When Mark Gottlieb was hit by another car while driving in January 2019, he damaged four vertebrae and smashed several teeth.
“A car basically came out of nowhere. I thought I was going to die,” he told CBS This Morning.
His Geico auto insurance plan included $ 250,000 in medical coverage. After physiotherapy and other treatments that Geico covered, Gottlieb had to undergo spinal surgery. He didn’t complete the operation with his Aetna health insurance plan because he thought he would be covered by the money on his Geico plan. However, the hospital and surgeon’s bills totaled over $ 700,000.
“It wasn’t a pain compared to when the bills came in,” he said.
Geico negotiated both bills heavily, paying more than $ 150,000 for Gottleib’s charges before his plan was exhausted, leaving him hooked for about $ 90,000 for the surgeon’s bill.
“I thought a quarter of a million dollars was a lot of insurance. I just didn’t make any sense of how that could happen,” said Gottlieb.
He handed Aetna the balance of the surgeon’s bill. Aetna told CBS News that they had offered to pay the standard nursing care rate as per Gottlieb’s policy. But because the surgeon and his office were not on the network, he would still owe over $ 4,000 to cover his deductible. So he withdrew his request for Aetna’s coverage.
After this experience, he fears that he will seek additional treatment to relieve his existing back pain, even from an in-house doctor.
“I’m doing absolutely nothing. I’m going to put in extra strength, Tylenol. You know the last thing I want to see is go to the doctor about this and get a huge bill in the end. I’m very scared of that what happened, “he said.
Dr. Elisabeth Rosenthal, editor-in-chief of Kaiser Health News, told Anthony Mason, co-host of CBS This Morning, that health and auto insurance don’t work well together afterward.
“Well, the first thing you need to know if you are in an accident and have personal injury insurance through an auto insurer that comes in first and pays the first part of the insuranceBut they really work differently. First, they have smaller networks. In some states, including New Jersey, they have set rates they pay for procedures. However, if the surgeon and hospital add some things that are not on the tariff list, they can calculate what they want. The sky is the limit, “said Rosenthal.
Rosenthal recommends that patients receive price estimates from their medical facilities unless this is an emergency procedure.
“You should try, or at least get in writing and not get it, you know, a lot of people are going to say to me, ‘Well, you know, I called the accounting office and they said don’t worry.’ So you have to get it in writing from the tax office, and then at least you have a bit of a struggle: “Look, I have an estimate in hand. So, honor it, “said Rosenthal.
Hudson Regional Hospital said in a statement that it “charged the state-mandated fee for all applicable services to Mr. Gottlieb and the remainder of his care the fees were reasonable.”
The surgeon and his office, Bergen Pain Management, didn’t pursue Gottlieb because of the nearly $ 90,000 outstanding bill.