medical bills :( and a question

abbysmom1005

My job for the day is to go through all the medical bills from my delivery. yuck!   i just finished going through and matching up EOBs with bills and it looks like we are going to pay just under $1800 out of pocket for everything.  We only paid about $900 for abby with our old insurance.  boooo!  I keep having to put it in perspective though and remind myself how lucky we are to have insurance and that while ours sucks compared to our old coverage (now aetna was humana) that it is still good. the total cost of everything (not negotiated insurance rates, but the total billed rates) was about $15,000. 

 ok now the question. for anyone who has good knowledge of insurance. and yes i know it depends on your individual coverage, but just trying to see if i am reading this correctly. 

On the EOB it gives the yearly plan summary which lists all of our deductibles, and out of pocket amounts, limits, and what we have currently paid.  on it it lists each individuals deductible and max out of pocket but there is also a section for "family limits".  If DH has not paid anything towards his deductible but we have met the "family limit" deductible doesn't that mean he no longer had to pay his deductible?  for his diabetes classes they said they will only pay once the deductible is met, but if we have already met our family limit deductible i would think he no longer has to meet his indivdual deductible, right?  I am going to call aetna to figure this out. i just know we have some very knowledgable nesties so i thought i would ask here first.

thanks!

mcurban

abbysmom1005:

On the EOB it gives the yearly plan summary which lists all of our deductibles, and out of pocket amounts, limits, and what we have currently paid.? on it it lists each individuals deductible and max out of pocket but there is also a section for "family limits".? If DH has not paid anything towards his deductible but we have met the "family limit" deductible doesn't that mean he no longer had to pay his deductible?? for his diabetes classes they said they will only pay once the deductible is met, but if we have already met our family limit deductible i would think he no longer has to meet his indivdual deductible, right??

Yes, at least that is the way it has worked for us (with United). HOWEVER, be aware that the deductibles are different than the co-pays. We have maxed out our family limit between Jon's treatment and Tommy's deliver, BUT we still have copays at Jon's oncologist + Tommy's pedi visits. ?

abbysmom1005

yeah i do not mind paying the co-pays.  but the classes are $250 each and he is suppose to go to 3 of them.    i am going to give aetna a call this afternoon. 

thanks!