Cost of Health Care

healthcarecost.gifHas anyone else been tracking their medical expenses from this injury?  Sure makes me happy that I was insured when the injury happened.  Granted, I probably would have opted for the non-surgical treatment if I didn’t have insurance, but the cost is still staggering.  I’m also glad that I was able to make a choice with regards to treatment based on what was best for my long term well being.


I don’t want this to turn into a health care debate, so I’ll hold back any commentary regarding health insurance.  I’m just curious about the expense involved with this relatively routine surgery.  I can’t even begin to imagine the cost involved with open heart surgery, cancer treatments, etc.

piggybank320.jpgI believe I’m closing in on $11,000.  This includes ER visit, pain meds, crutches, surgery, casts, boot, post op visits, etc.  The only thing not included is physical therapy.  I’m guess that with PT added in I’ll be  over $12,000.  I can think of a lot better ways to spend $12,000.  The good news is that I have a high deductible HSA through work, so I was 100% covered as soon as I hit the deductible limit.  That probably occurred sometime around when they stuck the IV in my arm before surgery!  The bad news is that my HSA is now drained.

Anyone else care to share what their medical expenses have been so far?

29 Responses to “Cost of Health Care”

  1. Tom - sounds like we are in similar markets…here are my expenses to date (~5.5 weeks post op)
    - $11,419.30 ($9500 was the surgery, hospital and surgeon and anestheologist)
    - $590 paid OOP to date, for deductable and co-pays - I am extremely lucky to have a fantastic health care coverage at work.

    I was a bit surprised when I got the hospital EOB ($8K), because we (insert *chuckle* from my wife, “what do you mean we”) birthed children at the same hospital, and the bill for each was $4100 for natural birth, no epidural, but still two nights stay for mom and baby. Just seemed like we got more “care” in those few days, but who knows?

  2. I don’t have the exact figures in front of me, but it’s probably about the same for me as well.

    Did you know that if you don’t have health insurance, the hospital charges individuals several times more than what they charge the health insurance companies? (sometimes like 300% - 500% more)

    The insurance companies get group rates and individuals get “regular” rates. :twisted:

    So if you don’t have insurance, not only are you paying for your own hospital bills, but you are also paying several times more than what the insurance companies typically pay. double screwed!

    To think that I considered going without insurance this year, as I’ve always been healthy except for the occasional colds!

    I’ll post the actual figures in a few weeks when I can get all my paperwork straightened out.

  3. The story that follows is by far the most embarrassing part of my injury. As some may know from reading my posts, I’m an ER nurse (sorry for the waiting room times;). I had just moved and was going to start work in about 10 days, and with plentiful jobs, I was still mulling my options. My previous heath coverage had expired about 1.5 weeks prior to my injury, and although I did think about it, I knew I would have insurance soon. And along the lines of what Dennis said, I think I have seen the doctor 2x in the last 6 years. So what’s a nurse doing without insurance? Good question. As soon as the tendon popped, that’s all I could think about, no insurance. I heard somebody say “call an ambulance” and I yelled “NO AMBULANCE”. Then somebody wanted to take me to the ER, which I refused also, knowing they would basically do noting but send me a bill. Heck, I had my ABC’s (airway, breathing, and circulation) so it couldn’t be that bad right? The one advantage I have is knowing how the system works, and how to work the system, a bit. I knew within seconds I needed surgery, and I knew I needed ortho, so I self refered after calling many doctors in the area. The advantage here is I could shop a bit and find a doctor I was confortable with, and not just get the on call. It was a very surreal experience shopping for someone to fix me as if I just need a new clutch and brakes at a good price. Insurance takes a long time to pay, and they don’t always pay what the doctors/hospitals charge. I negotiated a discount by offering to pay in advance and the orthopedist gave me a 50% discount for paying in advance, so the bill from the ortho was just under $1,500. I didn’t want to have the surgery in an outpatient surgery center, nor did my MD, so I then had to deal with the hospital OR charge. With some help from the MD’s billing staff, I got a fairly good deal. The OR estimate was about $14,000 (which is actually very close to the final bill). If I paid in advance, I was told the maximum out of pocket would be $4,000, that a smokin’ blue light special of about 70% off! The next an final attempt to break me would come from the anesthesiologist. Since there was no way to know who or what group it would be, I couldn’t negotiate prior to surgery. Once I got the bill though, I was able to get a 25% reduction by paying in full, bringing that to $1,100. A very painful, embarassing lesson to say the least, but I was glad I knew my way around a very confusing system. I would have paid 10x that to have my leg work normally again though. The short term insurance I had considered had a very high deductible of $5,000, so it wouldn’t have covered that much. It was a very scary experience. Everybody I have dealt with though has really been great, and wanted to help me as much as possible, and I’m thankful for that.

    What’s that na-na-na-na-na noise I hear? Look out! It’s the “Just Over Six-Thousand Dollar Man” limping in my direction.


    And yes, I have insurance now.

  4. Jim..
    way to work the system. I encounter patients without insurance all the time. Based on the fact that we don’t have to file claims, bill, rebill, resubmit, use a collection agency we have a time of service discount…saves everyone the headache of dealing with ‘the system”
    Doc Ross

  5. Dennis..
    I hear what you’re saying but my experience and reading what Jim wrote you can definitely negotiate with health care services. They don’t want to wait for payment or deal with cost associated with collecitons. So don’t be afraid to ask for them to decrease their bill.
    Doc Ross

  6. Jim and Doc - Thanks for sharing that. I didn’t realize that you can negotiate to lower the price of health care. That’s really good to know, and I hope more Americans without insurance know about that as well.

    Maybe a page on “No insurance? How to navigate the health care system and save $$” would be helpful for the uninsured and uninformed.. which is probably about half the country. :(

  7. This post was quite helpful when I began my journey back to two feet. I am also a “cash patient.” I specifically asked the doctor’s office and surgery center if they had tiered rates (insurers vs. us) and they vehemently claimed that had one price. For my own sanity, I believe them. The good news is that they give a 20% discount off those prices for cash (actually checks/credit cards).

    I had my procedure done at a surgery clinic (in by 11 and out by 3) and am in Week 4 of recovery. I’ve been keeping a log and here are the costs so far:

    Crutches $43.20
    Ortho office visit (with x-rays) 400
    The Boot 90
    Pre-op physical (state required) 300
    Operation (incl surgeon and anesthesiologist) 6800
    Parking (why they can’t include that, I don’t know) 8
    Meds 35
    Follow up office visit #1 300

    Physical therapy (12 sessions planned) 1200

    And the total is…geez…I don’t wanna know. I’ll wait for tax season next year.

    BUT…the good news aka the silver lining:

    -I was able to dictate my treatment without the confines of a crappy individual health plan (no worries of in-network/out-of-network)
    -I was able to skip seeing a GP to get the needed/dreaded referral to a specialist. This may have saved day(s).
    -All the business admins I spoke to were understanding and tried to shave off as much as possible
    -If I had a catastrophic health policy it most likely would have had a $5K deductible. Add that to the annual premiums and I’m not too far above that.
    -My surgeon uses a surgery clinic (out-patient) as opposed to a hospital. This was a much better way to go.
    -This procedure is one of the cheaper surgeries out there. Apparently, bunion surgery is more complicated and more expensive.

    The DOWNSIDE (besides spending the cash) is that, in California, I am ineligible for acceptance into an individual policy now because of this “pre-existing” condition. I have to be out of a doctor’s care/supervision before I can apply for one. California is one of the states that does not allow for exclusions in health policies (except for maternity as far as I know).

    Oh well…hopefully this helps someone.

  8. Thanks to everyone for your input! I had a complete rupture of my right achilles tendon on Sunday, June 29th, 2008, while playing frisbee with my two sons in law. I jumped to grab the frisbee with my left hand, heard a “pop” and felt like a hardball had hit my ankle. My son in law who is a cardiologist heard the pop and surmised that I had torn my tendon. I will have surgery on July 3rd. Fortunately I have health insurance. I will keep track of my expenses and comment later.

  9. hey i am hoping its only about $15,000.

    i was hit by a car and the hospital is doing it on a lien basis.

    meaning they are taking $ out of the settlement i get.

    i had the surgery and everything and when i asked the surgeon how much he said he hadnt looked at the bill but he was guessing anywhere from 20-30k.

    could this be possible? how can i find out if he is charging me unfairly?


    email me


  10. Approximate figures follow…I was uninsured right between jobs…ouch
    Ortho - $1,500 after 50% off for paying in advance.
    Anesthesia - $1,100 25% discount for paying bill in full.
    Hospital (OR outpatient) - $4,000 negotiated down from $13-$15K for paying cash in full.
    Physical therapy - $$1,500 33% discount for paying cash each session.
    Odd and ends: Crutches, Braces, Bandages, Multiple pairs of shoes worn out in less than a month, etc. - $1,000
    Approximate total - $9-$10K

    Looking forward to having a fully functional left leg - PRICELESS

    I’d have paid 10x that (glad I didn’t have to) to be healthy. You can be sure that Murphy won’t be riding shotgun any more as far as medical insurance is concerned.


  11. Here are my costs to date - but I have California company plan and live in Oregon and that has made some complications in the system as well as some advantages - I have a great plan, but in Oregon they don’t have all the rules (see post of daveleft) …(keep in mind I’ve already paid my plans deductible this year)

    1. Stanford, Cali Hostpital Visit - 50$
    2. AShland OR ER Visit - 50$
    3. MRI - 120$ - 10% of the cost of the MRI
    4. 40$ in Copays - misc doc
    5. PT - 300$ cost to pay and drain first out of my pocket before they will start billing insurance. THen 20$ an appt after that.
    6. approx 200$ in misc I don’t know what bills that come in teh form of 13$ here, and 7$ there.
    7. Wheel chair - 60$
    8. pain meds and advil etc - 25$
    My surgery was about 14K according to the insurance. I haven’t paid yet for that (crossing fingers)

    So medical is about 785$ as of today. The tax discussion in April will be interesting what tricks you folks out there do…..Anybody a “taxman” out there?

    Other volunteer items

    1. viti’s and other misc vitamins and scar rubs - 50$
    2. Achillestrain brace - 110$
    3. Boy soccer socks, compression socks, mini brace - 100$
    4. Hired a housecleaner and daily helper for first six weeks - approx 1200$ (can I write her off???)
    5. Having food delivered (live alone - hard to cook) - have no idea - but WAY too much.

    I have saved in gas, and travel and Entertainment, in fact, I saved about 6K from not going on a Europe trip for three weeks…..not sure thats a good thing…but there it is.

    I really feel for the folks with no insurance and wish I could help in anyway. I hope to donate a lot of my items to Dennis’ site for future folks, and just wish I could offer some sort of relief.

    chat soon. Go bears.

  12. I’m Canadian and I’m floored by these numbers.

    I blew my achilles out two Fridays ago, stayed in Emerg overnight because they made a bed up for me, saw the ortho specialist the next day and he said he was free to do surgery that day. I had a spinal, surgery took about an hour and I was home by 3pm.
    They gave me crutches on the way out the door and a bill for them for $30. Apparently 80% will be covered by my work’s health insurance.
    Stopped to pick up a prescription of Dilaudid on the way home - $3.56 after my company insurance.
    2 weeks post-op I got my wraps off and an air-cast instead. $140 charge, pending insurance coverage which I guess will be 80% again.

    I’m cheating though because my mom is a physiotherapist, but that cost would most likely be covered by our universal health care or my insurance.

    Anyway, just thought I would share a different experience.

  13. I too, did not have health insurance when my achilles snapped playing softball. My softball league is insured but my doctor does not accept third party insurance. When I was told I needed surgery I immediately explained to the staff about my unfortunate, and stupid situation concerning the lack of insurance. The office manager said that the surgery would cost anywhere from $7000 to $10,000. My husband called the following day to discuss payment plans and the cost was reduced to payment of $5000 up front, anestesia included. I’ll submit the bills to the insurance company and see what happens.

    I’ve learned 2 lessons–I will never go without insurance again and, sometimes it pays to ask questions. Surgery on Tuesday, July 21st. Wish me luck and good luck to all!

  14. Wow, Thought I would give an Australian Perspective.

    Many of those numbers above, like Vcela said…floored me.

    I went via our private systems as I have top the hospital cover plan. (appx $ 2500 AUD per year for a Family)

    Private Hopital for initial diagnosis…(I already knew the problem because my brother in law did it 4 months ago) $ 300

    Ultrasound before I was allowed to get a referral $ 70 Full rebate from Govt Health.

    Follow Hospital Visit for referral…wow there is some red tape in getting to see a surgeon…$ 55

    Surgeon 5 min visit to confirm and book surgery $ 170 (50 rebate from health fund)

    Hospital for Day Surgery inc Assistant Surgeon, Anesthetist, etc…about $1500 our of pocket after Health Fund rebate about $200

    I’ve just got back from my 2 week follow up to get out of the cast and into a boot and the Surgeon saw me for 1 min to check healing…no cost…Physio to fit boot $ 70 ($35 back from health fund) and the boot ($ 200)

    I don’t see another medial person now for 6 weeks (I can adjust my own boot angle every 2 weeks or the physio will do it free if I drop by). and I’m out of pocket under $ 500 AUD (appx 180 Pounds or $ 400 US)

    and that is the via the private system..If I went public it would be mostly free, but god knows how long to wait before an operation…weeks, months…didn’t even want to find that out…

    But even without insurance…$ 2500 AUD would probably cover most of it so far.

  15. Hey, i’m an Aussie too and i went through the public system. I ruptured on 13/6/09 and was operated on the next day. I was put in a cast and 2 weeks later was put into a walking boot. The only down side is that I have to go to the clinic to see the surgeon and that can be a wait of about 1 - 2 hours. I also complained about a sore calf when i was there for the first visit but they weren’t worried and were very busy (saw local GP and was diagnosed with a large DVT) but other than that have been very happy with the public system. Seeing surgeon tomorrow and am hoping to be walking out of there in 2 shoes!! Still haven’t had physio yet so hoping he gives the green light for that as i am dying to drive!! Good luck with your recovery. Tina

  16. Another Aussie here commenting on costs.
    I originally planned to go public but ended up going private to get choice of surgeon.


    ER visit - public, seen in 1 hour, discharged with back slab cast: Free

    Hire of crutches: A$30

    Orthopaedic clinic visit - public, seen after about 20 minutes, review by student, registrar and consultant, ultrasound confirmation of complete rupture and marking for incision, new front splint plaster: Free

    Private orthopaedic surgeon pre-op consult: $66 fully refunded by Federal govt “Medicare” (normally would pay about $80 out of pocket but wife is also a doc and docs look after each other!)

    Surgery, anaesthesia, boot (fitted in hospital), day bed in nice private hospital: $0, it was fully covered by my insurance (for which I pay A$600 p/a for a fit 36yo male, hospital and ambulance cover only). Public hospital cost would have been same, i.e. nil.

    Discharge meds: antibiotics, endone, panadeine forte: A$45

    2 x follow-up surgical consults: included in surgery fee, no out of pocket.

    Physiotherapy: not covered under my insurance and I don’t think I’ll have more than 2 sessions - A$240 (A$120 per session)

    That would have been all the costs, except today I have a bit of a skin infection around the wound, and the surgeon couldn’t fit me in for an appointment (which would have been free to as he doesn’t charge post op care above government rebate) so:
    GP consult: A$66 (half refunded by federal govt)
    Antibiotics: A$15

    Grand total: A$363, or less than US$300, two thirds of which is for PT.
    If I had gone through the public system, the total cost would have been $30 (hire of crutches), and physiotherapy and rehab aids would have been provided through the hospital outpatient department at no cost.

    As far as cost without insurance to go private, I believe it would have been about A$1500 out of pocket after what the government pays through Medicare. Total cost without insurance or government rebate would have been under A$5000/US$4000 by my guess.

    Maybe some of you Americans should consider a holiday over here to get your surgery done, even after airfares and hotels you would still be saving money if you don’t have insurance ;-)

  17. As a comparison, here in the UK with private treatment paid for by my husband’s corporate insurance, so far it’s cost:

    Initial consultation = £150.00
    MRI scan = £618.00
    2 night hospital stay + op theatre = £2446.80
    Consultant’s pre-op + surgery fee = £908.00
    Anaesthetist’s fee = £165.00
    Post-op check-up + cast = £301.00
    Check-up + cast-change = £206.00

    That’s £4794.80 so far (GULP!) and have another cast change today plus (if all goes to plan) cast-removal/check-up on Sept 8th followed by as yet undecided number of PT sessions.

    Husband says I’m worth it! But then he’s glad to be getting some money back for the tax his corporate insurance costs him each year.

    I’ve also bought a couple of pieces of equipment, which I may be able to resell or donate to charity:
    Used wheelchair = £96.98
    Crutch carrier bag for wheelchair = £17.99
    Fingerless gloves for wheelchait = £6.98
    Shower chair = £27.49
    Half-leg cast cover = £17.00
    Folding walking stick (in readiness!) = £7.90
    Replacement crutch ferrules = £6.18
    That all totals £180.53.
    Crutches are borrowed from NHS A&E (who misdiagnosed me, hence going private).


  18. Thought I would throw in a Canadian experience. I am now three weeks past surgery. Costs to date are rental for crutches which were $45.00 for two week. Thought that was expensive so we bought new ones for $32.00. We have also rented a wheelchair for $47.00 a month. We will recover 80% of these expenses from our supplementary coverage. I have had two consultations with my doctor, ultrasound, and two consults with the orthopedic surgeon prior to surgery. Post-op consult with surgeon; fists-full of painkillers, removal of original cast and staples, application of new cast, which is very cool purple. I will have another cast replacement two says from now. And I expect at least another two casts in my future. So, all in I am about #24.00 out of pocket to date. Physiotherapy is not fully covered in Canada and although I will recover approximately half the real costs this will be the most expensive element in the process.

  19. I’ve had TWO ATRs, at 8-year intervals, both in Canada. The first one was repaired surgically, and I paid ~$15 for the crutches, ~$200 for a hinged boot, and a few bucks here and there for a cane tip, a waterproof cast protector, a cast shoe, and various other trinkets. I think The System picked up most of the cost of my numerous Physio sessions.

    The second time (last December) I skipped the surgery in favor of a new-fangled non-op cure (details on my blog) and re-used the crutches and cane from the previous time. I paid $150 for an AirCast boot (then re-used my old hinged boot starting at 7 weeks), and a whopping $1200 for 3 injections of Platelet-Rich Plasma (aka PRP), which I don’t especially recommend. Some of those things are covered by my wife’s corporate-benefits health insurance. The System in Ontario unfortunately STOPPED covering PT between my two ATRs, so I paid $65 a visit myself, plus parking (until I started bicycling there).

    I think the case for skipping ATR surgery has recently become very strong (more details on my blog), but with Canadian health insurance, there’s no cost-saving for the patient.

  20. I am now 6 weeks post op in California with Aetna high deductible individual insurance. My cash expenses as follows (with insurance co’s negotiated rates:)

    MRI - $729
    Orthopedic surgeon pre, post visits (7 in total) and surgery + cast:$860 (!!!)
    anaesthesiologist : $890
    Hospital cost :$2040 (half day out patient surgery)
    Boot: $250
    So, with P/T still to come in, total thus far is about $4750.

    Note that the surgeon ‘retai’ rate was $1400 and the hospital ‘charges’ before negotiation were $29,000 !!

  21. Thank-you to all who have indicated your costs. I believe I ruptured my achille’s tendon yesterday. I’m afraid to find out as I don’t have insurance and in a few weeks, my contract job will be over. I will have to dip into my 401K from my previous job to pay for these services, but at least now I know I will probably be able to negotiate with the orthopedic surgeon and the hospital for the costs if I pay in advance.

  22. Wow! I had my ATR surgery 10/19/10 and my expenses are nothing like what’s listed above. I didn’t have the ER fee (I walked on it for 10 days after I ruptured it because I thought I had just torn a calf muscle) so just went to my regular sports medicine doctor when it started getting worse. Anyway, I had my $25 co-pay for the doctor who referred me directly in to the orthopaedic surgeon, which was another $25. They skipped the MRI because it was obvious & I had just had an MRI on my shoulder a few months prior. Those are spendy so I asked if we could skip that step. With my insurance I pay 20% (I had already met my yearly $300 deductible). Unless there are more bills coming in, MY cost so far is just under $2,000. I don’t have all the details handy to break down the cost, but the most expensive by far was the hospital - for 1/2 a day & some fig newtons & apple juice after surgery! I have 6 weeks of PT coming up 2x/wk @ $25 so there’s another $300+. Oh, my knee cruiser (scooter) which I HIGHLY recommend, was $44 out of pocket. I forsee more bills coming but I believe all the big ones have already arrived. After reading the amounts above I feel better about my insurance!!

  23. hello, how can i tell if my insurance covers the surgery btw? i have Oxford HMO/Liberty Network.. just ruptured it about 3 hours ago..playing squash…

  24. dazhi - The only way to know for sure is to review your health insurance documents or to give your insurer a call. Your insurer should be able to tell you your coverage information over the phone.


    This post will probably make a lot of fellow rupters feel better, which is my hope. Full rupture Jan 26th, 2012. Even though I’ve never felt that “Bat to the ankle” feeling before, I kind of knew something was serious when I went down in a game of basketball. Just felt wrong and I did the typical “Look around for the person who stepped on my ankle” thing. I tried to walk it off but it felt like I had just put on those hideous Sketchers curved fitness sneakers. No pain really, just weirdly uncomfortable. I had the peg-leg, flat-foot walk.

    I was laid off in July of 2011 so I had no insurance. I was freaking. AND, to top it off, my wife and I were moving from Chicago to NJ in 3 days w/ enough stuff to fill a 16′ truck and 2 cats, one of which likes to sh!t in various places. I was in honest shock by what had just happened. I came home and we did the research, leading me to this blog. I was trying to crunch the numbers to see what type of set back this was going to create (financially and mentally.) It was just the worst possible timing for all this. That first night I cried for the first time in years. Like many of you I’m sure, I kept thinking about a life without active sports. A $10K+ bill, confinement for 10 weeks, depending on my wife for all the little things and so on. It was overwhelming.

    I’m glad I didn’t head to the ER, which would’ve been costly for nothing more than the slightest peace of mind. I knew what I did. I wasn’t in pain. A therapist would’ve been more effective that first night :).

    I had no choice but to put off this injury until we arrived in NJ in 5 days. I helped where I could, but the heavy stuff we moved was left to my good friends. I still hobbled fairly effectively, but no progress in the heel (Which was only wishful thinking.) Pretty much stayed the same until we arrived. I did buy a pair of crutches off Craigslist ($15) and an ankle brace at Walgreens ($32.) Did the trick. But doing this move while being on crutches for the first time in my life (37 years) was a humbling experience.

    We arrive in NJ, had help to unload and was now focused on this friggin heel. I decided that heading straight to the Ortho was my best bet as an uninsured citizen. Called around, read reviews and set something up w/ a $250 initial visit doctor in Linden, NJ (Follow up visits are $75.) I was also looking for docs that were known to be conservative in their approach (within reason of course - I still want to do this the proper way.) I was assigned to my man Walter Pedowitz, who has accolades that rival the best. Great guy, and his easy-going personality kept me at ease (I asked what to do if my leg itches, and he said to scratch my nose.) He’s a big proponent of the non-surgical route and said most of his colleagues are doing the same these days. Not much of a difference in the re-rupture rate plus no complications of surgery. That’s good and all, but to be honest, I was only concerned w/ the final tally if you know what I mean. He put me in a hard cast, NWB, crutches etc for 6 weeks. This will be followed by 4 weeks in a walking boot. 10 weeks, which is normal.

    OK, so to summarize at this point in this journey::::::

    I’M RELIEVED! Yes, 10 weeks is a long recovery time. I will probably never be the same on the court again. I’m already a little set back by the isolation this has created in my life. We are moving into an apt in the Lower East Side Manhattan at the end of Feb. I will still be on crutches and that doesn’t seem practical in a city like NY. Not at all actually. BUT, I may come out of this being better off WITHOUT insurance. If all goes as planned, I may be in for under $600 total (PT not included.)

    Cast and Initial Visit: $250
    A few follow up visits: $225
    Boot: >$100.
    Crutches: $15
    Shower cap: $12

    Sh!t happens, and I just experienced it first hand. It’s been two weeks and I’m trying to feel better about my situation. At least it’s the middle of winter and not summer. Thank the lord it wasn’t my driving foot. It’s all about the positives right? Thanks for letting me share my experience.

  26. I’m US citizen without health insurance living on the East coast in the Philadelphia metro area. My surgery did involve a tendon transfer. I also had referral or two along the way. So paying privately, out of what were retirement savings, here’s the damage so far. Numbers rounded off for the bigger bills:

    Pre-surgery consulation, diagnosis, etc
    Dr A. $150
    Dr B. $255, $95
    Dr. C. $265.
    MRI — $500 cash after shopping around (down from $1400 - $1700).

    So $1265 to get the party started. If I had just gone to the emergency ward immediately after the injury like one is supposed to, that total probably could have been cut in half or more.

    Surgeon’s fees, with two post-op visits included (week 2 done; week 6 upcoming): $4200. That’s paid in full in advance, with alleged discount.

    Hospital facilty fees: $6000. Was originally $4600, and a week before the operation they raised the fee. NOT happy about that, but I was not at a point where I could cancel or reschedule. Having already made various arrangements for after the surgery.

    Required EKG and cardiology exam for surgery clearance: $150.

    Aanesthesiology: still fighting about that. Was quoted one price in December which I paid in full. Got a bill a week ago with no mention of my previous payment. New bill: $2244. Not paying that one. They need to explain to me what the H is going on.

    Walking boot: $270.

    Total paid so far, including a few miscellanous items like band-aids: $13,000.

    My goal is to keep under $15,000.

    I’m obviously not happy about the cost, and still working on the hospital to refund me the difference between what they charged me and what they originally quoted me.

    But at the same time, and not that I’m doing it right now sadly, money can always be made back. If I’m not able walk properly at all, if I’m not able to maintain my health and at some point get back to activities I enjoy, then those once-upon-a-time retirement savings are not going to do me much good.

    Btw, if any of you find just wrong that the hospital would give me one price in mid-December, and then in January eight days before surgery demand $1457 more, let me know. Maybe I’ll get an online letter going that people can sign; or Twitter campaign; or whatever.

    Bottom line: I’d say $15K.

    In reply somewhat to the previous comment by Bells:

    If you are UNINSURED, and get the conservative option (non-surgical) option started right away, you’ll avoid a nightmare not just of bills but of bureaucracy.

    But if you are UNINSURED and do require surgery, the current American healthcare system actually makes it more challenging for you.

    That said, whether your status is — insured, unisured, Ozzie, American, Canadian, et cetera — my best to you and my hopes that you have a full and complete recovery.

    Four weeks from surgery now, and moving forward!

  27. Hello my friends in suffering…

    I am sincerely moved by everything I read here and felt the urge to add a thing or two that maybe would benefit somebody in a time of need.
    I am in the US since 1995, I was 28, and never had medical insurance for maybe couple years at the time, due to continuos job changes or life unexpected turns. I love to travel and taking longer vacations implies new job acquisition after every return.
    My first ATR happened playing basketball in Montreal, Canada. Of course not insured awaiting a response to a job interview. I was 38 and thank God it was my non driving foot. Panicked and alone I could not dare to drive back to US, I was living in Vermont back then. In 2003 the internet was not that rich in stories or opinions for that matter so my limited research put me in a local facility (urgent care) where I paid $140 Canadians and ended up with a nice blue waterproof cast in a down ward position. It was fast, can’t remember details but, that I was told to be back in 6 weeks for the second cast in straight angle position. The surgery was not even mentioned, there was no MRI or X-ray ’s just the Thompson test. Medical personnel was precise, flawless in their routine being in and out of there in less than 1.5 hours. Weird to say but a pleasant experience.
    I never made it back there for the second cast, being done in the US, in South Burlington, Vermont. Cash cost for the second $480 everything included from parking and crutches to X-ray and meds, by the way totally unnecessary at that point, but paid as required by the system. Total time in both casts close to 8 weeks as the second was self removed with an electric cutter. Rehab was short and back to normal in no time. Total cost $620.
    I am a self reliant person and in this day and age with so much information around I feel that everything is within reach when it comes to anything one needs to know.
    Anyways, back to the present time - first week in July 2014 playing soccer this time, with some friends.
    It popped like breaking a bunch of green onions in half and all my memories from 11 years ago went back in a flash. No need to tell you that I knew immediately what happened playing doctor to a ton of people gathered around to see what…caught uninsured again between jobs.
    Again, please don’t think that am irresponsible or immature when it comes to value of being insured however not at any price. I learned to maneuver through the loops during the years and here are the new costs.
    Any major city in the US has an hospital based as university medical center for teaching, research or scientific purpose. They always are ready to negotiate very low cash prices just to have you as a patient or practice on you. Don’t think guinea pig or lab rat experience, however do your research in as much you give or take in the deal based on any situation you in. Although I knew my steps I gave in to my wife begging to use a different route this time.
    I went to an urgent care clinic saw the doctor and got the referral to orthopedic doctor for the cast application, $160. Direct orthopedic visit not allowed without a referral. Only in America.
    Researched the cash MRI option, found it for $280 however I decided not to due on urgent care doctor that gave a firm ATR diagnostic. The orthopedist visit and cast application cost $168 negotiated from $350. They did not have waterproof fiberglass cast available so I ordered from Amazon $32. I will be back on August 1 for the second cast application and this time I will let them use whatever plaster they want as my wife is not happy with me dripping for hours after shower. The waterproof padding that goes under the fiberglass is very low quality, I should have bought that too.
    My dear friends, I am not frugal nor irresponsible and I care a lot about my health, however the one streets smart capacity can’t be ignored. I traveled a lot and saw lots of medical systems at work during the years, on me and others. I am neither judging the system here that does nothing but collecting if people pay. My point is: do your research if money is not an option, all answers are at an arm length or a click away no matter the subject and the information is the only thing worth paying. I will come back as progress and cost will be noted. Over and out for now.

  28. If I had a 3rd ATR now (not bloody likely “unless I grow a third wheel”) and had to pay scarce cash for medical care, knowing what I know, I think I’d be tempted to treat it myself, following a combo of the three non-op protocols at I cannot counsel anybody else to go this route, nor am I a medical professional. (And I’m well covered by Ontario’s excellent health-care system, too, so my last — second — ATR cost me the price of a boot and part of the cost of my PT appointments — maybe Cdn$600-700.)

    IIRC, a few of the athletic types on YouTube who’ve gone non-op have basically treated themselves, too. Barring quite rare complications, the info does seem to be out there, though self-care is still a pretty radical choice for most — and especially for “first timers”.

  29. I don’t want to start a political/medical insurance debate, but I was staggered by all the out of pocket costs listed here.

    Even though some of the posters had some insurance, the high deductibles and other cash (out of pocket costs) shocked me.

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