Ugh, medical bills! WWYD?

[Ava]

I just need some feedback on the best course of action here. My partner gave birth back in April, so now we are being hit with all the lovely medical bills. Having never gone through this before, I had no idea how much our out-of-pocket costs would be. Needless to say I thought the insurance would pay more than they did - I did not understand how deductibles & co-insurance works, but I do now! Anyway...

We have some money in an FSA that we can use towards the bills, but it will only cover about half. Also if I drain the FSA I'll have to re-work my already tight budget to fit in medical costs for the rest of the year (co-pays, prescriptions, etc). We also have money in savings that we could pull out to pay off the medical bills. But I'm wondering if it would be better to just pay off the smaller bills now with the FSA, and try to set up a payment plan for the larger bills. That should leave us enough in the FSA to still cover co-pays, etc for the rest of the year. We'd also continue to earn interest (meager as it is) on our savings for longer, instead of pulling out a big chunk to pay off the hospital now.

I'm just not sure it's worth the hassle of a payment plan to earn 2% interest for however many months the hospital will give us to pay off the bills.

So - WWYD?

 

[KristiA]

We are going through this right now. My little guy was in the hospital for four days in February. When all was said and done, we still owed about 700ish dollars. I called and the hospital gave us two options. The first was to divide that into four and make monthly payments- that was their policy- to pay the balance off in four months. The second option was to get a loan through a bank (that they do all the paperwork for) and take a year to pay it off. I think the interest was really low, like 7-8%. My DH opted for this option. So we get the paperwork in the mail and I am not kidding, this application was ridiculous (which I am sure they do on purpose so you will just pay it off sooner). Needless to say, after filling out two pages with many more to go, DH got really mad and said to just call and we would pay off in four months. Not sure this helps you out any, but that's what we are doing.

 

[Disneychix]

Are well-visits and immunizations exempt from co-pays from you HI? If so than I would use all the FSA money you can. It would be a shame if you didn't take advantage of it by the end of the year.

Def call the hospitals and Drs to get clarification on the bills plus work out payment options. Usually they are willing to work with you.

DS was born premature and I didn't understand any of the deductibles vs co-insurance vs what was covered. It drove me batty! I'm still nervous 2yrs later that I'll get some lost bill in the mail!!

Congrat's on the baby BTW!

 

[AuroraBeauty]

Ava,

Congratulations to you and your partner on the birth of your child. I hope the baby is healthy and your partner is getting back into her pre-baby energy.

Double check every item you were charged for and make sure there are no errors. Hospitals are notorious for making billing errors.

Also, confirm everything with the insurance company. The hospital may accept assignment from the insurance company and you would only be responsible for a co-pay or co-insurance. There are so many different types of coverage, it's a challenge to know exactly what was supposed to be covered.

If you have a financial liability that you can not cover now out of pocket, definitely contact the hospital to arrange a payment plan. If they offer you a plan that does not work for you (say, 3 months) then let them know it won't work and given them a plan that will work for you.

But, before you say you'll pay make sure the amount is correct.

Best Wishes!

 

[Dani C]

Determine what you can afford to pay, and pay it regularly (at least $50 a month) until you can pay it off.

Amazingly enough, medical bills that are past due are not uncommon. Also you might like to know that most financial institutions rarely hold medical bills that are behind (but are being paid regularly) against you as much as other debt when making credit decisions.

Children are a blessing, but they are also expensive (from the time you go to the hospital to prepare to have them through the time that they leave home and get out on their own).

All the best!

 

[nuttypretzel]

Review each medical bill very carefully. Do not pay anything until your insurance company processes the claim. Your insurance will have a contracted price for each service. They pay based on that price. You only owe the difference between the contracted price and what your insurance paid. I have found many doctors and hospitals are trying to bill me for the full list price less the insurance payment. They are not entitled to this amount. I also have had doctors submit the bill to the wrong insurance carrier then come back and bill me for the full amount stating that the procedure was not covered. Make certain you only pay what you actually owe and not what the billing service says that you owe.
As far as the rest of the year is concerned, check to see if you have a maximum out of pocket. If you have reached that limit, you will not owe co-pays or deductibles for the rest of the year.

 

[Ava]

First I would call and see if you can get a discount if your pay now (or in the next few days). We do this all the time and rarely get turned down for a discount. Sometimes we even get our part of the co-pay comped. For this to work you need to be ready and able to pay today. We even get to charge our to our CC for the points.

I never even thought of asking for a discount. We do have the funds to pay now (in savings) so this is another option for us. Thanks for the idea!

Disneychix, we do have to pay a co-pay for DD's well-visits/immunizations. We also have some other medical expenses (prescriptions, contact lenses for me, etc) that we usually use our FSA for. So I'm sure we would use up the money before the end of the year.

Aurora & nuttypretzel (love the name, haha!), we've gone over all the bills and have spoken to the insurance company to make sure everything is correct and we understand what we owe & why we owe it. We hadn't paid anything towards our deductibles yet for the year, so we owe those plus our 20% co-insurance. We are disputing my partner's bill with the hospital - they have her discharge date down as 5/3, when she was actually discharged on 5/2. Only the baby stayed until 5/3. My partner did stay until after the hospital's usual discharge time for maternity patients because the baby was still in NICU, so we might have to pay for the extra day anyway, but they are pulling her chart and are supposed to call us back next week. And our pediatrician's office has tried to bill us for things before the insurance co has paid their portion; I haven't gotten to them yet, but I do plan to call and tell them no way - you bill me AFTER the claim is processed by insurance. Believe me, I won't pay any bill until I'm sure that it's legit!

 

[Soon2B4]

My hospital will allow 6 months to pay off a balance. Also, check with the hospital to see if their financial requirements are. Sometimes they have a higher income level to have your bills wiped out. That is usually on the back of the bill itself.

As far as what PP said about co-pays after you reach your out of pocket max, those do not count in my experience. A few years ago my DS had cancer and we racked up some bills quickly. Even after we reached his out of pocket max, we still had to pay a co-pay every time he went to the doctor. Maybe other insurance works differently, but we still had to pay that no matter what.

 

[bumbershoot]

We are disputing my partner's bill with the hospital - they have her discharge date down as 5/3, when she was actually discharged on 5/2. Only the baby stayed until 5/3. My partner did stay until after the hospital's usual discharge time for maternity patients because the baby was still in NICU, so we might have to pay for the extra day anyway, but they are pulling her chart and are supposed to call us back next week. And our pediatrician's office has tried to bill us for things before the insurance co has paid their portion; I haven't gotten to them yet, but I do plan to call and tell them no way - you bill me AFTER the claim is processed by insurance. Believe me, I won't pay any bill until I'm sure that it's legit!

Ask for a detailed list of charges from the hospital while your'e doing all that...don't trust that they will catch things. Also request her and baby's records! Our records were wild. At one point in DS's info it says he's a girl, and at another point the records state that he was circumsized (which he very much was NOT). That's the point that I called to demand the itemized charges, to make sure I wasn't being charged for something someone else did to their baby.

Call each place that sends a bill (and know that you might get a bill years down the road and you will be responsible for it) and see what sort of financing you can do. I don't mean...interest charges or anything.

But one hospital we dealt with was evil. Didn't work with us at all. Never communicated, never sent bills, etc. They were very difficult.

Another hospital system in the area has been wonderful. Their billing people are lovely lovely humans, they communicate, send bills, sent the zero balance when that happened, etc.

So see what sort of hospital you're dealing with. If they are difficult, just pay them.


But you know, honestly, having been through what we have been through...I'd just pay it all off now. FSA and savings, be DONE with it. Better than missing a payment and being sent to collections from ONE missed payment, then being in limbo while collections is figuring out their universe (then find out they put finance charges on the bill that whole time that there was no way to pay anyone b/c it wasn't in the hospital's hands anymore, but we weren't set up with the collection place). Yay Franciscan hospital system in WA for THAT one!

 

[mhsjax]

Review each medical bill very carefully. Do not pay anything until your insurance company processes the claim. Your insurance will have a contracted price for each service. They pay based on that price. You only owe the difference between the contracted price and what your insurance paid. I have found many doctors and hospitals are trying to bill me for the full list price less the insurance payment. They are not entitled to this amount. I also have had doctors submit the bill to the wrong insurance carrier then come back and bill me for the full amount stating that the procedure was not covered. Make certain you only pay what you actually owe and not what the billing service says that you owe.
As far as the rest of the year is concerned, check to see if you have a maximum out of pocket. If you have reached that limit, you will not owe co-pays or deductibles for the rest of the year.

Not all insurance companies work that way. If the insurance company is not a ppo or hmo or something similar then they probably don't have an actual contract for a negotiated amount, in which case you are responsible for the full amount that was not paid by the insurance company.

 

[Piecey]

Like a PP said-- call and ask for an itemized bill ASAP.

I had Lucas 6/3/09 and I've had over $25k in bills pile in ALREADY (emergency c-section) for me alone.... I've called and have itemized copies coming in the mail because sometimes mistakes happen and every little bit of $$ you can save is worth the time!!

Get a copy of the bill-- exactly what it is for, go through your plan brochure on your insurance and figure out why they didn't pay what you expect. Call them, get them to explain it to you.

 

[princessbride6205]

That's the most frustrating part I think - getting bills months down the line. We received the final bill for DD's birth when she was 6 months old. You never know how much you'll owe!
Hopefully you can have a sense of humor when you read the itemized bills. We were charged for individual cotton balls when DH was in the hospital for an injury. And guess what? Insurance doesn't cover supplies like that - so the cotton balls were not covered. Who makes these rules?!

 

[daleswife]

I am going through the same thing right now. I had surgery back in March and I have a deductible of $3000. I still owe my Dr. $600+ and I owe the hospital $1800+. I send them what I can afford a month. Which is not much. But they just take into consideration that at least I am paying something on the bill.

I had surgery again June 25th and since my deductible was paid from the last surgery, I dont owe anything to the Dr or the Hospital (my insurance pays 100% of in-network after the dedcutible.....I have good insurance).....and I thank God for that cause I got the EOB from the insurance company and the Hospital bill alone was $23100!!!!!!!

 

[Mrs. Bradbury]

I just wanted to add that while everyone is spot on in telling you to ask for itemized billing, you also need to pull out your insurance plan and compare what they're supposed to pay to what they actually paid. Our family has had enough medical bills in the past that I'm positive my insurance company rejects almost all claims at the outset, hoping I'm not astute enough to challenge it. It makes me sick to think of the hardworking but not-so-smart people that are strapped with medical bills they shouldn't have to pay, simply because the insurance company wants to make as big a profit as they can. In my case, my employer is self insured, so they are sticking it to their own employees.

The insurance company Mr. Incredible worked for? That's the way they really are.

Congratulations on your little miracle!

 

[Mrs. Bradbury]

I just wanted to add that while everyone is spot on in telling you to ask for itemized billing, you also need to pull out your insurance plan and compare what they're supposed to pay to what they actually paid. Our family has had enough medical bills in the past that I'm positive my insurance company rejects almost all claims at the outset, hoping I'm not astute enough to challenge it. It makes me sick to think of the hardworking but not-so-smart people that are strapped with medical bills they shouldn't have to pay, simply because the insurance company wants to make as big a profit as they can. In my case, my employer is self insured, so they are sticking it to their own employees.

The insurance company Mr. Incredible worked for? That's the way they really are.

Congratulations on your little miracle!

 

[akenneson]

I agree with making sure you look over everything carefully. Then, if you don't want to shell out the money all at once, call the billing department and ask what they can do to work with you. When I had my first daughter, we had about a $2000 bill (after insurance) from the hospital. I asked what my options were for a payment plan. They split it up over a 2 year period with a reasonable monthly payment, no interest. And they told me that if for some reason I couldn't make my payments one of the months or it was going to be late, to just let them know so it wouldn't go to collections or anything. They were really very nice. Fortunately, we were able to pay it off way ahead of time, but it was nice to have the options and to see the willingness of the hospital to work with us.

 

[dhardawa]

Not all insurance companies work that way. If the insurance company is not a ppo or hmo or something similar then they probably don't have an actual contract for a negotiated amount, in which case you are responsible for the full amount that was not paid by the insurance company.

Just want to clarify, an insurance company is not a PPO or HMO. An insurance company offers different products. A PPO or an HMO is a product. I work for a major insurance company and a legit insurance company (i.e. not a self-insured employer or something) will have contracted rates.

 

[wishtdream]

I just wanted to add that while everyone is spot on in telling you to ask for itemized billing, you also need to pull out your insurance plan and compare what they're supposed to pay to what they actually paid. Our family has had enough medical bills in the past that I'm positive my insurance company rejects almost all claims at the outset, hoping I'm not astute enough to challenge it. It makes me sick to think of the hardworking but not-so-smart people that are strapped with medical bills they shouldn't have to pay, simply because the insurance company wants to make as big a profit as they can. In my case, my employer is self insured, so they are sticking it to their own employees.

The insurance company Mr. Incredible worked for? That's the way they really are.

Congratulations on your little miracle!

I agree with the above post

also:
My insurance goes through periods when they reject every claim. As the insured I must call and explain to them why the service was needed and they often resubmit.

Neo- Natal bills are automatically rejected because they are out of network (there is no in network provider - they do not accept any insurance) and your child also has a Pediatrician. On appeal they are always paid.

It seems to be a game of cat and mouse. What can we get these poor unsuspecting people to pay for today?

For the birth of my first child I received a bill for $7000 for the assisting doctor on my child's 1st birthday. This was the first bill I received from this doctor. In the process of dealing with my insurance and her office I found out that she was scamming me and had already been paid by my insurance.
For the dame delivery which was a scheduled C- section I was billed for an epesiotomy sp?

Be careful call your insurance and the provider on every single claim

good luck

 

[fatuhiva]

I had a trip to the ER last summer. I got a bill from the ER physician for about $500. When I called the insurance company to ask why I was being billed so much I was first told it's because the ER physicians are out of network. There was no offer to adjust the claim. I questioned how was I supposed to know that since it was an in-network hospital, and also asked what hospital in this area had in-network physicians. I was told that hardly any ER physicians are in-network- still no offer to adjust the claim. My next question was where was I supposed to go in a true emergency to be able to utilize my health insurance since there were no ERs around here with in-network physicians. It was only at this point that the insurance company rep said "we understand that & realize in this case you have no choice in the physician so if it's an in-network hospital we will re-process the claim and treat it as an in-network physician." It was obvious that although the insurance company's policy was to do this, the reps on the phone were trained not to immediately offer that resolution. The customer had to really question/complain about the bill to get the adjustment.

 

[Ava]

Neo- Natal bills are automatically rejected because they are out of network (there is no in network provider - they do not accept any insurance) and your child also has a Pediatrician. On appeal they are always paid.

The neo-natal bills from the hospital were all paid as in network, the only bills we have to pay as out-of-network are the actual neo-natologists that treated DD. Thankfully what they billed was fairly small, and we only owe a percentage of those bills.

For the birth of my first child I received a bill for $7000 for the assisting doctor on my child's 1st birthday. This was the first bill I received from this doctor. In the process of dealing with my insurance and her office I found out that she was scamming me and had already been paid by my insurance.

Yikes! Glad you got it cleared up and didn't have to pay, and hopefully that doctor lost her license for scamming patients! There really should be a time limit for billing, a few times we've gotten bills from doctors many months after the services happened, sometimes many months after we'd stopped seeing that doctor!

P.S. - For those who were talking about different types of insurance, we have a PPO. The "best" plan that my company offers, which is why I'm surprised by how much we owe out of pocket.