Tourist Ends Up With Wild Bat in Mouth, $21,000 Medical Bill

The Unforeseen Consequences of Skipping Health Insurance

Erica Kahn, a 33-year-old resident of Massachusetts, reflects on two critical mistakes she made that led to an unexpected and costly medical situation. The first was choosing to forgo health insurance after being laid off from her job as a biomedical engineer. The second mistake came when a wild bat landed on her face during a night of stargazing in Arizona. This bizarre incident set off a chain of events that left her with a significant financial burden.

Kahn was photographing the night sky at the Glen Canyon National Recreation Area in August when she noticed several bats flying around. She wasn’t concerned until one of them got tangled between her camera and her face. In a moment of panic, she screamed, and part of the bat ended up in her mouth. Although she didn’t know how long or which part it was, she estimated it was only a few seconds. The experience left her shaken, but she didn’t think the bat had bitten her.

Her father, who is a physician and was traveling with her, advised her to seek medical attention immediately. He recommended starting rabies prevention treatment within a day. Kahn believed she would be covered if she obtained insurance before visiting the hospital. She found a policy online the day after the incident and was told that services related to an accident or life-threatening emergency would be covered.

The Medical Procedure and the Financial Fallout

The following day, Kahn visited a hospital in Flagstaff, Arizona, where she began rabies prevention treatment. Over the next two weeks, she received additional doses of the vaccine and immunoglobulin shots in Arizona, Massachusetts, and Colorado. However, the bills that followed were far more than she anticipated.

According to explanation-of-benefits statements, Kahn owed a total of $20,749 for her care across four facilities. Most of the charges were from Flagstaff Medical Center, where she received $17,079 for the rabies and immunoglobulin shots. The rest of the costs were spread across other locations.

The Billing Problem: Waiting Periods and Coverage Gaps

Kahn’s insurance policy did not cover any of the services. An explanation-of-benefits letter stated that the waiting period for the service had not been met. Kahn was shocked, thinking it might have been a mistake. She later realized that she had made a crucial error in timing.

When she was laid off, she had the option to stay on her former employer’s COBRA plan for 60 days at a cost of about $650 a month. However, as a young and healthy person, she opted to go without insurance, believing she could quickly purchase a private policy if needed. She didn’t realize that COBRA coverage applies retroactively if enrolled within the 60-day window.

Kahn eventually bought a policy from Innovative Partners LP, which cost about $311 a month. However, the policy had a 30-day waiting period, which didn’t apply to benefits regarding accidents or loss of life. Despite this, the company denied her claims, citing the waiting period.

Understanding Health Insurance Policies

Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, explained that most health coverage plans take effect on the first day of the month after enrollment. She noted that insurance companies don’t want people to wait until they are sick to sign up, as premiums from healthy individuals help balance healthcare costs.

Corlette also mentioned that while the Affordable Care Act requires insurers to cover preexisting conditions, it doesn’t guarantee coverage for treatments received shortly after enrollment. She reviewed Kahn’s policy and described it as a limited “fixed indemnity” plan, which pays set amounts toward treatments regardless of total expenses.

Even with comprehensive coverage, Kahn likely wouldn’t have been fully reimbursed for the treatment received so soon after enrolling in the policy.

The Importance of Timely Medical Care

David Shlim, a travel medicine specialist, emphasized that Kahn made the right choice by seeking treatment promptly, even though she didn’t feel the bat bite her. Rabies is a deadly disease, and the fact that the bat entered her mouth meant she could have been infected through its saliva.

Shlim added that healthy bats don’t typically fly into people, and the bat’s entanglement with Kahn suggested it might have been sick. He also highlighted that rabies prevention treatment is significantly more expensive in the U.S. due to the high cost of immunoglobulin, which is made from vaccinated individuals’ blood plasma.

Navigating the Financial Burden

Despite the challenges, Kahn has since regained employment and now has good health insurance. However, she still faces most of the bills from her misadventure. She managed to negotiate a reduced payment for one doctor’s bill and has arranged a monthly payment plan for another. She continues to appeal the denials for the remaining $19,000 in bills.

A spokesperson for Flagstaff Medical Center acknowledged the difficulty in controlling the prices of critical supplies like immunoglobulin, which is essential for preventing rabies. The hospital emphasized its efforts to limit costs while maintaining necessary treatments.

Lessons Learned

Kahn’s experience highlights the importance of having health insurance, especially during times of uncertainty. Corlette stressed that people who lose job-based coverage should consider enrolling in individual insurance plans through federal or state marketplaces, many of which qualify for ACA subsidies.

Kahn now regrets not signing up for COBRA when she was laid off, despite feeling confident she would find another job quickly. “That’s a very big lesson I learned the hard way,” she said.

While the encounter with the bat didn’t destroy her love for the outdoors, she admits it was a funny story—until the medical bill arrived.