Broken Leg, $7,500 Bill, Insurance Paid Nothing - Welcome to High Deductibles

By DailySpark Team | December 2024 | 7 min read
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Last updated: January 2025

The skateboard ramp looked smaller from the ground.

My 14-year-old son learned otherwise when he landed wrong and we heard the crack from across the park.

Six hours and $7,500 later, we left the hospital with a cast, crutches, and a bill that our "excellent" health insurance refused to touch.

Not a penny. Not a dime. Nothing.

The Breakdown of a Breakdown

Here's exactly what breaking a leg costs in America with a high-deductible plan:

Ambulance ride: $1,200

Emergency room fee: $2,100

X-rays (3 angles): $850

Orthopedic consult: $600

Bone setting procedure: $1,400

Cast and supplies: $450

Crutches: $175

Pain medication: $125

Total: $7,500 Insurance contribution: $0 Out of pocket: $7,500

The "Coverage" That Doesn't Cover

I pay $1,400 a month for family health insurance. That's $16,800 a year.

What does it cover? Apparently nothing until I spend another $10,000 out of pocket.

So let me get this straight:

In what universe does this make sense?

The Infuriating Negotiations

The Network "Discount"

The hospital's original bill was $11,200. My insurance "negotiated" it down to $7,500.

They want credit for saving me $3,700. But they didn't pay anything. They just used their bargaining power to get a discount, then made me pay the entire "discounted" amount.

It's like your friend negotiating a car price down, then making you buy it while they take credit for the savings.

The Cash Price Secret

Here's what they don't tell you: If I had no insurance and asked for the cash price, it would have been $4,800.

With insurance: $7,500 Without insurance: $4,800

I literally paid $2,700 MORE because I have insurance.

The Follow-Up Financial Assault

The initial break was just the beginning:

Week 2: Cast Check

Week 4: New Cast

Week 6: Another Check

Week 8: Cast Removal

Physical Therapy (8 sessions)

Total follow-up costs: $3,900 Total for broken leg: $11,400 Insurance contribution: Still $0

The Deductible Trap Math

My family deductible is $10,000. After the broken leg saga, we'd spent $11,400.

Finally! We crossed the deductible! Insurance will help now, right?

Wrong.

Now they pay 80%, I pay 20%. And guess what? It's October. The deductible resets in 11 weeks.

My son needs surgery to remove some hardware: $15,000

January 1st arrives. Deductible resets. Son needs follow-up surgery: $8,000

What Other Countries Pay for Broken Legs

I researched this extensively while crying over bills:

Canada: $0 (parking fee maybe $20)

UK: £0 (perhaps £9 for pain meds)

Germany: €10 copay per day in hospital

Japan: ¥30,000 (~$200) maximum

Mexico: $1,500 total if paying cash

USA with high-deductible: $11,400

We're the only developed nation where a child's broken leg can cost more than a car.

The Alternatives I Should Have Considered

Medical Tourism

Flying to Costa Rica, getting treatment, staying a week in a resort, and flying back would have cost $4,000 total. Including the vacation.

Direct Primary Care + Cash

Services like MyPhysicianPlan provide unlimited primary care for a flat rate. Combined with paying cash for the ER, I might have saved thousands.

MyPhysicianPlan wouldn't cover the emergency, but for all the follow-ups, cast checks, and ongoing care, their flat monthly rate would have been far cheaper than my per-visit costs.

The Urgent Care Route

Should have gone to urgent care first: $300 total. They would have X-rayed, stabilized, and referred to orthopedic. Could have saved $6,000.

But you don't think clearly when your kid is screaming.

The Psychology of High-Deductible Hell

You Avoid Care

My wife's wrist hurt for three months. She refused to get it checked. "We can't afford another deductible hit."

It was fractured. Healed wrong. Now needs surgery.

You Become Your Own Doctor

I YouTube'd "how to know if foot is broken or sprained" instead of going to the doctor.

I WebMD'd my chest pain instead of the ER.

I ignored symptoms that turned into bigger problems.

You Resent Your Kids Getting Hurt

This is the sickest part. When my younger son fell off his bike, my first thought wasn't "Is he okay?" It was "Please don't be broken, we can't afford it."

What kind of healthcare system makes parents fear their children's injuries for financial reasons?

The Insurance Company's Perfect Scam

They know most families won't hit $10,000 in medical bills in a year. So they:

  • Collect $16,800 in premiums
  • Pay out $0 for most members
  • Keep the difference as profit
  • Call it "insurance"

    • It's not insurance. It's a reverse lottery where you pay to maybe get help if something catastrophic happens.

    What Would Actually Help

    Option 1: Reasonable Deductibles

    Cap family deductibles at $2,500. Period.

    Option 2: First Dollar Coverage

    Insurance starts paying from dollar one, even if just 50%.

    Option 3: Accident Exemption

    Accidents shouldn't count toward deductible. They're unpredictable and unavoidable.

    Option 4: Direct Primary Care

    Honestly, MyPhysicianPlan or similar services make more sense for routine care. Combine with catastrophic coverage for true emergencies.

    The Lesson Learned Too Late

    High-deductible plans aren't insurance. They're catastrophic gambling where:

    My son's leg healed in 8 weeks.

    My finances still haven't recovered 8 months later.

    Your Action Plan

    If you have a high-deductible plan:

  • Save the deductible amount - Have it sitting in an account
  • Know your cash prices - Call and ask before using insurance
  • Use urgent care - Avoid ER unless dying
  • Consider alternatives - Direct primary care, medical tourism
  • Document everything - Bills, calls, denials for potential appeals

    • The Bottom Line

    In America, breaking a leg with "good" insurance costs more than many people's annual rent.

    I paid $16,800 in premiums plus $11,400 out of pocket for one broken leg.

    Total: $28,200 for the year.

    The insurance company paid: Almost nothing.

    This isn't healthcare. It's extortion with an insurance card.

    And the worst part? My son is afraid to skateboard now. Not because of the injury, but because he heard me on the phone with the insurance company, crying about the bills.

    That's what high-deductible plans really break: families.

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    Note: Costs based on actual broken leg treatment in 2024 with high-deductible insurance. Individual costs vary by location and severity.