Shocked at Costs while on vacation.

[komomai]

Aloha, so I took a vacation back home to Hawaii, I'm a home hemodialysis user and I love it.  But since I would be visiting home from Thanksgiving to Christmas, I needed to go in clinic.  Well the clinic in Kaneohe Hawaii is run by DSI, I did 10 treatments at 3 times a week.  Well I've seen the bill from DSI and it's at $101,619.63, holy crap!  My insurance company covered mostly all of it but what is happening to the cost of health care in the US?  To compare I do a month of dialysis at home, 6-7 times a week, and my charges for all the supplies, dialysis machine and reverse osmosis machine comes out to about $4000 total, oh yeah also includes my once a month visit to do blood work and see my Doctor.  This is the cost of home hemodialysis in Okinawa, Japan.  Now I'm afraid to come back home when I retire, couldn't afford the health care. 

[Rerun]

I think when you are a visitor they really Jack you.  But, I don't care what they charge.... Medicare says they get $3,000 and that is what they get.  Period!

[Michael Murphy]

What's really amazing is that Medicare rates include a modest profit the rates insurance companies pay ( in my case it was about 5 times the Medicare rate ) they make a outrageous profit. The list price is about 15 times the Medicare rate and they make a obscene profit.

[Simon Dog]

The private insurance rate the FMC clinic I use was $445 per treatment.

When I went on Medicare, the rate dropped to about $245.

When I traveled and used FMC clinics out of town, the rate was a bit over $3000 per treatement.  I used a DaVoita clinic in Kent, WA and my insurance was billed, and paid, $5050 per treatment.

[iolaire]

To compare I do a month of dialysis at home, 6-7 times a week, and my charges for all the supplies, dialysis machine and reverse osmosis machine comes out to about $4000 total, oh yeah also includes my once a month visit to do blood work and see my Doctor.  This is the cost of home hemodialysis in Okinawa, Japan.

Do you happen to know how much a person visiting from the US would pay for in center HD in Japan?  A very rough (non exact) number would be great.  I've been trying to convince my wife to go to Kyoto for Thanksgiving (time of the fall leaves) and by that time I'll be on Medicare (only in the US) so I don't know what my other insurance will cover.

I agree something is wrong here in the US.  I travel a lot and dialysis is usually from US $250-$350, except for Canada in a Hospital where it was US $750.  Yet at my home clinic the bill is about $5,000/session, and my insurance pays a negotiated rate of $1,550 per session!  Yet in six months I'll get the same treatment paid for by Medicare for about $300/session or less.

[Michael Murphy]

Till January I was a private insurance patient at a fmc clinic 3 treatments was close to 5000 doallars which I know was less then the 15000 list price. It's sad when you realize Medicare rate are so much lower.  And if providers loose so much money why  do hospitals advirtise for Medicare patients

[kitkatz]

I see the average charges of 60,000 to 80,000 a month made for dialysis, not including meds and doctors visits at dialysis.
Crazy!   When Medicare figures out how much they have spent on me for dialysis they may come cut me off.

[Michael Murphy]

No they can't the law states we must be covered, the strange thing is I just went on Medicare not because I wanted to but because I was forced to after 33 months on dialysis, no choice for me Medicare must be primary. The only good thing is I could keep my private insurance as secondary and avoid Medicare drug coverage.  If the law hadn't forced me I would not go on Medicare.

[cattlekid]

I agree entirely.  I work for a Fortune 500 company that self-insures.  I had excellent insurance with no hoops to jump through, low OOP maximums and no lifetime maximum.  Me being forced onto Medicare was the most ridiculous waste of the taxpayer dollar ever.  I can't wait until April when I can tell Medicare to take a long walk off a short pier.

No they can't the law states we must be covered, the strange thing is I just went on Medicare not because I wanted to but because I was forced to after 33 months on dialysis, no choice for me Medicare must be primary. The only good thing is I could keep my private insurance as secondary and avoid Medicare drug coverage.  If the law hadn't forced me I would not go on Medicare.

[Simon Dog]

Medicare for dialysis was implemented because insurance companies were unwilling to underwrite the risk of paying for dialysis for potentially decades for a single patient, at the much higher non-medicare rate.

Despite the complaints about Medicare, I find I am able to see the same doctors, including some at big name Boston hospitals as prior to medicare, and my out of pocket is frequently less than it was with private insurance (which is now secondary).

Furthermore, since an out of town treatment is now $245, my "risk" if the claim is denied is about $50 per treatement, not 20% of the $5000 that some out of town clinics were charging when I was on private insurance.

[komomai]

To compare I do a month of dialysis at home, 6-7 times a week, and my charges for all the supplies, dialysis machine and reverse osmosis machine comes out to about $4000 total, oh yeah also includes my once a month visit to do blood work and see my Doctor.  This is the cost of home hemodialysis in Okinawa, Japan.

Do you happen to know how much a person visiting from the US would pay for in center HD in Japan?  A very rough (non exact) number would be great.  I've been trying to convince my wife to go to Kyoto for Thanksgiving (time of the fall leaves) and by that time I'll be on Medicare (only in the US) so I don't know what my other insurance will cover.

I agree something is wrong here in the US.  I travel a lot and dialysis is usually from US $250-$350, except for Canada in a Hospital where it was US $750.  Yet at my home clinic the bill is about $5,000/session, and my insurance pays a negotiated rate of $1,550 per session!  Yet in six months I'll get the same treatment paid for by Medicare for about $300/session or less.

Aloha iolaire,

Looking at my old bills, it comes out to about $300 per treatment.  Medicare won't work in Japan, so be prepared to pay the full price when you do your treatment.  Suggest you contact a major hospital in the area that you plan on visiting, to see if they have an hemodialysis center.  When I went up to the Chiba area to do surgery on my foot I stayed at this hospital.  http://jp-jmhc.com/en/hospital/20121010_628.html  It's called Chiba Nishi General Hospital.  They speak english and they do hemodialysis.  Good luck and it's great that you're able to still travel.

[iolaire]

Aloha iolaire,

Looking at my old bills, it comes out to about $300 per treatment.  Medicare won't work in Japan, so be prepared to pay the full price when you do your treatment.  Suggest you contact a major hospital in the area that you plan on visiting, to see if they have an hemodialysis center.  When I went up to the Chiba area to do surgery on my foot I stayed at this hospital.  http://jp-jmhc.com/en/hospital/20121010_628.html  It's called Chiba Nishi General Hospital.  They speak english and they do hemodialysis.  Good luck and it's great that you're able to still travel.

Great, thank you, I like those $300 prices as compared to the US prices.  This year has been quite for travel so far with two major holidays going by with no trip, but we did book a trip to visit my sister and her family in Belgium for memorial day, so last week I asked DaVita travel services to help setup my dialysis.