DAYTON — The feeling of being ripped off is not what you want to have after a trip to your medical provider, but after discovering an arm brace, he was given was marked up more than 1000%, that is exactly how one man said he feels.
Consumer Advisor Clark Howard said in many cases you can avoid paying the higher prices.
Medical markups are so hard to figure out, but you need to because what you don’t know will eat up your wallet.
William Bauman, a patient, said “I kind of tweaked my wrist and that was the cause of it all.”
After a trip to his doctor, Bauman was prescribed to wear a brace. He said, “I specifically asked the medical assistant if this was covered by Medicare as DME, Durable Medical Equipment and she said I wouldn’t have let you have it if it wasn’t.”
Weeks later Bauman got a bill. The actual cost of the brace was $525, and Medicare covered $260. “I was on the hook for $240 for a wrist brace that I could have bought on Amazon for $35,” Bauman said.
Clark Howard said he checked too. That same brace was just over $36. That’s a markup of more than 1000%.
Natasha Taylor with Georgia Watch said, “You’re almost putting the consumer in a situation where they can’t shop around because they need the equipment right at the moment.”
Taylor is the Deputy Director of the Consumer Advocacy non-profit George Watch. “But the issue really is that the market can charge providers, any rate because there’s no kind of baseline fee for durable medical equipment,” Taylor said.
She said it’s up to the provider to be transparent about the cost upfront. “This really does seem like a surprise billing issue,” Taylor said.
The federal government passed the No Surprises Act which protects consumers from surprise bills from out-of-network providers aftercare at an in-network facility.
“And the thing is, is that you can’t see the doctor unless you sign all your rights away. Nobody reads it. I mean, it’s like five pages of small print,” Taylor said.
Breg, the company that made Bauman’s braces addressed the price difference on their website saying in part, “When buying a product online there is no professional fitting or instruction for the brace. There are no insurance billing services available and nothing goes towards satisfying deductibles or co-insurance.”
Bauman worries that people will avoid their doctor because of the costs. “It’s the implications of this,” he said. “The cost to society and making poor health care choices because we’re doing so, with a feeling of distrust and mistrust.”
If there is something you need a prescription for, a medical device, or a test – do not just pay whatever you are told right then and there. Take the time to shop around and you will be surprised at how much you will save.