A Montana man was charged more than $540,000 in medical bills for dialysis after his kidney failed.
Throughout 2018, personal trainer Sovereign Valentine, 50, from Plains, was feeling more and more tired.
After constantly vomiting one day, he drove himself to the local hospital, where doctors diagnosed him with kidney failure, reported Kaiser Health News.
Valentine was told to immediately start dialysis despite his insurance provider seemingly having no in-network clinic.
He and his wife were shocked when they received astronomically high healthcare bills that charged as much as $53,000 for just one session of the life-saving treatment.
Sovereign Valentine, 50, from Plains, Montana, was diagnosed with kidney failure in 2018. Pictured: Valentine receiving dialysis
Valentine (left and right) started dialysis in January 2019 and his insurance company told him it had no in-network dialysis clinics. He and his wife received medical bills for dialysis that totaled $540,842.90
‘I was in shock, but I was so weak that I couldn’t even worry,’ Valentine told Kaiser Health News of learning he was in kidney failure. ‘I just turned it over to God.’
Dialysis is needed when someone loses between 85 and 90 percent of their kidney function, according to the National Kidney Foundation.
To keep the body working, dialysis helps perform the function of the kidneys including removing waste, salt and water; filtering the blood so there are enough essential chemicals in the body; and controlling blood pressure.
Valentine received his first dialysis treatment in January 2019 at a nearby hospital before a social worker met with the Valentines.
She said the 50-year-old needed outpatient dialysis three times a week for 14 weeks.
There were two clinics he could go to – each roughly 70 miles from where they live – so the couple went with Fresenius Kidney Care clinic in Missoula.
Not long after, a case manager from the Valentines’ insurance company, Allegiance, contacted them and said Fresenius was out-of-network so the couple would have to pay whatever the insurance didn’t cover.
Jessica and the insurance case manager could not find an in-network provider of dialysis on the company’s directory.
She said she asked both Fresnius and Allegiance numerous times for an estimate of their out-of-pocket costs, but never received an answer.
When the bill arrived, the Valentines were charged $540,842.90, with each dialysis session costing between $10,097.14 and $53,366.99.
Valentine’s wife contacted the state insurance commissioner that there is an in-network dialysis clinic that hadn’t appear on the insurance directory. Pictured: Valentine, left, and his wife during a dialysis session
Fresnius, the clinic where Valentine received dialysis, has offered a 50 percent discount, which lowers the bill to $262,400.08. Pictured: The initial bill the Valentines received
Allegiance, the insurance company, covered $16,241.73, which left the couple a balance of $524,600.17.
Jessica told Kaiser Health News that she cried when they first received the bill.
‘It was far worse than what I had imagined would be the worst-case scenario,’ she said.
But her husband said: ‘To me, it’s so outrageous that I just have to laugh.’
Fresnius later told the couple they were entitled to a 50 percent discount because of their annual income.
However, this only lowers the bill to $262,400.08.
‘It’s still a completely outrageous charge,’ Jessica told Kaiser Health News. ‘I want to pay what we owe and what’s reasonable and what his care actually cost.’
She learned from the state insurance commissioner that there is an in-network dialysis clinic that didn’t appear on the directory.
Allegiance argues that the couple should have found the clinic earlier.
‘There is always the potential for customers to misunderstand information about how their health plan works, especially in stressful situations,’ a spokesperson for Allegiance told Kaiser Health News.
The Valentines say they are currently considering seeking legal advice and, as a last resort, may file for bankruptcy.