Hoboken Healthcare: Leave Your Insurance Card at Home

For most of my twenties, healthcare was an afterthought. With the exception of one medical scare resulting from a severe allergic reaction to preservatives from sleeping on brand new sheets without washing them first, my husband and I spent less than a thousand dollars out of pocket (OOP) each year on healthcare.

Beginning with my first pregnancy at age 31, our family healthcare bills have been mounting steadily. Not a year goes by without a significant medical visit – when my son was 14 months old, he severely cut his foot on our balcony and had to be rushed to the local urgent care center with both kids in the double stroller, trailing blood along the sidewalk in our wake. We got off lightly with the expenses for his sutures – the total bill from PromptMD came to $279, much less than the $1,690 a friend paid for stitches at the local ER.

The routine bills have also become much heavier – pediatrician sick and well visits, dental cleanings, eye exams, glasses, and speech therapy add up to thousands of dollars each year. We typically spend about $6,000 per year on OOP healthcare expenses for five people.

In September 2011, my husband developed food poisoning after eating a bad sandwich. After a visit to PromptMD to diagnose his illness, we wound up late that night in the emergency room at Hoboken University Medical Center when his pain and bleeding grew much more severe. After months of confusion and billing issues, we received a final bill in mid-2012. Our total OOP cost? $293.40 out of a grand total of $2,816.

In November 2011, Hoboken University Medical Center was acquired by Hudson Holdco. The subject of a recent New York Times article titled, “New Jersey Hospital Has Highest Billing Rates in the Nation,” the company bills at extremely high rates and does not accept most health insurance plans. A visit to the Carepoint Hoboken University Medical Center website shows no mention anywhere of insurance – the patients section is oriented toward participating in clinical trials.

Carepoint recently launched its own health insurance plan and has been acquiring physician practices in Hoboken. Its aim is “a cross between an insurance plan management system and a medical provider built on three Hudson County hospitals: Bayonne Medical Center, Hoboken University Medical Center, and Christ Hospital.”

What are the ramifications for Carepoint patients who do not participate in their insurance plan? Balance billing. With the highest rates in the nation and virtually no private insurance accepted, walking through the Hoboken University Medical Center doors for even minor care virtually guarantees an out-of-pocket bill for thousands of dollars.

The other big player in the Hoboken healthcare scene? Hackensack University Medical Center – affiliated with Palisades Medical Center – has been on a buying binge of Hoboken medical practices. Hudson county residents are being squeezed between two healthcare behemoths, reflecting the national trend toward hospital and medical provider consolidation. The likely end result? Fewer services and spiraling costs.

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Kathy Zucker, CEO of Metro Moms Network, mother of three young children and winner of the New York Life Keep Good Going Shorty Award, writes about juggling career and family in an urban setting. Read her MomCondoLiving blog, follow her on Twitter (@KathyZucker), friend her on Facebook and watch her on Youtube.