After an Arizona family with health coverage from Blue Cross Blue Shield of Texas faced over $7,000 in medical bills, they headed to an out-of-network physician in Mexico to receive affordable care for their son, according to Kaiser Health News.
The family consists of 48-year-old Jesús Fierro Sr., 51-year-old Claudia Fierro and 17-year-old Jesús Fierro Jr. The Fierros are covered under Blue Cross Blue Shield of Texas through Jesús Sr.'s employer. The plan has an out-of-pocket maximum of $8,500 annually, a $2,000 family deductible and 20 percent coinsurance.
In December 2020, Mr. Fierro Sr., needed 18 days of inpatient care for a COVID-19 infection. In June, Ms. Fierro needed less than 24 hours of emergency care after fainting at work.
The Fierros received care at Yuma Regional Medical Center in Arizona, which is in network for the family.
Mr. Fierro Sr. was charged $3,894.86 for a total bill of $107,905.80. Ms. Fierro was charged $3,252.74, including $202.36 for treatment from an out-of-network physician, for a bill that totaled $13,429.50.
Some experts refer to families such as the Fierros as "functionally uninsured." They have health insurance but lack the savings to pay their final bill, according to Kaiser Health News.
In 2020, most payers agreed to waive cost-sharing payments for COVID-19 treatment because they received federal relief funds. Blue Cross Blue Shield of Texas said it would waive cost-sharing payment through the end of 2020, according to the publication.
A BCBS spokesperson declined to comment to Kaiser Health News about why Mr. Fierro Sr.'s COVID-19 bill was not waived.
"We understand the frustration our members experience when they receive a bill containing COVID-19 charges that they do not understand, or feel may be inappropriate," the spokesperson told Kaiser Health News.
"We thought about taking a second loan on our house," Mr. Fierro Sr. told the publication.
He claimed the Yuma hospital discouraged applying for financial assistance, and it would only lower Ms. Fierro's bill by $100, but they still plan to apply.
"Applying for financial support starts with an application — a service we extended, and still extend, to these patients," a spokesperson for Yuma Regional Medical Center told Kaiser Health News.
Then, Mr. Fierro Jr. dislocated his shoulder and needed emergency care.
Mr. Fierro Sr. and his son drove south to Mexicali, Mexico, to visit Alfredo Acosta, MD.
Dr. Acosta sees 14 patients a day with no appointment, with 30 percent to 40 percent of those being from the U.S. He charges $8 for most visits.
Dr. Acosta treated Mr. Fierro Jr., charged him $5, and the family paid in cash.
The Fierros are among millions of Americans who go abroad annually to find affordable healthcare, the New York Times reported in January.
"We pay a $1,000 premium monthly for our employment-based insurance," Mr. Fierro Sr. told Kaiser Health News. "We should not have to live with this stress."
The Fierros are paying off their original bill in $140 monthly payments, and still owe more than $2,500.