Reply to Insurance Just Screwed Me

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[quote=Anonymous]It appears that it would have. What Healthy Families did was enable me to have my prenatal care covered. Care First had told me verbally twice when I was signing up that they covered prenatal, then they denied that. They also told me once I called to ask why my prenatal bills weren't being paid that I did NOT have L&D coverage - only in the event of a "complication."

The book I had said otherwise, but as we discussed last year, their mumbo jumbo is impossible to decipher. After speaking with a supervisor, I was again told: NO L&D Coverage.

But, my OB submitted a request to them to estimate L&D out of pocket and they said $1000. We were shocked, and I kept that paper as proof in case they denied anything.

So all my prenatal was covered by DCHF, and then L&D was billed to Care First with any balances sent back to DCHF. The first Explanation of Benefits left me at $1000, but then it was filed again, and somehow that turned to $500. The hospital never sent me a bill for that. I assume the rest went to DCHF to be paid off. The doctor's bill was $1700, that was denied. And one more bill was denied for $200 for the day of the baby's birth with a doc name I didn't recognize so not sure what that was. Anesthesiology?

I have a residual bill from the nuchal (from Dec 2011) which is a nightmare, but in talking with the lab directly, they explained that DCHF/Medicaid recipients always get the paid. The OB's office told me that too - they don't even submit a claim, they just do something called "Global Billing" and it gets reduced/paid.

The prenatal care ended up not being that expensive, maybe a few thousand over 9 months, but it was the wishy washy responses of Care First on the L&D that scared me. I'm glad I got the DCHF, it saved me a ton of money. I qualified again because the year of the baby was a worse financial year than the one prior, but I don't really use the insurance now.

In a funny post-script to the Care First story, my husband tried to add me to his policy again and again I was denied. We got the letter yesterday. They cited a procedure I had done 2 years ago (which never had insurance coverage and I never contested that, I paid out of pocket) as the reason. I don't get it. My husband was like, "Oh, I'm fighting this." Yeah. Good luck hon.[/quote]

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