A woman who nearly died of cardiac arrest last year is now facing bankruptcy because she was taken to the "wrong" hospital while unconscious. Although she has insurance, the medical center that saved her life is out-of-network.
For Megan Rothbauer, the difference between a $1,500 bill and a $50,000 one was roughly three blocks. The 29-year-old was treated at St. Mary's Hospital in Madison, Wis. Meriter Hospital, which was in her insurance network, is just down the street.
"I was in a coma. I couldn't very well wake up and say, 'Hey, take me to the next hospital.' It was the closet hospital to where I had my event, so naturally the ambulance took me there," she told News 3.
Her hospital bill, after being in a medically-induced coma for 10 days, was $254,000. Thanks to the Affordable Care Act, Blue Cross Blue Shield had to pay its in-network rate, which covered more than half of that. She also negotiated with the hospital to cut the remainder by 90 percent.
That's huge, but it's still several times the $1,500 maximum she would have paid at the "right" hospital. And it doesn't include the bills from doctors, therapists and the ambulance, which bring her total out-of-pocket expenses up over 50 grand.
Rothbauer and her fiancé have postponed their wedding and are seriously considering filing for bankruptcy.
Her insurance company says there's nothing else it can do, as it has no contract with the hospital that treated her. And the hospital says that instead of focusing on her medical bills, she should just be grateful to be alive.
"When you're looking at saving a life, you're not looking at whether or not you can save them money," a rep for SSM, the healthcare system that includes St. Mary's, told 3 News.
"I can only do so much. The hospital can only do so much. And I think the best outcome is the person walked away from the emergency room."
Any problem less serious than death isn't really a problem. Cool, helpful philosophy for a healthcare business to have.