Cost Awareness Anecdote: Unlucky Student

The following anecdote is from Kimberly Seelye, a patient and a graduate student at the University of Michigan



Last
 July,
 I
 found
 myself
 needing
 to
 visit
 a
 doctor
 for
 an
 urgent
 medical
 issue.
 My
 period
 had
 started
 in
 April
 and
 never
 stopped.
 It
 was
 light,
 so
 it
 wasn’t
 too
 much
 of
 an
 annoyance, 
but 
after 
three 
months 
I 
figured
 I
 needed 
professional 
help.




I
 had
 started
 graduate
 school
 in
 Michigan
 the
 year
 before
 and
 was
 back
 home
 in
 California
 for
 the
 summer.
 I
 wasn’t
 sure
 if
 the
 new
 insurance
 that
 I
 paid
 over
 $2,000
 per
 year
 for
 through
 the
 school
 would
 cover
 a
 doctor’s
 visit
 in
 a
 different
 state.
 I
 called
 the
 insurance
 company
 to
 check
 and
 they
 said
 they
 cover
 any
 doctor
 in
 the
 country.
 Happy
 to
 hear
 this, 
I 
called 
and 
made 
an 
appointment 
with 
the
 doctor 
I 
had
 been
 seeing 
for 
years.



Though
 my
 insurance
 had
 changed,
 my
 doctor’s
 appointment
 was
 the
 same
 as
 always,
 I
 just
 had
 a
 slightly
 higher
 co‐pay.
 I
 had
 a
 routine
 check‐up
 and
 the
 doctor
 ordered
 some 
blood
 tests 
to 
help 
diagnose 
my 
problem.
Within
 a
 few 
weeks,
the 
doctors 
figured 
out
 what
 was
 wrong
 and
 cured
 it.
 I
 returned
 to
 school
 in
 September
 happy
 and
 healthy.
 As
 far
 as 
I 
knew, 
my
 business 
with 
the 
doctor 
was 
finished.



While
 in
 California
 for
 the
 summer
 I
 didn’t
 have
 a
 permanent
 address.
 I
 stayed
 with
 friends
 for
 a
 few
 weeks
 at
 a
 time
 and
 house‐sat
 for
 other
 friends
 while
 they
 were
 on
 vacation.
 This
 arrangement
 allowed
 me
 to
 live
 cheaply
 for
 the
 summer
 and
 save
 money
 for school. 
However, 
when
 the
 doctor’s 
office 
asked 
for 
a 
local 
address, 
I 
didn’t 
have 
one. 
I 
gave
 them
 the
 address
 of
 a
 good
 friend
 I
 was
 staying
 with,
 figuring
 my
 friend
 would
 tell
 me
 if
 mail
 arrived
 for
 me
 at
 her
 house.
 Although
 I
 wasn’t
 expecting
 to
 receive
 any
 mail,
 I
 tried
 to
 have
 my
 mail
 forwarded
 to
 my
 school
 address
 at
 the
 end
 of
 summer,
 just
 to
 be
 safe.
 The
 Postal
 Service
 said
 they
 were
 unable
 to
 forward
 my
 mail
 because
 my
 school
 address
 was
 considered
 a
 business
 address
 and
 they
 don’t
 forward
 from
 residential
 addresses
 to
 business 
addresses. 
This 
frustrated 
me, 
but 
as 
I 
said, 
I 
wasn’t 
expecting
 any
 mail 
anyway.




Around
 October
 I
 received
 a
 call
 from
 a
 representative
 of
 the
 doctor’s
 office
 saying
 I
 had
 an
 unpaid
 bill
 in
 the
 amount
 of
 around
 $100.
 I
 told
 her
 that
 I
 had
 moved
 back
 to
 Michigan
 and
 never
 received
 a
 bill.
 She
 said
 she
 understood.
 She
 allowed
 me
 to
 pay
 my
 bill
 over
 the
 phone
 with
 a
 credit
 card
 and
 updated
 my
 address
 in
 her
 files.
 A
 week
 later
 I
 received
 a
 voicemail
 about
 an
 unpaid
 bill
 from
 the
 same
 office
 and
 dismissed
 it;
 I
 had
 just
 paid 
my 
bill 
a 
week 
earlier.



In
 November
 the
 friend
 I
 had
 stayed
 with
 in
 California
 informed
 me
 that
 she
 had
 a
 stack
 of
 mail
 for
 me
 that
 she
 had
 forgotten
 about
 and
 would
 send
 it
 right
 away.
 When
 I
 got
 this
 mail,
 I
 saw
 that
 there
 were
 several
 copies
 of
 an
 unpaid
 bill
 from
 the
 doctor
 in
 the
 amount
 of
 $1,500,
 and
 they
 were
 threatening
 to
 send
 my
 account
 to
 a
 collection
 agency.
 I
 was
 shocked
 and
 horrified.
 I
 didn’t
 have
 $1,500,
 so
 I
 couldn’t
 pay
 it.
 I
 was
 also
 heading
 into
 finals
 season
 at
 school,
 so
 I
 didn’t
 have
 much
 time
 to
 sit
 around
 and
 think
 about
 what
 to
 do
 with
 this 
bill.




A
 few
 months
 later
 I
 got
 a
 letter
 from
 a
 collection
 agency
 saying
 that
 I
 now
 owed
 them
 $1,500.
 I
 realized
 I
 couldn’t
 ignore
 the
 bill
 any
 longer
 and
 called
 my
 doctor’s
 office.
 A
 representative
 at
 the
 office
 told
 me
 the
 bill
 was
 for
 blood
 tests
 and
 mailed
 me
 an
 itemized
 bill,
 which
 had
 never
 previously
 been
 sent
 to
 me
 at
 any
 address.
 She
 also
 said
 that
 my
 insurance
 should
 have
 paid
 for
 it
 and
 that
 I
 should
 ask
 them
 about
 it.
 I
 called
 the
 insurance
 company
 and 
they 
said
 that 
my 
plan 
“doesn’t 
include 
all 
diagnostic 
tests.” 
So 
that 
was 
that. 
I
 was 
stuck 
with 
this 
$1,500
 bill 
that 
I 
never 
saw
 coming 
and 
couldn’t
pay.




As
 a
 graduate
 student,
 100%
 of
 my
 income
 was
 student
 loans.
 Financial
 aid
 very
 specifically
 only
 covers
 school
 expenses
 and
 minimal
 living
 expenses,
 including
 my
 health
 insurance
 premiums.
 However,
 there
 isn’t
 an
 “unexpected,
 huge,
 medical
 bills”
 line
 in
 my
 financial
 aid
 award.
 No
 amount
 of
 frugal
 living
 would
 have
 allowed
 me
 to
 pay
 this
 bill.
 How
 else
 should
 I
 have
 handled
 this
 situation?
 Would
 I
 have
 been
 better
 off
 just
 bleeding
 indefinitely?