He and his wife both got cataract surgery. His bill was 20 times higher than hers

Last edited Tue Nov 22, 2022, 09:43 AM - Edit history (1)

Danilo Manimtim, who has a job evaluating disability claims for the state of California, knows the health care system and keeps tabs on his health benefits. He knew he already had met his health insurance deductible for the year, so he expected a manageable out-of-pocket expense for the surgery. He calculated his coinsurance would be about $750.

Then the bills came. ($4057)

Manimtim's big bill stems from a simple decision that turned out to be a pitfall in the nation's complicated health care system: He scheduled his surgery at a nearby hospital — a hospital that happened to charge about $7,000 more for the procedure than his insurer would pay.

Manimtim has proof that it could have been different right under his own roof: Four months later, his wife, Marilou Manimtim, 66, got the exact same procedure at an outpatient eye care surgical center in Fresno called EYE-Q. It is a half-mile from Saint Agnes Medical Center but is not affiliated with the hospital. (And she was billed $204)

https://www.wgbh.org/news/national-news/2022/06/27/he-and-his-wife-both-got-cataract-surgery-his-bill-was-20-times-higher-than-hers