I know that normally coinsurance only goes into effect once the deductible is reached. This situation is a little different.
Insurance details: High-deductible plan through UHC via work.
Individual deductible: $1650
Family deductible: $3300
20% coinsurance after hitting deductible.
Timeline for events:
Feb-19: Checked in for delivery at 9 PM
Feb-20: Baby girl born!
Feb-21: Discharged from hospital
My gripe:
The hospital charges were about $11,000. The date on the EOB is Feb-19, prior to baby being added to the insurance plan, which became effective her DOB. Therefore, only $1650 was charged to my wife’s deductible, with the remainder at 20% coinsurance.
Baby has had some additional screenings since being born, and those charges are now being applied to the family deductible. Had the hospital charges been applied to the $3300 family deductible, I think we would’ve spent about $900 less out of pocket, because the coinsurance would’ve kicked in earlier.
Am I right to challenge the insurance company that the hospital charges should apply to the $3300 family deductible? Most of these charges occurred on the 20th and 21st, once the baby was covered by the plan.
Thanks!
submitted by /u/my_user_name_is__
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I know that normally coinsurance only goes into effect once the deductible is reached. This situation is a little different. Insurance details: High-deductible plan through UHC via work. Individual deductible: $1650 Family deductible: $3300 20% coinsurance after hitting deductible. Timeline for events: Feb-19: Checked in for delivery at 9 PM Feb-20: Baby girl born! Feb-21: Discharged from hospital My gripe: The hospital charges were about $11,000. The date on the EOB is Feb-19, prior to baby being added to the insurance plan, which became effective her DOB. Therefore, only $1650 was charged to my wife’s deductible, with the remainder at 20% coinsurance. Baby has had some additional screenings since being born, and those charges are now being applied to the family deductible. Had the hospital charges been applied to the $3300 family deductible, I think we would’ve spent about $900 less out of pocket, because the coinsurance would’ve kicked in earlier. Am I right to challenge the insurance company that the hospital charges should apply to the $3300 family deductible? Most of these charges occurred on the 20th and 21st, once the baby was covered by the plan. Thanks!
submitted by /u/my_user_name_is__ [link] [comments]Read Morer/HealthInsurance