My son was born in July 2019 and was added to my plan (Aetna) within the 30 day window. My husband has insurance through his job with United Healthcare. He did not add our son to his plan.
There were no issues until December 2020 when Aetna stated they needed more information about the claim for his birth. When I called, I was told they did an investigation and that my son was covered under my husband’s insurance as the primary insurance with United. My husband called United who stated our son was never on the United plan. Aetna then called United with us on the phone and they confirmed the same thing and Aetna processed the claim. We had already paid our portion of the hospital bill at this point since it was a year and a half after his birth and Aetna processing the claim meant we would get a refund of several hundred dollars.
I then got an email earlier this week from Aetna saying they needed more information again. The claim was back to being marked as pending on their website. I called and was told United contacted Aetna in mid January and said their “intent” was to cover our son at birth so I was told it was a coordination of care issue and that my husbands company mandated that United be used for newborns and there is no choice offered by his company for whose insurance a baby can be on for the first 30 days of life. Aetna said his HR would need to provide a letter stating we were exempt from this rule and got UHC on the phone again who confirmed again that our son was never added to the plan but this time agreed that we didn’t have a choice in the matter and that he had to be covered by United. My husbands HR said we absolutely had a choice and were not mandated to use United and provided a letter stating that.
I sent the letter to Aetna and then got a response through their website messaging that we now need a letter saying my son wasn’t eligible to be on the UHC plan. He was eligible but we were told we weren’t mandated to use it. The claim is now marked denied and it’s over $12,000 so I am panicking about potentially owing that plus every other bill my son had in the first month of life. I’m sure we can’t add him to United 19 months later nor do I want to.
Any advice or guidance is appreciated. I don’t know where to go from here.
submitted by /u/LeelaFern
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My son was born in July 2019 and was added to my plan (Aetna) within the 30 day window. My husband has insurance through his job with United Healthcare. He did not add our son to his plan. There were no issues until December 2020 when Aetna stated they needed more information about the claim for his birth. When I called, I was told they did an investigation and that my son was covered under my husband’s insurance as the primary insurance with United. My husband called United who stated our son was never on the United plan. Aetna then called United with us on the phone and they confirmed the same thing and Aetna processed the claim. We had already paid our portion of the hospital bill at this point since it was a year and a half after his birth and Aetna processing the claim meant we would get a refund of several hundred dollars. I then got an email earlier this week from Aetna saying they needed more information again. The claim was back to being marked as pending on their website. I called and was told United contacted Aetna in mid January and said their “intent” was to cover our son at birth so I was told it was a coordination of care issue and that my husbands company mandated that United be used for newborns and there is no choice offered by his company for whose insurance a baby can be on for the first 30 days of life. Aetna said his HR would need to provide a letter stating we were exempt from this rule and got UHC on the phone again who confirmed again that our son was never added to the plan but this time agreed that we didn’t have a choice in the matter and that he had to be covered by United. My husbands HR said we absolutely had a choice and were not mandated to use United and provided a letter stating that. I sent the letter to Aetna and then got a response through their website messaging that we now need a letter saying my son wasn’t eligible to be on the UHC plan. He was eligible but we were told we weren’t mandated to use it. The claim is now marked denied and it’s over $12,000 so I am panicking about potentially owing that plus every other bill my son had in the first month of life. I’m sure we can’t add him to United 19 months later nor do I want to. Any advice or guidance is appreciated. I don’t know where to go from here.
submitted by /u/LeelaFern [link] [comments]Read Morer/HealthInsurance