| Urgent care made me go to the ER and I had surgery that night and stayed for a week. Better safe than sorry. |
Insurance are the ones saying it will be full pay bc we have not met deductible, which does not make a lot of sense due to copay. |
It probably wasn't in network? |
It was! |
Right, it goes towards your deductible. I get it, but it’s really more of a problem with insurance companies and the high costs of healthcare. I had to get a breast biopsy this year because the doctors said I might have cancer. Turns out I don’t, but I still had to pay for the procedure (more than your son’s ER bill) because I hadn’t met my deductible. I don’t see how you’re getting out of this one. |
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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Did you know he was going to ER? The Urgent Care doctor "recommended" right. It was your/your kid's call to go. [/quote]
I knew he was going where the guy recommended. My da actually asked about cost he said and the guy said it would be a copay. I’m not there so I was not going to tell him not to get medical attention after doctor said go to ER and he might go deaf! If he were home we’d have done things differently. In any case I still don’t get why this is not a copay because we do have an ER copay and I’ve never had a copay not kick in before deductible.[/quote] I’d follow up with your insurance before paying 2k.[/quote] Insurance are the ones saying it will be full pay bc we have not met deductible, which does not make a lot of sense due to copay.[/quote] Right, it goes towards your deductible. I get it, but it’s really more of a problem with insurance companies and the high costs of healthcare. I had to get a breast biopsy this year because the doctors said I might have cancer. Turns out I don’t, but I still had to pay for the procedure (more than your son’s ER bill) because I hadn’t met my deductible. I don’t see how you’re getting out of this one. [/quote] It’s just not clear to me how it’s not just a copay bc my plan lists a $150 Copay and nothing about having to meet deductible first. |
Ah, that's so weird. Is this BCBS? Mine has copay plus coinsurance for whatever materials/drugs were used, but still 2k is a lot! Have you called the insurance company and have them walk you through this? They should be able to have you download the brochure and point you to exactly where it explains why you have to pay the deductible before the copay. For your peace of mind if nothing else lol. |
It is BCBS! I have the brochure and it states right there that it is a copay and then 30% coinsurance but they kept telling me the entire bill would be my responsibility. It made no sense. |
| Why not pay for a lower deductible plan you can't have it both ways. We always pay for the lowest ppo |
Sounds to me like a bill before adjusting for negotiated insurance rates. It’s probably not what you actually owe. |
It sounds like the college ER did not bill your insurance properly and you’re faced with the full cost. Call and get the billing straightened out. (Assuming you don’t have an HMO or something similar that does not cover out of network) |
It sounds like she does have that kind of plan where she typically just pays the copay. |
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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Did you know he was going to ER? The Urgent Care doctor "recommended" right. It was your/your kid's call to go. [/quote]
I knew he was going where the guy recommended. My da actually asked about cost he said and the guy said it would be a copay. I’m not there so I was not going to tell him not to get medical attention after doctor said go to ER and he might go deaf! If he were home we’d have done things differently. In any case I still don’t get why this is not a copay because we do have an ER copay and I’ve never had a copay not kick in before deductible.[/quote] I’d follow up with your insurance before paying 2k.[/quote] Insurance are the ones saying it will be full pay bc we have not met deductible, which does not make a lot of sense due to copay.[/quote] Right, it goes towards your deductible. I get it, but it’s really more of a problem with insurance companies and the high costs of healthcare. I had to get a breast biopsy this year because the doctors said I might have cancer. Turns out I don’t, but I still had to pay for the procedure (more than your son’s ER bill) because I hadn’t met my deductible. I don’t see how you’re getting out of this one. [/quote] It’s just not clear to me how it’s not just a copay bc my plan lists a $150 Copay and nothing about having to meet deductible first. [/quote] Unless something specifically says the deductible doesn't apply, you have to hit the deductible before you start paying only the copay. It's definitely confusing. I've had a few plans like this where office visits are subject to the deductible. But ER visits always are. |
Does it specifically say your deductible doesn't apply? What does it say for outpatient office visits? |
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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Did you know he was going to ER? The Urgent Care doctor "recommended" right. It was your/your kid's call to go. [/quote]
I knew he was going where the guy recommended. My da actually asked about cost he said and the guy said it would be a copay. I’m not there so I was not going to tell him not to get medical attention after doctor said go to ER and he might go deaf! If he were home we’d have done things differently. In any case I still don’t get why this is not a copay because we do have an ER copay and I’ve never had a copay not kick in before deductible.[/quote] I’d follow up with your insurance before paying 2k.[/quote] Insurance are the ones saying it will be full pay bc we have not met deductible, which does not make a lot of sense due to copay.[/quote] Right, it goes towards your deductible. I get it, but it’s really more of a problem with insurance companies and the high costs of healthcare. I had to get a breast biopsy this year because the doctors said I might have cancer. Turns out I don’t, but I still had to pay for the procedure (more than your son’s ER bill) because I hadn’t met my deductible. I don’t see how you’re getting out of this one. [/quote] It’s just not clear to me how it’s not just a copay bc my plan lists a $150 Copay and nothing about having to meet deductible first. [/quote] Sounds like you don’t understand your plan and you’re just looking at a summary of benefits. If you think it’s wrong, call customer service and ask. But insurance companies intentionally pay very little for emergency room care because they want to discourage it for conditions that can be treated in doctors offices and urgent care. So your bill doesn’t surprise me. |