HEALTH INSURANCE CASUALTY OF THE DAY: Daniella Pigott – Birmingham, AL - 10/07/2008
RN Cares For Physician Husband But Cannot Believe Costs
“My husband is a physician – who, by the way, has never missed a day of work – and is also on dialysis for a failed kidney transplant. I'm a nurse, and have been doing his home hemodialysis for the past year,” said Daniella Pigott of Birmingham, Alabama. “Each month our insurance company sends us a copy of the billing statement. Remember, I am the one who does his treatments at home for three hours a day, five days a week. I also draw all of his labs, spin them in a centrifuge, and then take them to the lab. I also give my husband his medications IV.”

“Once you are placed on dialysis you get Medicare parts A and B so that means the dialysis companies can also bill Medicare for what our insurance company does not cover. So, you may be asking, what is the big deal? Well, our monthly bills are $49,000. We do not have to pay that out of our pockets each month, but someone (our insurance company and Medicare) is.”
Daniella and her husband went on vacation to the Bahamas recently and learned they’d have to pay “out of pocket” for their own expenses. “I was so worried that it was going to cost more than our whole vacation. Since we were on vacation my husband only did his treatments three times a week (Monday, Wednesday and Friday). Our entire bill for his treatments was $600. Yes, only $300 a treatment. That was not a co-pay, but the actual total cost for his treatment. The equipment in the Bahamas is exactly the same as the equipment in the centers here in the U.S. The nurses are registered nurses, and there was even a doctor on staff at all times – which is not so in every dialysis center in the U.S. So, if we lived in the Bahamas and my husband got dialysis in a center three times a week it would only cost $3,600 a month, less than a tenth of what our costs are at home? How is that possible?” Daniella questioned.
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Sponsored by the California Nurses Association/National Nurses Organizing Committee
Eighty-two percent of Americans think the U.S. healthcare system should be fundamentally changed or completely rebuilt (Commonwealth Fund, Aug. 7, 2008). America's nurses know that only single-payer, improved and expanded Medicare for all will fix our broken system and the tragedy of our devastated families. HR 676, by U.S. Rep John Conyers, is the most comprehensive, cost effective way to achieve guaranteed healthcare for all.
For more information, or to contact this patient: Liz Jacobs, RN 510/273-2232.
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Wife taking care of husband
It sounds like the insurance company should be paying Daniella!!
Wife taking care of husband
It is a true but sad state. Costs to insurance companies for a dialysis treatment in the US are extremely varied. Ranging from under $400 to over $2,000 per treatment. This will only improve if dialysis patients question their provider and doctor. While payment for providing dialysis to a medicare patient does not frequently cover cost and insurance has to help defray this cost; the margins that some dialysis providers get is in my opinion excessive. Home dialysis is delivered at a cost to the units, but not anything approaching $49,000 per month.
Insurance companies rarely care about the care-givers
One of the most horrible parts of our current system is the pain we put caregivers through as we send patients home sicker and sooner. It's not just the money -- it's also having to do complex medical tasks for which we feel unprepared; it's continuing to work full-time and then some for bosses crabby about time-off and needing your undivided attention to your job -- and then to worry silently about a sick loved one at home; it's juggling the laundry, the cooking, the medical care, the bills, the car repair and the interactions with family members and friends and doing so with a smile and good attitude. And then it's arguing with an insurance carrier that doesn't want to pay for a once a week visit from a home health nurse or some other small expense when they have saved thousands by having the patient go home earlier. Corrupt. Sad. Brutal. Unforgiving. Stressful. That's the reality that we hand one another if we don't fix this system.