The Medical Bills: What do I do if my insurance decides not to cover them?

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  • #83920 Reply

      Medical bills about 6 months ago I had a very expensive surgery on my stomach and I have had many, many, many complications. I can see on MyChart that I have numerous bills pending one 66k and another one for 70k both are pending insurance.

      What do I do if my insurance decides not to cover them? My husband makes OK money and since I’ve been super sick I’ve only made about 6k for the whole year so far.

      #83921 Reply

        Even if insurance covers it you will likely have to pay something up to your out of pocket maximum. When I gave birth my son went to the nicu and we had like $90k in bills. Insurance covered most of it but we had an out of pocket max of $14k and the insurance company was like Oh sorry we just happened to not be able to cover $14k of these bills. Sorry.

        Anyways you contact the hospital and get on a payment plan. Ask what happens if you can’t pay some months. Mine told me they don’t do anything unless you fail to pay for six months in a row and then it goes into collections. So I’ve been able to skip some months when I needed to. My hospital gave me a 36 month payment plan where whatever is not paid off by the end I owe in a lump sum. They also allow you to call them and tell them you cannot pay the entire amount due but can pay a lower number this month. They work with people constantly that have trouble paying. The goal though is to avoid collections.

        At the hospital, my bill has no interest accruing. In collections there would be interest and it would hurt my credit score.

        #83922 Reply

          Wait on insurance first. If they deny, exhaust all your internal and external appeals with insurance. Make sure the hospital/doctor sends in very good records if you have to appeal. I see so many appeals denied because the records sent in weren’t complete enough to document medical necessity was met.

          #83923 Reply

            Always ask for a itemized bill and review it carefully look for anything out of the ordinary and double charges etc. They have customary charges online now. Make sure you were not charged for something you did not even receive.

            Everything has to be disclosed now. Keep all your documents and bills in a 3 ring binder in date order.

            Keep a medical journal of what your physicians tell you that you can & cannot do and how you are doing be detailed and how it is impacting your daily life in case this leads to disability or a battle with your insurance. Being organized is key especially when it comes to medical. Glad you are on the mend.

            Take it one thing and issue at a time. Do not let it overwhelm you. You are still with us that is the important part. Praying for this issue to be a distant memory soon.

            You can check also: What do people do with dental costs who don’t have insurance?

            #83924 Reply

              Cross that bridge if you ever see but I think you won’t. Seeing billing before insurance is shocking. Be organized. Don’t pay any bill until you are absolutely sure the insurance has paid everything it can. Anything ER related, call before paying. They should process those as in network but usually you have to call to get them to do it..

              Your plan has a limit that you pay out of pocket. I work in insurance. Call them with concerns.

              Would you also like to explore: What do you plan to do for health insurance in the US before you get to Medicare?

              #83925 Reply

                Easier said than done but I have always been told not to worry about something until it’s something to worry about. If you have insurance there’s a good chance a lot of that is covered and some things not covered could be changed to reflect contract price with insurance. So don’t panic until insurance is done with it.

                What is left go to hospital financial office ask for itemized bill and ask them to go through it with you. I did that once and the financial lady didn’t even ask me anything, she read it and took stuff off saying ‘that doesn’t need to be on there’..

                If something wasn’t covered ask if it was coded correctly, if it can be resubmitted. The wrong code has happened to me before. If it still doesn’t seem right or you need more help move on to the social worker. It will work out, you just have to be assertive.

                Also, check out: I was wondering if I should open a health savings account in addition to my insurance?

                #83926 Reply

                  First and foremost, I hope you are well! I know how stressful medical bills can be. This situation happened to me. I had an unexpected hospital stay, and we were unable to pay when the bill came.

                  I called, and they set me up on a payment plan so that my account wouldn’t default, and in the meantime, we have applied for financial aid. Still waiting to hear back about whether or not we’ve been approved, but as long as you make small payments towards your account regularly, they are willing to work with you.

                  A lot of hospitals will even forgive the debt after a certain period of time. Just call and talk to their financial services.

                  Also, check out: We live in the richest nation in the world and our elderly Can’t get the care that they need!

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