Sunday, December 5, 2010

Cost-awareness anecdote: $978 American Dollars (contest finalist)

The following story is from Jessa Hartford, a social worker and substitute teacher from Sacramento, CA

On 4/29/10 I received a Mirena IUD. I thought about this a lot; I read forums and articles on the device and its side-effects. I decided that because I already have a beautiful son who is 2 years old with my wonderful boyfriend of 7 years and we do not need any more children at this point in our lives, that it would be a good idea. You see, we both have been unemployed for a little over a year now. And while on Unemployment we made too much to receive Medi-Cal for any members of our family. So, while on Unemployment I was paying about $300/month out-of-pocket in premiums for medical insurance for my son and myself. (My boyfriend thinks his body can heal itself.) Anyway, after paying $75 for the visit and only being in the appointment for about 30 minutes, and another $75 for a mandated follow-up appointment, I received a bill on 8/18/10 for $978. (That is 978 American dollars, just to clarify.)

As I stated, while I got this device I was paying out-of-pocket for my insurance premiums because I could not be approved for Medi-Cal. A couple months after getting the IUD both of our Unemployment checks stopped coming. We had no income. Zero dollars a month coming into our home. So I instantly went down to the DHA and applied for pretty much anything I could. I started receiving Medi-Cal for all 3 of us. (This was all before I got the bill, or knew how much it was going to be.) When I went to Kaiser’s Customer Relations Department they informed me that Medi-Cal would take care of whatever cost the IUD would be, but now that I have gotten this bill and spoken to them again, they are saying that they were mistaken when they told me that because I was not receiving Medi-Cal during the time I got the IUD.

After receiving the bill I decided I would just return it for a full-refund. Apparently there is a no-refund policy for IUD’s, but they did not state this at any point during the appointment or have any postings on the walls. I even asked if I could possibly return the IUD for some sort of hospital-credit or gift card maybe for a surgery later in life, but they would just not work with me.

In all seriousness, I do not know how I am going to pay for this bill. My boyfriend and I are now getting Unemployment checks again, which you would think would be a good thing. But, this means that when we have to report how much money we got in the last quarter, in the next week or so, I am fairly certain that our Medi-Cal will be discontinued, since we will again be making too much. That means that I will be stuck once again, with out-of-pocket monthly medical insurance premiums, on top of this $978 bill.

I appreciate any help in this matter, even if it’s just information about how I can get help paying for this. I am trying to find work substitute teaching, and am really just trying to make it work for my family. We thought we were being responsible adults and citizens by looking at our place in life and deciding that adding another number to our household would not be good idea, but this is the cost (quite literally) of making that decision. You would think the government would want to help keep the Unemployed from pro-creating – I’m just saying.


  1. A couple questions about this. You say you were paying for an out of pocket insurance at the time you got the IUD? If so, does that insurance cover it, or did you check to find out if they cover it before having the IUD placed?

    I'm not sure where Medi-Cal fits in. You said a 'couple months after' getting the IUD you qualified for Medi-Cal - if you didn't have Medi-Cal when it was placed, why would you expect them to cover it? The entire process including the bill should already have been finalized by then.

    Before getting the IUD, did you find out how much it would be or if your insurance covered it? The $75 is the general cost for the appointment - it's not going to cover the cost of the IUD or the OB-Gyn's cost to install it. It's like saying I took a $50 cab ride to the store, the sales assistant recommended a 50in flat screen, and when it was delivered I got a $1000 bill with it.

    If you were paying for insurance at the time, you should talk to the insurance company and see what they cover. Even if its not covered, look at it this way - OCPs can cost $50/mo depending on your insurance, and IUDs are good for 5 years ($3000 worth of OCPs), both of which are much cheaper than the process of pregnancy and raising a child.

  2. This is so sad, and it happens so often. Your mistake was in not knowing the cost before agreeing to it.. Your doctor's mistake was in not telling you the cost. He/she knew how expensive these devices are. Your best hope for reimbursement is to ask your Gyn to talk to the Mirena representative for their office. These company representatives can usually make things right.

    Here's another sad but true fact. You could have bought an identical Mirena on-line from a Canadian pharmacy for $250 US. Mirena IUD's are available worldwide, and Bayer/USA charges the most. Their cost nearly doubled (to about $800) when the FDA approved the Mirena for treatment of heavy periods instead of just for contraception.