isn’t felt until massive and permanent damage has been done. While it can be managed, it’s a chronic condition and causes a lot of complications. Both those options suuuuucckkkk. And I’ve seen them take too many of my friends and family. Get out in front of this early and it might… Read more »

Eileen
Eileen
1 year ago
Reply to  Sequentialkady

Thanks for all this. I didn’t know how to say that having high BP is a big deal, so your post is perfectly stated. Of anything in this post as “to dos”, seeing Dr seems to be the very first, number 1, most important with everything else a distant 2nd.

Celeste
Celeste
1 year ago
Reply to  Sequentialkady

OMG. Thank you for the hibiscus tea note; I naturally run low (60-62 bpm) and have been drinking 2-3 cups a day, feeling woozy, and taking my own resting HR it’s been 50-52. Neither my PCP nor my doc friend suggested this could be the culprit! Random internet friend, thank you!!!

infmom
infmom
1 year ago

Keep monitoring your blood pressure–and if you have chest pain, go straight to the doctor. My husband, who should have known better since he’s a certified first aid instructor, kept trying to “wait out” chest pains. He didn’t tell me about it till it had happened several times and then it was “Well, as long as you’re going in that direction, could you take me to urgent care?” Very lah-di-dah. He’d been having chest pain ALL AFTERNOON. They tested him ten ways from Sunday (and we have excellent health insurance so we only had the usual co-pay). Could not find… Read more »

Kay
Kay
1 year ago

That’s quite a scare. I can share a few tips – learnt it after taking care of parents with high BP.

– Low impact Exercise is the best thing for high blood pressure.
– Eat more fibre – oatmeal, bran, veggies, salads etc
– Drink herbal tea, reduce stimulants, get minimum 8 hr sleep stating at 10 pm
– Most of all reduce stress (Meditate, yoga, relaxation exercises)

Steveark
Steveark
1 year ago

I had zero symptoms but my doc sent me for an elaborate stress test with injected dye and rotating xray machines that took a video of my heart beating. They said they’d analyze it in a few days. So I went on with life and was 100 miles from home on business when two heart specialists called my cell. They said come back home now, we have you scheduled for surgery at 630 am tomorrow morning! I said, were they sure? I had gone on a 20 mile training run and then played a grueling three hour singles tennis match… Read more »

El Nerdo
El Nerdo
1 year ago
Reply to  Steveark

YIKES!!

Spencer for Hire
Spencer for Hire
1 year ago
Reply to  Steveark

That is crazy! Thank god you weren’t under the knife before they realized their mistake.

dh
dh
1 year ago

Re: high blood pressure: lower the booze intake.

Sara
Sara
1 year ago

JD – I’m sure I’ll get hate for it, but I suggest reading ‘How Not to Die’, by Dr. Gregor. There is quite a bit of science based info on lowing blood pressure via lifestyle vs. getting started on drugs. Wishing you all the best!

Siobhan
Siobhan
1 year ago
Reply to  Sara

No hate here – I’m with you 100%. An excellent book.

Eileen
Eileen
1 year ago
Reply to  Sara

I have 2 siblings who have adopted this lifestyle (not because of their own health issues) so I’m very much aspiring to move towards this (and am, verrrrry slowly).

I follow Forks Over Knives on instragram (motivation never hurt anyone) and found this “success story” today. Many/most of them include people extremely overweight, but this one was specifically for an otherwise healthy person, who found out she had high BP.

https://www.forksoverknives.com/plant-based-diet-hypertension-success-story/#gs.4w8xnb

Verity
Verity
1 year ago
Reply to  Sara

I agree whole-heartedly with these ladies. I watched Forks Over Knives on Netflix in early 2015. I found it super empowering and decided to eat that way for a month to lose a little weight. I lost more than I’d initially hoped without ever feeling hungry nor counting calories. When that month was over Lent had begun and my dad challenged me to keep it up until Easter (we’re Catholic). By the time Easter came around I had lost all my cravings for meat and most for dairy. I had some ham and creamy (dairy) mashed potatoes on Easter and… Read more »

Laura
Laura
1 year ago
Reply to  Sara

I was reading to see if anyone would suggest this. I had high cholesterol in my early 20s and while I’m certainly not perfectly plant based, moving in that direction has made a big difference for my health.

RichardP
RichardP
1 year ago

DEFINITELY look into an HSA. I researched them extensively prior to retiring as I expected I would get a high-deductible plan to keep my cost down. Then I ended up moving to Massachusetts which has really good state-subsidized health insurance (this was the plan created under Mitt Romney which became the model for the Affordable Care Act – i.e. Obamacare). But HSA’s are really great. The amount of money you can contribute annually is limited, but it’s not taxed. Then the earning are tax-free. And, when you withdraw the money for qualified medical expenses, you can withdraw it tax-free. My… Read more »

Chris
Chris
1 year ago
Reply to  RichardP

I agree with this. We have had an HSA for almost 10 years now with my husband’s last 2 jobs. We decided to pay most of our expenses OOP, and save the HSA money for something big. It was a blessing when I was diagnosed with breast cancer in ’15. If we don’t need to use it again before my husband retires, we will use for health expenses then. The HSA is the best tax break for high income earners, IMO. I just wish we could put more in. 😉

Spencer for Hire
Spencer for Hire
1 year ago

I am glad to hear everything is ok. Did this change your perspective on life in anyway? I try and stay grounded on the fragility of life, but can get lost in the day to day tasks. I have been lucky enough to not have a big health scare, but that also means I am likely taking my health for granted without realizing it. Medical billing practices are one of the most backwards processes in out there. Things need to be straight forward. My wife spent hours on the phone trying to figure out how much a visit would cost… Read more »

Nirav Patel
Nirav Patel
1 year ago

J.D., Glad you are ok after your trip to the ER. Check the bill again, they (ER) only billed you $2839 for the 8th item. They (insurance) allowed $6858.49. The sum of the items are: $6858.49. Seems weird that the insurance allowed whatever the hospital charged to stand without a mandatory discount for being an insurance member. You are entitled to a breakdown of the items with the CPT codes. There may be some bogus charges you can negotiate away right off the bat. Once you have the itemized bill (maybe?), you can look up the Medicare reimbursement for these… Read more »

Jamie
Jamie
1 year ago
Reply to  Nirav Patel

Exactly.

Look at every line and see what they add up to. And I would question any charge to you for either that CT they scanned the wrong area on, or the ultrasound they then ordered. One of those was their mistake. You shouldn’t have to pay for that.

Barb
Barb
1 year ago

I haven’t read all the responses. But building muscle is not enough. You need movement as well, first of all. Weight is not necessarily an indicator of heart risk issues. Get a doctor. NOW. You can always find one later if you hate him.

Elisa
Elisa
1 year ago

This is the proverbial wake up call. I had high blood pressure (about 180/90) for years. Fortunately, it got bad enough that my eyes started bleeding once when I was traveling: the hypertension had caused a small hemorrhage in my eyes. There’s nothing like seeing your eyes bleed to get you motivated to change your lifestyle, so I did. I started eating more veggies and less greasy fat, started walking more…and meditating. Like you, I also bought a home BP monitor. My best pal also turned me on to some blogs/websites that she used to turn her BP around (www.webmd.com… Read more »

Sam @ Financial Samurai
Sam @ Financial Samurai
1 year ago

Oh man! Glad you’re OK!

That’s a lot of money to spend. Hope you can get it down.

I had my physical and need to lose 5 lbs – 10 lbs. but I always do haha.

Health is wealth!

Sam

Dominick
Dominick
1 year ago

Just something to note about HSAs – there are requirements about the deductible and out of pocket max that have to be met in order for a plan to be HSA qualified. All HSA qualified plans are HDHPs but NOR every HDHP is HSA qualified.

Also – it looks like the insurance company rolled all of the charges into one big lumped item – the invoice from the hospital should show you the breakdown as well as the insurance discount.

Good luck and be well!

The Frug
The Frug
1 year ago

Glad you’re doing better. I have a high deductible (shit) plan as well. But since I pay 2k a month for a family of 4 plan I make sure we use every included wellness option including annual physicals for everyone. Some recommendations: Run your health care through the family business or your own LLC if possible, definitely set up an HSA and max out the annual contribution, track all of your medical expenses in quicken and personal capital. If you have a really high expense year you may qualify for an additional deduction.

Ryan Guina
Ryan Guina
1 year ago

J.D., Glad to hear all is as well as could be hoped for! Definitely find a cardiologist and figure out the blood pressure issue. Hopefully, all you need is some lifestyle changes to manage your BP.

As for the fitness, I would start slowly and work up from there. Your cardiologist should also have some recommendations. Just work toward sustainability – diet and exercise changes that you can stick with and make part of your lifestyle.

OFG
OFG
1 year ago

I’m know I’m going to sound like a crazy person, but do not postpone going to see a specialist. Find one as soon as you can and get yourself checked out. Put down the pruning sheers and get to it. High blood pressure can cause a lot of problems quickly, so don’t delay. If nothing is wrong you’ll have peace of mind. If something is wrong you’ll find medical solutions to help you live a long life.

Fred
Fred
1 year ago

Glad you’re ok. This was your wake up call, so do wake up!
My HSA contributions lower my gross income, I can invest the funds. It isn’t taxed when I ultimately use it to pay a medical expense someday. Its worth checking out.

Jenni
Jenni
1 year ago

Thankful you’re okay but holy crap what a bill! I had a similar examination when I had an ulcer (they had to check it was, in fact, and ulcer and not a heart attack) and the total bill was 21 euros (I live in Finland). That amount is just insane.

El Nerdo
El Nerdo
1 year ago
Reply to  Jenni

Finnish healthcare is indeed cheaper, but not by such huge ratios. Your health costs are just hidden/amortized in the form of various taxes you pay every day. Your cost is still there, just comes in different form. Health care prices in the U.S. are higher due to various factors (higher salaries of practitioners, greater administrative costs,) but on the other hand wait times are shorter than in the rest of the world, which is especially crucial when it comes to heart attacks. Not to say that our health care system is ideal, there is much we can do to improve… Read more »

Jenni
Jenni
1 year ago
Reply to  El Nerdo

Oh yes, the cost is definitely there in form of taxes, but the difference is still mind-blowing. Having grown up in the system you’re used to it, and I’d say the taxes aren’t as high as many people believe they are, because of allocation of those euros collected by the government. In my own mind a taxation of eg. 35% from someone who earns 100.000 EUR/yr is reasonable when you get free education, extremely subsidized healthcare when you need it, your kids get free lunch + books + supplies in school etc. So to us, this seems reasonable and something… Read more »

Eileen
Eileen
1 year ago
Reply to  Jenni

Yes, the heart attack/wait comment was odd. I think the suggestion is that because “wait times” are a supposed known issue with other health care models, that it would somehow become a risk. I must have missed the coverage of people dying from heart attacks because the ER in some countries wouldn’t see them. I’m just going to presume that the triage of emergency care does not differ all that much between countries. As an American, I’m not aware of what routine or diagnostic (non-emergency) care is like in other countries, but I do know that you don’t always get… Read more »

El Nerdo
El Nerdo
1 year ago
Reply to  Jenni

Oh, I wasn’t arguing about reasonableness of the system or not. I just meant to highlight that there is no free lunch. Things might appear free or very cheap at the point of use, but everyone pays the full cost one way or another. The US has high costs for suboptimal outcomes (France and Switzerland do it better last I read), but the cost isn’t really 21 euros vs. $7k. I don’t know figures for Finland, but say the UK which is as thrifty as it gets, it’s half the cost of the US and they’re at about half the… Read more »

Jenni
Jenni
1 year ago
Reply to  El Nerdo

The Finnish VAT is definitely high, yes. As for what taxes are used towards healthcare I can’t say, since they’re not earmarked. The article you posted was not wrong, but a bit strange as I’ve heard of no other place where you would get directed to a nurse if you are seeking out a doctor. I don’t know what that situation was about so I can’t comment on a broader scale, but I suspect there is somethin more to it than the article explains. ER waiting times can be rough yes, if you are coming in with eg an eye-infection… Read more »

El Nerdo
El Nerdo
1 year ago
Reply to  El Nerdo

@Jenni Right, per capita we pay about double. But I’ve been trying to point out that “cost” per se is not the problem. I mean, high cost can be seen as a positive in various ways: we pay our doctors and nurses more, we have better and more modern equipment, we produce greater innovation in pharmaceuticals, etc., and so top professionals, and patients seeking top healthcare, often come here, and in Europe they go to Switzerland. Now, if we had universal insurance and it was well regulated, these high costs could be covered. Switzerland has expensive high-quality healthcare but everyone… Read more »

El Nerdo
El Nerdo
1 year ago
Reply to  El Nerdo

@Jenni again

I forgot to mention military hospitals and the Veteran’s Administration! Which add to the complexity of the equation. But they are also government funded. Big lapse, sorry about that.

Siobhan
Siobhan
1 year ago

Hi there, I’ve recently started reading your blog. I’m just gonna jump in and say something which might be important: diet is a huge factor in HBP/heart attacks as you probably know, but specifically, animal products have been pretty strongly linked to heart attack in several studies. Lowering your meat intake – even if it’s just for a few dinners a week – will probably affect those numbers. I went full meat-and-dairy free a few years ago, as did my partner, and his blood pressure dropped quite a bit. Mine did a little, but I’m young so not a huge… Read more »

Josh @ Biglaw Investor
Josh @ Biglaw Investor
1 year ago

JD, sorry to hear about your recent need to interact with the US healthcare system. It’s such a mess for all of us consumers. I hope you update us on the ~$7K bill. We recently had a kid and have started consuming healthcare services, so I’ve been going through the same thing reading Explanation of Benefits (should be called Explanation of Non-Benefits). Finding a primary care physician sounds like a good idea! Those annual exams are probably free, so at least once a year you can check in with the doc and make sure things are on the right path!

Michael
Michael
1 year ago

I can relate with an unexpected trip to the ER…mine was for a kidney stone. I have had one before but never to the point that it caused vomiting. As a result, I was told I needed to go to the ER just in case it was too large to pass (It ended up being 4mm and I passed it on my own). I spent about 2.5 hours in the ER. I had an abdominal CT scan done, blood draw, urinalysis, after which the doctor prescribed 1 bag of fluids and two medications (pain and nausea). The hospital has submitted… Read more »

Angelica
Angelica
1 year ago

Yikes! I agree with everyone else, get to a specialist as quickly as you can. Lots of good advice here. I have a full coverage HMO with the majority of costs covered by my employer, so when I noticed some slight reddening of my knuckles I went in right away and was diagnosed with rheumatoid arthritis. I recognized it as my mom was diagnosed when she was 35. The pain wasn’t bad so I could have put it off but I’m glad we found it way early and I’m in remission. All this to say – stay on top of… Read more »

Tom
Tom
1 year ago

About negotiating: I’ve tried this several times (in Georgia) and have been told that the price is part of a contract agreed between the provider and the insurance company, and if the provider lowers the price as part of a negotiation, this would be insurance fraud and illegal. Has anyone else heard this?

Michael
Michael
1 year ago
Reply to  Tom

I had this happen at a non-profit hospital after the birth of both of my daughters. They would not negotiate and were perfectly happy with a $25/month payment plan.

ABAA
ABAA
1 year ago
Reply to  Tom

This is usually true – when people say to negotiate the price of a health care bill, that option generally applies to people without insurance who are paying cash. The hospital or doctor can negotiate in that situation (better to get something from a cash patient then nothing at all). However, if you have insurance and your hospital visit/doctor services are “run through” your insurance, then you’re getting the large discount that applies due to the insurance company and the health care provider having a contract — this can range from 20-50% depending on the service. Granted, these discounts are… Read more »

Michelle
Michelle
1 year ago

Alcohol really raises blood pressure and lack of exercise. They also both cause depression so maybe those two things might really help you if you reduce the alcohol and exercise, just simply having a good daily walk is great! Good luck.

Joe
Joe
1 year ago

You’ll have to eat better and exercise more. Don’t put it off.
Yes, also find a good family physician. You need to take care of your health now that you’re getting older.
I hope no more chest pain for a while. It sounds like some kind of warning. Best wishes.

Michael Clark
Michael Clark
1 year ago

Keep all mailings you get from insurance, the hospital, the doctor’s offices. Ideally, put the date you receive the bill in the mail. Most insurance only gives the hospital or doctor 6 months or a year to bill you, and if they wait too long, you can’t be forced to pay the bill. Also, ask for an itemized bill so you can make sure everything you’re being billed for matches up to the details in your EOB. Most hospitals and medical practices can’t (or won’t) give an additional discount beyond what the insurance company has negotiated the price to be,… Read more »

Adam
Adam
1 year ago

Oh man… Get. On. That. HSA. Train.

Seriously, it’s amazing. My wife’s employer kicks in a fair bit each year and lately we’ve been maxing it out instead of contributing to an IRA; right now we have over thirty grand in the thing, mostly in an index fund. If we stay in great health then at age 65 it becomes more-or-less a retirement fund and we can withdraw funds at no penalty (only paying taxes). In the meantime if some big medical expense comes up, we won’t get obliterated.

It’s a fantastic savings vehicle.

Lindsay
Lindsay
1 year ago
Reply to  Adam

Your brief comment here makes an HSA sound really appealing, Adam. But sources I’ve read elsewhere seem either confusing or not nearly as rosy about HSAs. I’m just curious if you could recommend a good source for more information on this. (Perhaps/hopefully J.D. will do some research on this and share also!)

Adam
Adam
1 year ago
Reply to  Lindsay

Sure! Here’s the source that convinced me:

https://www.madfientist.com/ultimate-retirement-account/

Tom Murin
Tom Murin
1 year ago
Reply to  Adam

I’ve been on the HSA train since 2012. My employers have contributed to it annually (it saves them on Social Security taxes and their portion of the health insurance premiums) and I’m putting in $5,600 this year. It reduces taxable income – so it’s like getting a 30 % discount or so on your medical expenses. My account is with Optum Bank (part of United Healthcare) and they issue a debit Mastercard that I use most of the time. You could pay any way you want to and then reimburse yourself (if you wanted credit card points, for example). You… Read more »

Adam
Adam
1 year ago
Reply to  Tom Murin

Yup, any expenses that we use the HSA for get paid via a rewards card, and we pay ourselves back. My wife has a cosmetic prosthetic that needs replacement every five or six years and that’s generally enough to cover signup bonus required spending for any card we want.

Kelly
Kelly
1 year ago

As far as I understand the “Insurance system”, you cannot be billed for an amount more than what your insurance company would be liable to pay. Therefore, if the insurance policy had a contract with the hospital that it will only cover $2,500 for a service/procedure, then your responsibility is $2,500 (not $8,500).
If you have to meet your deductible of $10,000, then the $2,500 gets applied to your deductible and you pay the $2,500.

Elise
Elise
1 year ago

As someone who works at a hospital, I know too well the frustrations patients experience with ER and in-patient bills. There seems to be a constant disconnect between the billing side of things and patient care, and providers are rarely kept informed of the intricacies of out of pocket costs for patients. Until we live in a society where transparency of costs is required, figuring out ways to avoid a potential devastating blow to our savings due to an unforeseen health incident is essential. You mention HSAs and I notice at least a few others chiming in. My employer offers… Read more »

Luke
Luke
1 year ago

I really do not understand that explanation of benefits. Are there people with the insurance company (or the doctor’s office) that will walk you through that? It looks like you were “charged” an amount for the urgent care visit (and all the other stuff), but the “amount allowed” is what hits your deductible? Plus, the amount “not covered” in total would seem to be logically what you would end up paying, but the sum of that column doesn’t appear anywhere… Not to mention – the urgent care visit itself is covered, but none of the tests or diagnostics/treatment are covered?… Read more »

Anne
Anne
1 year ago
Reply to  Luke

I write medical billing software – and that EOB doesn’t make sense. Maybe there is more on the parts of the paper not shown?

My guess is that the emergency room was out-of-network, but the plan covers ER visits regardless. The labs were somehow considered outpatient and out-of-network and thus show $0.00 allowed, but because they were ordered from the ER, they were swept in with the other charges. Not well presented on the EOB, if that’s the case.

stellamarina
stellamarina
1 year ago

Your experience just proves what everyone says about the costs of ER…..just put your nose in and the bill is already a few thousand dollars copayment even if you have insurance. You made the right choice to go to a clinic first which would have cost way less but then, even after you tested OK, they second guessed themselves and sent you to ER and big expenses. I imagine you could have had the tests done elsewhere at a cheaper rate on another day. Also I doubt that you will get a break on the mistake test…..after all the technician… Read more »

beth
beth
1 year ago

Please get a primary care physician and follow up with a cardiologist soon. Your money means nothing without your health. I am Canadian so I don’t understand any of the money part of your article. I was with a family member at my local hospital for an entire day of tests and exams a few weeks ago and the only cost was $10 to park. Do you have first aid and CPR training? You are back at work now so why don’t you bring a trainer in to your work place and get lots of staff trained. Have your wife… Read more »

Eliot
Eliot
1 year ago

Here’s some HSA info to add to your research:
https://www.madfientist.com/ultimate-retirement-account/

Eric
Eric
1 year ago

Try L-Lysine for that canker sore. I started getting them in my throat/back of mouth decades ago and finally a doctor recommended 1000mg of lysine when they first come on and each day until they’re gone. It cuts the duration in half, sometimes even making them go away over night. Cutting out alcohol also helped.

Susan
Susan
1 year ago

Hi JD: thanks for sharing this story with us. I will tell you the two greatest things I ever did for my physical and mental health were to stop drinking and start exercising. My anxiety was through the roof, and my weight had ballooned, and no matter how hard I tried, I couldn’t stop drinking on my own. You might not need to go as drastic as I did (treatment) but the decision to cut out booze and move my body tackled 98% of what ailed me. You can do this.

Brooklyn Money
Brooklyn Money
1 year ago

JD, get and stay well please! I’m really selfishly wishing you many more years of health because I read the new (old) GRS everyday!

El Nerdo
El Nerdo
1 year ago
Jen From Boston
Jen From Boston
1 year ago

There are two charges from radiology on that EOB. It’s possible one of them is for the oopsie CT scan. It’s also possible one of them is for the ultrasound and the smaller one is for the doctor to review the ultrasound… I would look into that. I have an HSA and I really like it. I don’t like the insurance company that comes with it, but that’s a separate issue. And not all HSA managers are equal, but another separate issue. I’m hoping to build up a healthy amount in the HSA so going into retirement my husband and… Read more »

TJ
TJ
1 year ago

First, glad you are okay. I’m with Nirav Patel, how can the total you are responsible for be more than the charge? I don’t get it. Medical costs are totally out of hand. Last year I went to the doctor for the flu, wanted the shot that is supposed to shorten how long someone suffers. $700 later I was home. Next time I will suffer through it. I updated my insurance this year. And I’m still afraid to go in for the “free annual physical” because of my experience last year. Doctor visit is covered with the free annual physical,… Read more »

Ben
Ben
1 year ago

Contact Patient Financial Services or some hospitals call it Patient Accounting and ask for a detailed bill which will list all the charge codes billed. You are going to see the CT is probably that larger $1,649 Radiology charge and you should push back. The $677 Outpatient could be the ER Physician portion of the bill but often you are going to get that on a separate bill. There is a good chance that Outpatient charge is from your visit to Radiology for the CT and you can dispute. The labs are ridiculous and those cost a few dollars each.… Read more »

Ben
Ben
1 year ago
Reply to  Ben

You should also ask for their payment plan policy when all is settled. They will usually offer 12-24 months interest free and you then ask for double that. 36-60 months plans are not uncommon.

Amelia
Amelia
1 year ago

I’m glad you didn’t have a heart attack! I have had success losing weight and keeping it off with https://www.naturallyslim.com/home. No – I don’t sell their program or make any money off recommending them in any way. I got it free through my health insurance but you can also pay for it out of pocket. I think Naturally Slim is the approach to weight loss like FI is the approach to wealth. No counting calories, no food restrictions, no crazy exercise. It’s just about learning tricks to eat intentionally and learning to eat just enough. I’m passionate about it in… Read more »

Angela
Angela
1 year ago

I would recommend avoiding a cardiologist. It seems you do not have a diagnosis of heart disease, and even if you did, a good PCP should be able to manage that. When you have a hammer, everything is a nail. Specialists are much more likely to run unnecessary tests or prescribe extra medications. Locations with a strong system of general practitioners have much better health outcomes at a much lower cost. Based off of this story, the only thing I would even consider ordering for you is a stress test (PCPs can order these). While I haven’t interviewed or examined… Read more »

Karl Steiner
Karl Steiner
1 year ago

Sorry to hear about your scare. Here a description of what it’s like to have an actual heart attack in your early 50s.

https://www.mindfullyinvesting.com/i-hope-you-have-a-heart-attack/

It’s not necessarily all bad.

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