Insured Woman Treated at 'Wrong' Hospital Billed $50K

In a coma, she couldn't tell paramedics to take her to hospital up the road instead
By Elizabeth Armstrong Moore,  Newser Staff
Posted Nov 13, 2014 2:40 AM CST
Updated Nov 13, 2014 7:58 AM CST
Woman Faces Bankruptcy For Care at 'Wrong' Hospital
Megan Rothbauer is stuck with hefty medical bills.   (WISC-TV screenshot)

After suffering a heart attack that nearly killed her at age 29 last year, Megan Rothbauer would love to be celebrating being alive, not to mention planning her wedding and future family. Unfortunately for her, she was in a coma when paramedics arrived and could not ask them to take her less than half a mile further up the road from St. Mary's Hospital in Madison, Wis., to her in-network Meriter Hospital, reports WISC-TV. Now the fully insured 30-year-old is facing more than $50,000 in medical bills instead of her $1,500 out-of-pocket maximum for the 16-day stay that both saved her life and brought on her biggest headache. She's even postponed her engagement as she contemplates bankruptcy.

"I was in a coma," the projects manager for a manufacturing company says. "I couldn't very well wake up and say, 'Hey, take me to the next hospital.'" Rothbauer doesn't fault the paramedics, who had no way of knowing which hospital would cost her less; CBS News reports that Wisconsin state law requires a person in need of emergency care be taken to the closest hospital. The Affordable Care Act required that her insurance provider, Blue Cross Blue Shield, pay its in-network rate, or $156,000 of the $254,000 hospital bill. After talking with Rothbauer, the hospital reduced its $98,000 bill, but she's still left with a $50,000 balance. (Separate bills cover the doctors, ambulance, and others involved in her care.) "It's just ridiculous," one health care advocate says. "The level of frustration is astronomical." (Meanwhile, the Supreme Court will hear another ObamaCare challenge.)

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