Hospital bill$

[odoole]

I hope this is the appropriate place to post this. DH and I are really stressed out about all the hospital bills arriving at our door every day, and just recently we've started getting collection agency notices (though they were addressed to my 8 mo son).

He's acually been pretty healthy, only been hospitalized twice for premie-related issues, but due to complications switching him from mine to DH's insurance, we're looking at paying a $5000 out of pocket deductable TWICE - so $10,000 for my son who is less than a year old. On top of that, one of his treatments may be deemed "experimental," so I'm not confident it will be covered, but that's a wort or another day.

DH and I are both students with a combined $500,000 in educational debt (no, not a typo). So in a way, these bills seem like a pittance compared to that, yet it's money we simply don't have. Plus it just seems so unfair to have to pay the max twice because of insane insurance company policy and a clerical error.

How do we advocate for ourselves. Is it best to work with the insurance company or the hospital? He hospital has already gotten a ridiculous sum if money from my son's insurance coverage, is there a way they can just give us a break on the out of pocket fees?

I just want some advice about how to approach this and advocate for myself. I just want to enjoy my life with my son and worry about his health, not the pricetag.

[MotherWhimsey]

I'd contact both the hospital and the insurance company. When you call the insurance company keep asking for someone who can help. The first person on the phone won't be authorized to approve much. Just keep on going up the line till you get to someone who can help.

When you call the hospital, ask if you can lump all his bills together and work out a payment plan. It can be as low as 50 bucks (or lower, just depends) a month so long as you are paying on it it can't go to collections.

[DirtRoadMama]

Well, I think we need to know more about why you have to pay the deductible twice. If you changed insurance, and both have a $5000 yearly deductible, that would make sense. But you mentioned a clerical error. What was the error? If proving that it was an error would help, I'd start there.

If there is no error, then as much as it sucks, you'll be stuck with each policy's deductible.

I agree with MotherW that you can get the bills consolidated into one through the same hospital, and as long as you pay something on it, they won't send it to collections. However, if you are already getting collection notices from collection agencies, you will be stuck dealing with those agencies.

[khaoskat]

Another thing to look at is what policies to the hospitals have in place for a child whose family falls within certain income guidelines.

Also, you can contact an attorney about a Bad Faith claim against both insurance companies. Often times they will clear things up quickly that way.

[odoole]

Well, what happened was he was covered at birth under my own personal plan that actually expired a couple weeks after he was born (it was supposed to expire before he was born, but he was born 6 weeks early so I just happened to still be covered under this plan). Before he was born, we paid for a new plan for me and DS under DH's insurance plan. He was in the NICU for 5 days at birth. This is where the error comes in, I'm not sure why this happened and I don't know I can prove this wasn't our intention, my son's plan through DH's insurance didn't have a start date until 2 weeks after his birth.

But even without that error, if DH's plan had begun on DS's birthdate as it was suppose to, my insurance company claims that DS's NICU bill would automatically go under my personal plan (they cover pregnant women and their babies for a period of time after the birth of the child). That NICU stay hit our first max. Then when DS was 5 months, he had a 3 day hospital stay and MRI and echo, and some other stuff. If he had been on DH's plan, we wouldn't be responsible for those bills because we would have already hit our max.

Does that make sense? So there are really two issues going on here. One is a mistake in DH's plan's start date, and the other is the insurance company's policy that a newborn is put under the mother's personal health plan.

[MotherWhimsey]

You're pretty much stuck with that double deductable then. We had the same thing happen with my dd and her check ups in the hospital after birth. Even though I didn't have a maternity rider in our state the mother's insurance has to cover the baby for 30 days but it can have a ridiculous deductable and OOP max. So we were responsible for those bills. Until the second policy kicks in, you're responsible for the OOP expenses not covered under the first policy.

[sbgrace]

Talk to the hospital first. If you talk to them initially they will set up payment plans (you want that in writing) with you. But in my experience once it goes to collections there aren't payment plans anymore and you're talking credit hits and such. Call the hospital first and see if they can set up a payment plan for you. Hospitals are used to people not paying and write off a lot of debt (as well as turn over to collections fast). So if it's not at collections yet they will generally happily set up an agreement. We did it orally once and despite regular payments the hospital sent us to collections. Do get it in writing.

My BIL was in a serious accident and after 3.5 years of regularly paying the hospital did spontaneously write off the remainder of his debt.

[moongazer]

I second the suggestion to talk to the hospital about any income-based programs they may have to help pay the bill. Ds was in the NICU for 30+days at birth and, based on our income, the hospital decreased our bill by 75%. We were surprised that we qualified because our income is too high qualify for WIC, SSI, etc. A social worker at the hospital should be able to give you an idea of what you might qualify for.
HTH

[JessicaS]

Does the hospital have any sort of financial assistance?? When my ds was in the hospital they were able to help us with a large chunk of his bill. We don't qualify for any sort of government assistance but we did fall within their guidelines.

[odoole]

Thank you for the advice. I will use it as I go forward with this. I have a meeting with someone at the hospital next week to go over this and we'll see what kind of low-income plans they can give us. At the very least, I'm hoping they will be able to explain what all these bills are for anyway. I think it's preposterous to charge close to a hundred thousand dollars for something and not give a very detailed explanation of what the charges are. In no other industry would that fly. I know at least a couple of the bills are mistakes -- doctors we've never seen, procedures we've never done. It's such a mess.

[maybemom05]

Someone in your state Attorney General's office should work with insurance companies, and they might be able to help you, or at least give you the name of someone more senior at the insurance firms than the folks at the call center - who in my experience can be less than helpful.

You will probably have to do a bit of digging on your state gov't website, but somewhere there will be a Bureau of Insurance or something similiar.

Good luck!