Don't know what to do

tamarar5 · December 2014

Somehow, something got messed up when adding A to our insurance. Now they are saying that they won't cover her until January 1 OR cover any expenses from her birth.

I. Am. Panicking.

We were in the hospital for 4 days!

Rynleigh · December 2014

Keep fighting it, but also contact the hospital immediately - tell them the situation, and advise that you need to discuss financial assistance right away. Most hospitals are willing to substantially reduce bills for uninsured patients, sometimes to lower than your out of pocket expenses would have been with insurance. Don't hesitate because hospitals are also quick to send unpaid bills to collections.

tamarar5 · December 2014

HR is saying we didn't submit the paperwork within 30 days. I didn't even GET paperwork to fill out until she was almost a month old and turned it in the same day.

Rynleigh · December 2014

Was the form dated within 30 days of delivery? Did you submit by fax, email, or postal service? If it was postmarked for 30 days or less from delivery, or faxed/emailed 30 or fewer days from the date of delivery, special enrollment applies and must be honored. If you didn't get it in until after the 30 day mark, they do have the unfortunate power to refuse to honor it until their open enrollment period

If it was more than 30 days for certain then the very best thing you can do is call the hospital and request a financial assistance packet and get it completed as fast as you can. Just being uninsured is often enough to clear most of the debt even if you aren't low income.

ggatlanta · December 2014

In many states, if you paid a premium, they cannot deny you coverage for the time the premium covered for a paperwork error. Ie they can't say after the fact that you forgot to sign some form and just offer to refund your premium for that time - well, they can offer, but you can't be forced to accept it. So, if you paid a premium, like one that covers a family of 3+ or something, you could try that argument. If your premium changed to include the baby, then I would definitely make that argument. Good luck.

kleigh926 · December 2014

I was always told that a baby is automatically covered under your insurance plan from birth-30 days, so doesn't that mean that anything that happened in that time frame, including the hospital fees, is covered even if you don't add them after the 30 days is up? The other ladies gave you good advice, I would fight this to the end.

kleigh926 · December 2014

Bump burp.

ggatlanta · December 2014

kleigh926 said:
I was always told that a baby is automatically covered under your insurance plan from birth-30 days, so doesn't that mean that anything that happened in that time frame, including the hospital fees, is covered even if you don't add them after the 30 days is up? The other ladies gave you good advice, I would fight this to the end.

I think this is only true IF you successfully add them within the 30 days. That's a grace period to allow you time to add them.

I admit I knew about those deadlines and requested / completed the paperwork as soon as possible after both babies. It's a crazy time of course but I guess I'm type A and really needed to know all the rules ahead of time.

tamarar5 · December 2014

@kleigh926‌ that is what I was told too, but they have revised every single charge.

I just got off the phone with the hospital and they're sending me paperwork, but I have to be denied medicaid first. And my medicare worker is our of the office for two flipping months. Left another message with a backup person, but her VM punt blank says she won't be calling anyone back.

Rynleigh · December 2014

They will have to cover the actual delivery its self regardless if she has maternity coverage, period - that part has no bearing on whether the baby is added to the plan or not. Maternity coverage applies to labor and delivery. What wouldn't be covered if baby didn't get successfully added is any care the baby received, including vaccines, supplies, nursery time, and nurse and doctor's fees.

tamarar5 · December 2014

So the bill is still climbing.

Our part is now up to over $9500.00. And so far, it doesn't look like we have any other recourse other than to pay it out of our pocket.

It's like everyone is tying someone's hand behind their back. The hospital can only make so many concessions. The insurance can't process papers or make an exception if hr doesn't send them. Hr won't send them because they said they received them late. In addition, hr is denying that they gave us misinformation. (Hr gave us the new person paperwork stating they couldn't process it without baby's birth certificate, but birth certificate wasn't processed for six weeks). So basically it's no one's fault but we're getting screwed because we missed deadlines we didn't know about. It's just miserable.

Oh, and here's a laugh for you. The hospital's idea of a payment plan is allowing us to pay off the bill over 12 months. To the tune of $800 and change a month. That's double out mortgage payment.

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