Frugal Babe

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Health Insurance Deductible Scare

November 3, 2008 By Frugal Babe

When I checked the mail late last night, we had an EOB from our health insurance company, saying that we were going to be billed $2600 for my husband’s recent knee surgery.  Holy smokes.  This was his second knee surgery this year, and we had met our $3000 deductible back in January when he had the first one.  Our policy covers 100% after the deductible, and we had pre-certified everything before the second surgery (and had been assured that everything was covered, as our deductible had been met).  The billing people at the hospital also confirmed this before the surgery, so we figured all was well.  So when I saw the EOB, my heart dropped.  What could I have missed?  And how could I have missed something so big?  It was saying that we were still being charged towards a deductible, and I started to wonder if maybe the hospital was no longer in network, and that they were hitting us up for the out of network deductible.  But both the insurance and the hospital had confirmed they were in network, on the day of the surgery.  Oy.  I had to go to bed and try to not think about it until today.

This morning I called our health insurance company, and explained the situation to a very helpful lady.  She put me on hold to try to figure out what was going on, and was gone for a very long time.  But eventually she got back on the line and said that the mistake was theirs, and that we did not owe anything – the whole surgery would be covered by insurance.  So that was a happy ending indeed.  We’re looking into LASIK for my husband right now, and if it had turned out that we actually owed another $2600 for his knee, we would have had to postpone the eye visit for a good long while, to give us time to pad the HSA back up again.  So I’m happy to report that everything turned out ok.  I wish I had waited until this morning to get the mail, so that I didn’t have to worry about it while I was going to sleep last night!

Filed Under: health, insurance 2 Comments

Comments

  1. DD says

    November 11, 2008 at 11:12 am

    I’m glad it worked out so you guys were covered.

    Now it may be the cynic in me, but I think insurance companies make these kind of “mistakes” on purpose. Hoping that some people will just pay them instead of following up like you did.

    Reply

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