In the aftermath of beating H1N1 virus, some children may never be elligable for Health Insurance agin becuase of the lifetime cap…that is unless you are on medicaide, then the tax payers paid for it.
But Carolyn Howard has no idea what saving her daughter’s life will cost.
“Are you expecting to see a big bill at the end?” asked CBS News correspondent Mark Strassmann.
“Hopefully not,” Howard said. “Praying and hoping that I don’t see one.”
Tony Estlinbaum’s finally home. He fought H1N1 for a month in the same ICU, at Children’s Hospital in Oklahoma City.
As a stress relief, his parents used to joke about the whopping expense.
“How much is this going to cost to be in the ICU for a month?” Hugh Estlinbaum asked.
“Hold your breath for three seconds, oh, there’s $500,” Lizzy Estlinbaum said.
More coverage of Tony and others at Children’s Hospital:
A Child H1N1 Patient’s Joyous Homecoming
Two H1N1 Kids Now Show “Miracle” Progress
Two H1N1 Patients, Two Different Outcomes
A machine called an ECMO is the big expense. It’s a lifeline for the heart and lungs and requires two nurses in the room, around-the-clock.
“Staffing, training, equipment – very quickly you’re going to be running into the hundreds of thousands of dollars,” said Cole Eslyn the CEO of OU Medical Center.
Lateasha Howard’s hospital charges? $1.2 million – and rising.
Tony’s bill? Almost $900,000.
And that’s just the hospital.
“That doesn’t include the doctors or nurses, or the CT or the plastic surgeons that came into the room,” Hugh Estlinbaum said. “The list is long.”
Hospitals usually negotiate much lower settlements. But unlike many insurance plans, the Estlinbaums have a lifetime cap on expenses: $1.5 million. Tony’s hospital stay and continuing rehabilitation could top that.
“I don’t know how we’re going to do these medical bills,” Hugh Estlinbaum said. “I have no idea.”
Every insurance plan’s lifetime cap varies. But in extreme H1N1 cases, with sky-high medical bills, a child who once had a severe flu might have trouble getting health insurance ever again.
“Their ability to purchase individual insurance in the open market is very limited, if not zero,” said Dr. Peter Kongstvedt, a health insurance expert.
Carolyn Howard relies on Medicaid — which will pay Lateasha’s bills.
“You’re better off having Medicaid than private insurance with that type of cap,” Kongstvedt said.
Congress is now considering three major bills to overhaul American health care. All three would eliminate lifetime caps.
“I can’t put a price tag on what he is worth,” Lizzy Estlinbaum said. “There is no price tag on what he is worth.”
So the Estlinbaums could soon face a new crisis. Not medical – financial.