The Appendectomy Lottery: You Pay $14,600, Insurance Pays $18,400

Last updated: January 2025

Tuesday, 2 AM. Pain so bad I thought I was dying.

Wednesday, 6 AM. Waking up from emergency surgery minus one appendix.

Thursday, 10 AM. Hospital billing department explaining how I "won" the insurance lottery because I'll "only" pay $14,600 of the $33,000 bill.

They said it with a straight face. Like I should be grateful.

The Bill That Made Me Vomit (Not from Surgery)

Total Hospital Charges: $33,000

Here's how my "excellent" high-deductible insurance handled it:

Phase 1: The Deductible Hit

• First $10,000: I pay 100%
• Insurance pays: $0

Phase 2: The Coinsurance Kick

• Next $23,000: I pay 20% ($4,600)
• Insurance pays: 80% ($18,400)

My Total: $14,600 Insurance Total: $18,400

They covered more than I did! I won! Except... I still owe $14,600 for an organ removal I had no choice about.

The Itemized Insanity

I requested an itemized bill. I wish I hadn't:

Operating Room (2 hours): $8,500

• That's $4,250 per hour
• Or $70.83 per minute
• To use a room

Anesthesia: $3,200

• Thank God I was unconscious for these prices

Surgeon's Fee: $6,500

• Fair enough, she saved my life

Recovery Room (3 hours): $2,400

• $800/hour to lie in a bed

Regular Room (18 hours): $3,600

• $200/hour for a shared room

Medications:

• Tylenol (2 doses): $47 each = $94
• IV antibiotics: $380 per bag x 4 = $1,520
• Anti-nausea medication: $89
• IV saline bag: $284 (it's salt water!)

Supplies:

• Surgical gloves: $53
• Gown: $84
• Blanket (they let me keep it): $140
• Tissues: $11 (not a typo)

Labs and Imaging:

• CT scan: $3,400
• Blood work: $1,800
• Urinalysis: $92

Miscellaneous:

• "Mucus recovery system": $213 (it's a tissue box)
• "Thermal therapy": $97 (an ice pack)

The "You're Lucky" Gaslight

Everyone kept telling me how lucky I was:

Nurse: "Lucky they caught it before it burst!" Surgeon: "Lucky you have insurance!" Billing: "Lucky you hit your deductible!" Insurance: "Lucky we cover 80% after deductible!"

Lucky? I'm $14,600 poorer for an emergency I couldn't prevent, predict, or postpone.

What This Actually Cost in Other Countries

I researched this while on morphine:

Canada: $0 (maybe $15 for parking) UK: £0 Australia: $0 (with Medicare) Germany: €10/day hospital fee Japan: ¥100,000 max (~$700) Singapore: $2,000-4,000 SGD **Mexico (paying cash): $3,000 USD USA with high-deductible: $14,600

I could have flown first-class to Singapore, had the surgery, recovered at the Ritz Carlton for a week, and flown back for less than I paid here.

The Payment Plan Prison

"Don't worry," billing said, "we offer payment plans!"

Their generous offer:

• $14,600 over 24 months
• $608.33 per month
• 0% interest (how kind!)

That's a car payment. For two years. For an organ I no longer have.

The Timing Torture

If This Happened in January:

• Full $14,600 out of pocket
• But deductible met for the year
• Rest of year's care would be "cheaper"

But It Happened in October:

• Paid $14,600
• Deductible met!
• November-December: Some coverage
• January 1st: Reset to zero
• Start over

I paid maximum price for minimum benefit duration.

The "What If" Scenarios That Haunt Me

What If I'd Waited?

People ask why Americans delay emergency care. This is why.

I almost didn't go to the ER. Almost tried to "sleep it off." At $14,600, can you blame me?

If it had burst while I waited: Sepsis, ICU, possible death. Or worse: survival with $200,000 in bills.

What If I Had No Insurance?

Cash price (I asked): $18,000 Payment plan available Charity care possible

Without insurance: $18,000 (negotiable) With insurance: $14,600 (non-negotiable)

I saved $3,400 by paying $16,800 in annual premiums. That math doesn't math.

What If I'd Used Alternative Coverage?

Services like MyPhysicianPlan couldn't help with emergency surgery, but they could have handled all my follow-up care for a flat monthly rate instead of per-visit charges.

Post-surgery I needed:

• 4 follow-up visits: $200 each = $800
• Wound care supplies: $340
• Lab work: $400

MyPhysicianPlan would have covered all that for their flat fee of ~$150/month instead of $1,540 in follow-up costs.

The Recovery Bill Shock

The surgery was just the beginning:

Week 1 Post-Op:

• Pain meds (not covered): $180
• Follow-up visit: $200
• Wound care supplies: $340

Week 2:

• Infection scare, urgent care: $350
• Antibiotics: $90
• Second follow-up: $200

Week 4:

• Final surgical follow-up: $200
• Lab work: $400

Week 6:

• Return to work clearance: $150

Total follow-up costs: $2,110 Insurance paid: $0 (new year, deductible reset)

Grand total for appendix removal: $16,710

The Psychological Aftermath

Medical PTSD

This will probably kill me someday, but at least my family won't inherit medical debt.

The Guilt

The Rage

What Other People Paid (Real Reddit Stories)

"Paid $22,000 for burst appendix. USA! USA!"

"Canadian here. Total cost: $0. Sorry."

"Had appendectomy in Thailand on vacation. Total: $2,000. Hospital was nicer than US."

"$31,000 after insurance. Filing bankruptcy."

"Flew to Mexico. Total with flight: $4,000."

The System Working as Designed

This isn't a bug. It's a feature. Insurance companies know:

It's the perfect crime. Legal extortion. Pay or die, then pay anyway.

Survival Guide for High-Deductible Appendectomies

The Bottom Line

In America's healthcare lottery, having your appendix removed with "good" insurance means:

• You pay: $14,600
• Insurance pays: $18,400
• You're told you're lucky

This isn't insurance. It's a partial discount program with a $16,800 annual membership fee.

My appendix tried to kill me. The bill almost finished the job.

But hey, at least I "won" the insurance lottery.

Next time, I'm buying a lottery ticket instead of health insurance. Better odds, better payout, and at least when I lose, it only costs a dollar.

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Note: Based on actual appendectomy costs with high-deductible insurance. Individual bills may vary by hospital, location, and how much they think they can get away with charging.