Relaxing Doesn't Make Babies

Insurance SUCKS

February 28, 2008 — 3:43 pm

Okay, so you may or may not remember that we switched insurance companies as of the beginning of this year. The old one covered all maternity care with no co-pays and it also covered all pediatrician visits with no co-pays… however the premiums were a large step above what the offered Blue Cross/Blue Shield premiums were. BC/BC also had no copays for maternity (other than a $100 fee for the actual birth) and pediatric care. Plus it had more allowances for chiropractic care (which Den uses, and now so do I) as well as a couple of other things that were of note to us. Slightly better coverage, much lower premiums. Good plan!!

I got a bill in the mail from the hospital where my Midwife group is for $40. I thought, huh, that’s strange. Then I got another one. I pulled out all of my records, including the Explanation of Benefits that the insurance company mailed me, to take a closer look. It says both that I owe $40 co-pay for one date of service, but also has a note saying that I’m not responsible to pay the difference between the submitted charges and the allowable charges. And I know I’m not supposed to have a co-pay! So which was it?

I just called an insurance rep to figure it out. The end result: yeah, we have to pay those bills. I pointed out that we are NOT supposed to have co-pays for maternity care! Says so right in the book. She checked it out.

Soooo it turns out I don’t have co-pays for maternity care. I do have co-pays for outpatient facility use. My Midwives are located in a hospital. They do all their billing through the hospital. They are considered an outpatient facility. Which is a $40 co-pay per visit. Fuck fuck fuck!

Did I mention that I’m now halfway through my third trimester? And that I’m moving to weekly visits? *bangs head against the wall*

So much for saving money… it appears we’re going to be coming out even this year, at least. Thank goodness the premium is so much less, that should make up for these unexpected fees. Damnit!

One response to “Insurance SUCKS”

  1. Dayzofrain says:

    Make copies of the bills and the paid receipts….

    and check with whomever does your taxes. You might be able to declare the costs on next years taxes and get some of it back