Teacher billed $109,000 for heart attack despite having health insurance addresses Congress

A high school teacher who was billed $109,000 after suffering a heart attack spoke at the White House, calling on Congress to end surprise medical bills.

Drew Calver, 44, who teaches history in Austin, Texas, was invited by President Donald Trump to his announcement in the Roosevelt Room on Thursday.

Trump called for legislation that would end the practice in which a patient arrives at the hospital for an emergency, only to be treated by an out-of-network doctor who leaves them with a huge bill. 

He then asked Calver to speak about his experience.

The married father-of-two, who has insurance, discussed how he was taken to an out-of-network hospital and was charged double what he makes in a year following his 2017 heart attack. 

‘I feel like I was exploited at the most vulnerable point in my life, so I hope Congress hears this call to take action, close the loopholes and work towards that transparency,’ he said on Thursday, according to ABC News.  

Drew Calver, 44, a high school teacher who was billed $109,000 after suffering a heart attack, was a guest President Donald Trump at the White House and called on Congress to end surprise medical bills. Pictured: Trump delivers remarks as Calver and his wife (far right) listen

Calver, a father-of-two, suffered a heart attack in April 2017 and was taken to St David's Medical Center, which was out of his insurance network, but the closest to his home in Austin, Texas. Pictured: Calver, left, with his wife, Erin

Calver, a father-of-two, suffered a heart attack in April 2017 and was taken to St David’s Medical Center, which was out of his insurance network, but the closest to his home in Austin, Texas. Pictured: Calver, left, with his wife, Erin

‘For too long, surprise billings, which has been a tremendous problem in this country, has left some patients with thousands of dollars of unexpected and unjustified charges,’ Trump said during the meeting. 

‘Not a pleasant surprise, a very unpleasant surprise.’       

In April 2017, Calver was at home with his eldest daughter, then, after his wife, Erin, headed out to the store with their youngest daughter, then six, reported Kaiser Health News and NPR.

He was in his bedroom when he was overwhelmed by excruciating chest pains and crumpled to the floor.

Calver called out to his daughter for help, and a neighbor rushed him to St David’s Medical Center in Austin, which was the closest hospital to his house. 

In the cardiac unit, medical tests showed that the fit and seemingly healthy swim coach had a blockage in his left anterior descending artery (LAD), which required emergency surgery.

Commonly known as a ‘widow-maker heart attack’, it’s the same type that famed actor and director Kevin Smith suffered in February 2018.

It occurs when LAD, which carries blood to the heart, becomes almost or completely blocked. Without emergency care, it’s almost always fatal. 

Because the hospital was out of network, and Calver's insurance only paid $55,000, he was left with a balance of  $108,951.31

Because the hospital was out of network, and Calver’s insurance only paid $55,000, he was left with a balance of  $108,951.31

This bill shows an itemized list of charges, including more than $10,000 for his hospital room

Calver was charged just under $3,800 for five EKG tests, according to the bill

This bill shows an itemized list of charges, including more than $10,000 for his hospital room. Calver was charged just under $3,800 for five EKG tests, according to the bill

Even as Calver was being prepared for a procedure to insert four stents into the clogged blood vessel, he asked hospital staff whether his health insurance policy would cover the treatment, since St David’s was out of his network. 

Staff assured him they did and told him to relax. The operation was a success and Calver was released home four days later, reported KHN-NPR.

But, a month later, the six-figure hospital bill arrived in the mail. 

St David’s had charged Calver $164,941 for his surgery, hospital stay and room charges. Aetna had covered $55,840.

This meant Calver was left with a balance of 108,951.31. The amount included more than $42,000 for the stents, two of which were billed at $19,000 apiece, and $10,000 in room charges.

At first, he said he thought that a mistake had been made either by the hospital or by his insurance company.  

Soon after, the family began getting phone calls from debt collectors demanding payment.

After the story received national attention, St David's agreed to reduce Calver's bill to $332.29. Pictured: Calver with one of his daughters

After the story received national attention, St David’s agreed to reduce Calver’s bill to $332.29. Pictured: Calver with one of his daughters

Calver had been subject to balance billing, which occurs when insurers pay for emergency care, in or out-of-network, but because the insurer and hospital can't settle on a price, the hospital bills the patient. Pictured: Calver, second from right, with his wife and two daughters

Calver had been subject to balance billing, which occurs when insurers pay for emergency care, in or out-of-network, but because the insurer and hospital can’t settle on a price, the hospital bills the patient. Pictured: Calver, second from right, with his wife and two daughters

Time after time, Calver and his wife would explain to the collectors that they lacked the funds to pay the amount in full, but they said they were never offered any financial assistance, reported KHN-NPR.

The Calvers were being subjected to practices known as surprise bills and balance billing.

Surprise bills are when patients go to a hospital within their insurance network but are treated by an out-of-network doctor. 

Balance billing occurs when insurers pay for emergency care, in or out-of-network, but because the insurer and hospital can’t settle on a price, the hospital bills the patient. 

Calver says his annual income is about half of the $109,000 balance. 

‘They’re going to give me another heart attack stressing over this bill,’ he said. ‘I can’t pay this bill on my teacher salary, and I don’t want this to go to a debt collector.’

After the story received national attention, NPR reported that Calver received a new bill from St David’s, which was reduced to $332.29.

‘It feels great that this is over for me and my family, but this isn’t just about my bill,’ Calver told the station. ‘I don’t feel any consumer should have to go through this. 

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