Delaine Dixon: The High Cost of Staying Healthy on a Fixed Income

For Delaine Dixon, a 61-year-old Texan living on Social Security, managing her health has become increasingly difficult due to unexpected facility fees. After three cervical spine surgeries, Delaine relies on ongoing pain management. But when her insurance provider, Humana, was no longer accepted at her local Baylor health center, her care became even more complicated. “I had to see a pain management doctor who’s no longer in my network,” Delaine explained.

When she called the office, staff told her she could still see her doctor, but only if she paid an additional charge. “They said, ‘Well, since we don’t take your insurance anymore, you can still come, but you have to pay the $35 co-pay plus $195 facility fee.’”

Like many Americans, Delaine was frustrated and confused by the additional fees. “I don’t understand what that is. But I really like this doctor, and he’s fast, and so I guess I will pay.” When she asked about the charge, staff explained it was not for the doctor’s services but for using the building itself. “They said it’s for using the facilities at Baylor Scott and White,” she recalled. “I don’t understand. So, if I met him out in the parking lot… I don’t understand.”

What makes it worse, she said, is how little actual care she receives during her visits. “I didn’t even lay down on the bed or lean on the chair. The doctor spends no more than five minutes in the room, never even looks at me, just comes in, writes the prescription and leaves. He could’ve done this over a Zoom call.”

Despite her frustration, Delaine said she may not have a choice moving forward, though the high costs have already forced her to put off needed care. “I really need to go back to him,” she said, “but I was going to call and I’m sure they’re going to tell me it’s $195 again.” She explained that she hasn’t made another appointment yet because of the expense, even as her health has worsened in recent weeks. “I’ve had two cervical surgeries in the past eight weeks because of a tumor, and just last Tuesday I fell and broke my ankle.”

Delaine has been enrolled in Humana for several years, but changes to her coverage last year came as an unwelcome surprise. “I didn’t have any idea that they were going to drop all these places,” she said. When asked if she would have chosen a different plan had she known, she was clear: “Yeah, I would’ve got another one.”

The loss of coverage has extended beyond just her preferred pain management physician. “It’s also [affected] Touchstone Imaging and all the x-ray places and stuff like that are not on that plan either. The closest one is like two hours away, and with all the surgeries and stuff I’ve had, it’s been impossible to go get a CAT scan or MRI or anything else.” Faced with these barriers, she is considering switching providers altogether. “So, I may just change insurances, and I’ll make sure that they’re included on my plan … I don’t know what else to do.”

For someone living on a fixed income, these costs are especially difficult. “I live on Social Security, so it’s very tough,” Delaine said. “But it’s either that or I don’t get medicine.” Her story highlights the burden that hidden facility fees place on patients, especially those with chronic health needs and limited incomes.