I got married in May, my wife has a variety of physical and mental illnesses which land her in doctor’s offices and hospitals more often than we can keep track of. There are currently 8 or more offices which my wife has had care in across 3 of the local medical networks.
Our main issue is that we have no idea how her insurance is covering her and what the right course of action would be.
Before we got married, she qualified for and was covered by State insurance (Americo Caritas) which seemed to cover everything 100% except for a few prescriptions, which had an out of pocket expense of $1. But even so, there seemed to be some issues and things were billed incorrectly.
I don’t even know where to start with a lot of this, so sorry if I ramble…
She had a long stay at a hospital in September 2020 and then had regular visits and sessions every week for a few months. She was never billed by mail or any other way. A few months later she was contacted by collections about unpaid bills. We don’t have any information from the collections company or information from the hospital about what to do or why this happened. At this point we don’t even know who the collections agent was or how to contact them, and the hospital won’t answer our questions about that particular bill.
Then we got married. Things seemed okay with her coverage except she lost some of her benefits (food stamps) because of my income. Luckily, the State insurance was approved for another year… But… She believed that we were required to put her on my insurance through my employer, so we did so… And that seems to be when things got more chaotic.
Can anyone tell me how that might work? She has ADA status and we ABSOLUTELY could not afford a 10th of the care she needs even with decent insurance. Copays alone would put us in debt. So we really need that State insurance… But is she required to also be on my insurance through my employer? And if so, how are things covered? How are bills processed?
A couple months later she was back in the hospital, but she caught a flu and they quarantined her and didn’t even treat her original issue. After discharge, she continued with their programs and returned to work.
Again, we never saw a bill from the hospital, but we did start getting letters from my insurance about claims and coverage for her care. We called the hospital again and they told us that there is no current balance, but that things are still caught up in insurance and billing.
Even her case worker has no idea what’s going on. We could owe thousands, or we could owe nothing… The latter of which seems impossible. None of the charges are coming up on her online portals, and we have no idea how to get an itemized statement from them. And the biggest mystery is why did some bills end up in collections before we knew anything about them and what do we even do about that now? They only contacted us once, which seems really off, and the number we have is disconnected. Maybe it was a scam, but that call was like 7 months ago and there are no receipts or records and our memory is of no help to us. And it seems like the hospital knows something but isn’t telling us.
Mostly, we need to know if it’s even necessary for her to be on my insurance? If it is, how does billing work?
submitted by /u/banryu95
[link] [comments]I got married in May, my wife has a variety of physical and mental illnesses which land her in doctor’s offices and hospitals more often than we can keep track of. There are currently 8 or more offices which my wife has had care in across 3 of the local medical networks. Our main issue is that we have no idea how her insurance is covering her and what the right course of action would be. Before we got married, she qualified for and was covered by State insurance (Americo Caritas) which seemed to cover everything 100% except for a few prescriptions, which had an out of pocket expense of $1. But even so, there seemed to be some issues and things were billed incorrectly. I don’t even know where to start with a lot of this, so sorry if I ramble… She had a long stay at a hospital in September 2020 and then had regular visits and sessions every week for a few months. She was never billed by mail or any other way. A few months later she was contacted by collections about unpaid bills. We don’t have any information from the collections company or information from the hospital about what to do or why this happened. At this point we don’t even know who the collections agent was or how to contact them, and the hospital won’t answer our questions about that particular bill. Then we got married. Things seemed okay with her coverage except she lost some of her benefits (food stamps) because of my income. Luckily, the State insurance was approved for another year… But… She believed that we were required to put her on my insurance through my employer, so we did so… And that seems to be when things got more chaotic. Can anyone tell me how that might work? She has ADA status and we ABSOLUTELY could not afford a 10th of the care she needs even with decent insurance. Copays alone would put us in debt. So we really need that State insurance… But is she required to also be on my insurance through my employer? And if so, how are things covered? How are bills processed? A couple months later she was back in the hospital, but she caught a flu and they quarantined her and didn’t even treat her original issue. After discharge, she continued with their programs and returned to work. Again, we never saw a bill from the hospital, but we did start getting letters from my insurance about claims and coverage for her care. We called the hospital again and they told us that there is no current balance, but that things are still caught up in insurance and billing. Even her case worker has no idea what’s going on. We could owe thousands, or we could owe nothing… The latter of which seems impossible. None of the charges are coming up on her online portals, and we have no idea how to get an itemized statement from them. And the biggest mystery is why did some bills end up in collections before we knew anything about them and what do we even do about that now? They only contacted us once, which seems really off, and the number we have is disconnected. Maybe it was a scam, but that call was like 7 months ago and there are no receipts or records and our memory is of no help to us. And it seems like the hospital knows something but isn’t telling us. Mostly, we need to know if it’s even necessary for her to be on my insurance? If it is, how does billing work? submitted by /u/banryu95 [link] [comments]Read Morer/HealthInsurance