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does anyone elses insurance do this

yo.mamayo.mama member
in Babies: 0 - 3 Months

After deductible (standard), my insurance will pay 90% (standard) of newborn wellness care in hospital, but only up to $750 (WTF).

I have NEVER heard of this before. We have a low deductible plan, and I totally did not expect a large bill for my completly healthy infant, and I have $1200+ bill for him.

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Re: does anyone elses insurance do this

  • hunnybunny2021hunnybunny2021
    Many insurances are like this... makes no sense to me why, but most parents get a large bill for baby from the delivery.  I am still waiting for ours... :(
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  • RooskyRoosky
    I have never heard of that...that doesn't sound right.  Hmmm.....I have only heard of an out of pocket max.  That number seems very low.=(
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  • alaskabride2bealaskabride2be
    This is just a way they get out of paying for lots of stuff. It is just a "benefit cap" many insurances have these for different categories and your just happens to have it on newborn care. Some insurances make is a $$ cap and others have visit maxes. So even if you have met your max out of pocket and they should be paying 100%, you are still responsible for the services if you go over the cap. Thankfully my insurance doesn't have a cap for DS.
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  • rouge411rouge411
    This is getting more and more common on plans, but I have seen it mostly for adults, not kids. It's pretty bizarre that they would do that with the hospital bill - they held you responsible for the remainder? If you haven't done so already, I would verify with the insurance company that you are responsible.
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  • FinallyMrsBMWFinallyMrsBMW member
    We just got word that they have filed it with the insurance company.  Our DD is almost 5 months old and we still haven't gotten the final bill.  I'm really hoping that since we met our max out of pocket that we don't get a surprise bill.  Hopefully it all works out for ya!
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  • yo.mamayo.mama member

    imagerouge411:
    This is getting more and more common on plans, but I have seen it mostly for adults, not kids. It's pretty bizarre that they would do that with the hospital bill - they held you responsible for the remainder? If you haven't done so already, I would verify with the insurance company that you are responsible.

    I've been through the ringer with our insurance company, and I even found where the clause is buried in their benefits manual. We are suppose to pay it. I triple check these things though, because my insurance company is always trying to get out of stuff. I asked for an itemized bill for DS from the hospital too. It's ridiculous. $700 a day for room and board fee, when he roomed in with me and was bfed and DH and I did everything for him. That's $1400 right there! $400 for his required and standard hearing test.

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