My first example is a recent one.  I am being hounded by a collection agency for not paying a bill to Sentara Home Health for “supplies.” Last year I had to get IV antibiotics because I was allergic to the oral antibiotics I needed to take and because I have an immune deficiency which means I have to be treated with the high powered stuff that costs more.  Before I agreed to get the antibiotics at home, I called my insurance and my provider called my insurance to see if I was covered for this particular drug.

Aetna informed us both that I was covered for the drug.  Sentara asked me to sign a document saying I knew I was responsible for payment if the insurance didn’t pay.  I wouldn’t sign it.  I said I would only sign it if I put a disclaimer on the document.  I received the drugs for several weeks.  And then again several weeks later.  Same discussion.  Aetna said they’d pay.  Sentara asked me to sign the form.  I said same thing, “I am only signing this……”

Fast forward.  I get a bill from Sentara for $1,600.  It’s not for the drug.  It’s for supplies.  Supplies I didn’t need because they kept sending more than I needed.  Supplies I assumed were covered.  Sentara knew they weren’t covered but didn’t tell me.

You see, Sentara can’t make money on the antibiotics because Medicare has a negotiated price for the drugs. Sentara can make money on supplies.

When I called Aetna, who covers Part D of Medicare, says they can’t always tell you in advance exactly what will be covered.  I told them they had said the drug was covered.  They said, “yes, the drug is covered.”  But they didn’t say the supplies weren’t covered.

Are you still with me?  My lawyer told me I had to pay because on another unrelated document I had signed, it said I was responsible for out-of-pocket expenses.  This document had been signed three months prior to the antibiotics being given but because the home health agency “lost” the document I signed with the additional wording.

What to do different when signing a document

I don’t think there was anything I could have done differently except:

  1. Keep a record of who I talked to at Aetna the first time I called to find out I was covered
  2. Make copies of everything I signed for the home health agency
  3. Record what the nurse told me when she came to my house
  4. Not let the home health company drop off bags of supplies unless I needed everything in the bag and I had a list of everything in there and what it costs (I doubt I could get this)
  5. Refuse treatment