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Left with $150,000 in medical debt, a once-Olympic hopeful stands up to surprise billing

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Posted at 1:35 PM, Aug 06, 2021
and last updated 2021-08-06 16:35:53-04

LOS ANGELES — From Olympic-hopeful to battling the health care system, Phil Gaimon is among millions whose livelihoods have been threatened by medical debt.

While Congress passed a new law banning surprise medical bills, it won't go into effect until January 1.

“Oh, I was shattered. I was freaked out when it was $90,000," said Gaimon. "And the second bill came, and that might have been the first time I cried in the entire accident. The pain didn’t do it to me, but wondering if I’d have to sell my house. You just don't know, and it's scary."

After retiring from professional cycling in 2016, Gaimon continued training like a pro. He posted routes and progress on social media, gaining a loyal following of supporters and sponsors.

"I was far more valuable having adventures on YouTube and getting hill climb records than I was finishing 18th at some weird race in Belgium no one's heard of," Gaimon.

Three years into retirement, he was contacted by USA Cycling. The coaches were looking for a fourth athlete to complete their team for the Tokyo Olympics.

“I just thought, 'Cool, I’ll go there. I'll make one video for my YouTube channel, Phil tries out for the Olympics. And that'll be the end of it.' But I went, and my time was really fast," said Gaimon. “From then, it was throwing all my plans and the rest of my year in the trash, because if the Olympics is possible, then nothing else really matters.”

But his aspirations were cut short while competing in an Olympic-qualifying event in Pennsylvania. He suffered life-threatening injuries after colliding with another rider.

“The next two months were just like a blur of hospitals, where you can't tell day from night," he recalled.

Covered by two insurance plans, he encouraged supporters to donate funds to No Kid Hungry instead of his medical bills.

"And ironically, I was not covered," he said.

His case was featured in the Kaiser Health News series Bill of the Month. His care at two East Coast hospitals was out of network, leaving him with $150,000 in medical bills.

"For months, I thought it was a mistake," said Gaimon. "Spent my day writing letters and making phone calls and trying to educate myself on what else to do.”

A new law going into effect in January protects Americans nationwide from costly surprise bills.

It bans providers from charging out-of-network prices for emergency care. For scheduled procedures, out-of-network providers must give patients an estimated bill ahead of time.

Ambulances, however, will still be exempt from the law.

“I think a lot of people are scared into paying for these bills or bullied into it or tricked into it. They tried to do it to me," said Gaimon.

The law will establish one system for filing complaints, which can be made verbally or in writing. The government must respond to consumer claims within 60 days.

Providers could face up to $10,000 for each violation.

Gaimon says he won't write a check until the numbers on his bill make sense.

“I picked a cause I believe in, No Kid Hungry. The cause of medical BS found me. I don't want to spend the rest of my life being a politician or spouting about that, but it is something everyone needs to know about," he said.