Paying Insurance Up Front

AdaliaAngel · November 2014

Has anyone else been required to pay insurance their entire cost up front? My OB just called and said that I have to bring $1500 to my first appointment this Thursday (Yes, they gave me two days warning), and that I'll be paying $250 a month for 5 months until "everything is paid off."

The problem with that is according to BCBS, who does my insurance, I only have $1480 left of my deductible. So how can they charge me more than that?

We just found out I'm pregnant. We didn't have savings before that, but our goal is to take as much as we can from each paycheck and put it into savings to pay for things like medical bills and baby needs. How do they expect people to magically have the entire cost up front when they didn't even know they'd need it?

Can they turn us down if we don't pay? If we give them every dime we have, we'll still be $400 short for what they want on Thursday. And with our paychecks, $250 a month extra just can't happen.

Has anyone else had this happen at their first visit?

Kbow91 · November 2014

That's a little e absurd. I would be looking for another OB

ashiscute · November 2014

Cassiek90 said:
Jesus I hope not. What is the cost for, just prenatal care? That seems crazy. I don't have much advice but I personally would be looking for another OB. What's the point of insurance if you're paying OOP?

Sorry I can't be of more help, I hope you get this resolved soon!

This. Contact your insurance. Do you have a high deductible policy or something? I would call them and have then explain to you and then search for a different doctor. I've only paid my co-pay at an appt.

AdaliaAngel · November 2014

@ashiscute My deductible is a little high, but it's like half of what they're trying to charge me..

[Deleted User] · November 2014

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lindylogana · November 2014

I've had to pay upfront before but only $150 a each visit. $1500 and then still paying monthly is crazy high. I'd be calling my insurance company ASAP!

teisha030782 · November 2014

Omg no! How my dr office did it with my son is that I would pay like $30 every visit. That way by time the baby arrives I will owe next to nothing. I'm so sorry that's a lot of money upfront.

teisha030782 · November 2014

Call your insurance because that's ridiculous.

slweaver0626 · November 2014

My whole prenatal, giving birth, and hospital stay cost us $3,000 out of pocket after insurnce. I feel like you are being scammed.

[Deleted User] · November 2014

That' not how insurance works! If you have a $5000 deductible the Dr doesn't get to charge you $1000 each visit for 5 visits. They can only charge the agreed upon price generally $150-$300 a visit. I've never heard of being charged everything up fron unless your seeing someone who is out of network for your insurance.

You should call your insurance to confirm their contracted rate with your OB. Then search for a different OB.

hpoff33 · November 2014

I would definitely call your insurance. That just doesn't seem right.

sosueme · November 2014

Yeah, no. You shouldn't be forced to come up with your total OOP expenses prior to receiving service. I'm with all the PPs, call your insurance or start looking for an OB.

Edit: words.

Chasity08 · November 2014

It all depends on what is being done on that first visit. BCBS generally has higher allowables than most other insurances. If at your first appointment you have your office visit, an ultrasound, labs, etc...perhaps they will all be hitting your deductible/oop and the estimate would be $1500. I wouldn't pay more than the estimate for that visit (with ultrasound and labs and all that jazz, call the billing dept at your OB and find out exactly what is being included in that estimate). After that I would pay the OOP for the services being rendered that day. As for the delivery, hospitals will not make you pay that up front, it's part of their policy, so don't worry about that just yet.

However, please know it is well within the realm of most OB practices to ask for payment up front. Just like someone with a co-pay only plan, the co-pay is paid prior to your seeing the Dr. If you have no co-pays on your plan (like myself), and it will be going towards your deductible, you should expect to pay that up front.

Good luck! I do medical coding and billing so if you have any more questions that you would like to PM me I would be happy to answer them for you! Good luck!

AdaliaAngel · November 2014

@chasity08 Thanks! The first visit, they just do a general check up, go over my medical history, and I meet the doctor. They MIGHT do an exam. But they do no blood work or ultrasounds at that visit; they've already told me that.

UTMissy · November 2014

You will pay more than expected as for the most part, drs offices require the cost of all of your maternity care as well as labor/delivery paid for before the third trimester. It all gets paid as a lump sum so despite the fact that you are super close THIS year, the fees are actually going towards next years deductable when the baby is born. Most insurance plans work that way as the maternity bills get ridiculous so if they do lump sum, it keeps the paperwork down. However, remember that the dr and hospital are completely seperate.
I had extremely good insurance with my first so I didn't encounter this but with my last, I had to have the dr paid 100% before I hit third trimester which meant the deductable as well as the negotiated rate until I hit my out of pocket expense (which I didn't hit... the hospital was the bill that hit that number). It was unexpected but legit.
That being said, requiring you to show up with $1500 is concerning! I've never heard of a dr requiring that much upfront! Usually its in payments at the very least with a deadline to have it paid in full!

UTMissy · November 2014

For further clarification, of course they can charge you more than your deductable. That is the amount you have to hit for your insurance to start paying part of the bill! For instance, mine is $500 so I pay $500 and once I pay that total (with the negotiated rates), then it drops to 20% of the total as insruance starts to pay the other 80%. Once I hit my out of pocket (be sure to check to see if your deductable is included in that as its not always!) than insurance pays 100%. Last, some hospitals charge seperate bills for the baby so be prepared for that. That's always a fun unexpected bill to get...

JennyJensing · November 2014

Are you sure that's what they meant? It seems to me like they might have been saying, it will cost you $1500 OOP and you can pay that in monthly installments of $xx. I've never heard of what you're suggesting and I would be looking for another OB, as PPs suggested.

Chasity08 · November 2014

They can't actually make you pay for future services up front. I work at a respiratory and rehab company so I'll use that as an example
We require payment of deductibles and co-insirance up front for the service being performed (say a patient getting a cpap machine for sleep apnea) but we can't say "well we expect you will need this many replacement supplies over the next year so you have to pay for those too" no way. I would be paying for the expected services from that day only, and nothing more. If they're unwilling to do that than as the PPs have said, find a new OB.

AdaliaAngel · November 2014

@jennyjensing Yes, that's definitely what she meant. She gave me a total cost of what we'd owe, and then said, "So you'll owe $1500 at your first appointment, and pay $250 monthly after that." I said "Okay" and she said, "So you'll bring the $1500 on Thursday? Great." And that was the end of the conversation.

I'll see how this appointment goes and what I can do to get them to span it out somehow.. I know going in for an exam does NOT cost that much, and I don't want to let that money go until I at least see a heartbeat..

shelbutler · November 2014

My OB requires you to pay $1,400 up front and then a monthly payment after IF YOU DO NOT HAVE INSURANCE, so everything is paid in full by the third trimester. Are you sure they're not reporting your insurance wrong? I had that happen once before when my insurance changed.

acpm4683 · November 2014

Call BCBS or your agent!!! This does not sound right at all regardless of the plan or deductible.

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