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Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: MustardTiger on May 31, 2016, 03:20:37 PM

Title: Insurance deductible question
Post by: MustardTiger on May 31, 2016, 03:20:37 PM
Hope you guys can help clear this up for me.  My wife gave birth to our daughter in April.  My wife's deductible/oop was 3500 and we easily reached that and have already paid for this.  I was told that the first month of the baby would be covered under mom's policy, and we had to add her after that.

Note that the baby required no special care or attention after birth.

We added our daughter to my wife's policy, giving her a 3500 deductible as well.  After adding her I got a bill from the hospital for 3400$ under my daughter's name for servicing occurring within 3 days of birth?  Is this correct?  Do you have to meet the separate deductibles?  If this is correct I feel horribly mislead by the advice I was given by the insurance/hospital, especially considering I would have switched the baby to a lower deductible during my open enrollment after birth. 
Title: Re: Insurance deductible question
Post by: merula on May 31, 2016, 03:28:11 PM
Am I understanding correctly that you and your wife have separate policies? If so, I think the disconnect was that you heard "covered under Mom's policy" as "included in Mom's individual deductible" when they meant "the insurance covers the baby as an individual for a month, and after that you need to either leave her there or pay for coverage elsewhere".

You might still be OK, though. Having a baby is usually a "qualifying life event" that allows you to make insurance changes. Or at least it is at my employer and many others I've heard about.
Title: Re: Insurance deductible question
Post by: MustardTiger on May 31, 2016, 03:30:52 PM
So it's normal to double bill Mom and baby for a routine hospital stay?  Yep I definitely misunderstood.  Yes I have insurance through my work that is quite good for me but outrageously expensive to add dependants, thus they have an ACA policy.
Title: Re: Insurance deductible question
Post by: slappy on June 01, 2016, 06:45:57 AM
When I had my son, I had to pay $1000 deductable for myself and $1000 deductable for him.
Title: Re: Insurance deductible question
Post by: I'm a red panda on June 01, 2016, 07:01:41 AM
So it's normal to double bill Mom and baby for a routine hospital stay? 

It's normal to bill two people, each for their own hospital stay.  (If either was double billed, then that is wrong- they should each only be billed once.)

On my insurance plan, the baby does not have to meet it's OWN deductible, but as soon as a dependent is added to the plan, the plan's deductible increases.  So during pregnancy, I easily met my $600 deductible, but ANYONE (baby or mother) on the plan would have to be responsible for the additional $1,200 deductible once on a 'family' plan.  (My baby wasn't born alive, so I didn't end up finding out exactly how it worked.)  That's part of the reason my husband isn't on my plan- we want seperate deductibles, not one large combined one.



If you are still in the period that your daughter's birth is a qualifying event, you may be able to get her on your insurance policy and have it retroactively cover the hospital stay for your daughter.
Title: Re: Insurance deductible question
Post by: jda1984 on June 01, 2016, 10:45:10 AM
They will also bill for all patients in an ambulance.  We had our first at home (unintentionally) and got two $1100 bills for transport to the hospital 8 blocks away.  At least I got to ride for free!
Title: Re: Insurance deductible question
Post by: Choices on June 01, 2016, 03:36:21 PM
I can totally understand your frustration, and the billing for each (mom and baby) is likely correct. On the bright side, the baby's deductible is almost met for the year and it's only May, so while it's more than you expected to spend now you would have probably paid most of it anyway.

In addition, most policies have a total family deductible, so if you're on the same plan, check the fine print. If your family's deductible is $7000 and mom and baby have already paind $6900, you and any other kids probably won't have any charges for the rest of the year.
Title: Re: Insurance deductible question
Post by: dandarc on June 01, 2016, 03:45:48 PM
Not sure on the specifics of mom & baby, but my wife and I are on a "family plan" through her work, but seem to have individual deductibles within the plan - pleasant surprise the year we found that out.
Title: Re: Insurance deductible question
Post by: moosestache on June 02, 2016, 04:00:28 PM
Definitely check your plan, when we added our son to my plan the insurance company told me that we had separate deductibles within the family plan.  I knew that wasn't the case and it took several calls to get it straightened out.  Apparently it is common to have separate deductibles within a family plan although not with my company's policy.
Title: Re: Insurance deductible question
Post by: JustTrying on June 02, 2016, 06:38:30 PM
It definitely sounds normal to me that you'd have separate bills for both Mom and baby. I'd be more curious about who told you the baby's bills would fall under Mom, and follow-up with those particular people.