Understand Your Insurance Coverage, Ladies

Ok, the insurance debacle is one that we all struggle with. Isn’t it confusing trying to determine what’s covered, what’s not, what you pay, what your employer pays and what the insurance company pays? Or what your doctor charges.

So, today I decided to look up how much more I had to pay toward the looming $5,000 out of pocket maximum that I’ve been dreading. We got a bill that exceeds our mortgage payment that we’re responsible for. Knew it was coming, but it still hurts to pay that.

Anyway, I start looking online at what my insurance covers, the deductible, the credit toward my out of pocket maximum, etc., and the new bills that I can expect to arrive soon. For $7 and $20. Weird, why aren’t they more? I was totally confused.

So, I called the UnitedHealthCare hotline. After getting miffed at the robot I was trying to get information out of (which actually gave me information), I asked to be transferred to a representative.

Keep in mind, I have done all this before. I had called, asked for how my coverage works, and repeated it back multiple times to be sure I understood. Today, I did the same thing. And, lo and behold, I’m ONLY RESPONSIBLE FOR 20% OF THE COSTS until I pay the $5K out of pocket.

Wait, huh? How did the rep several months ago let me believe that I would have to pay $5,000 before they would cover anything? How did this woman today explain it so well that I now understand that since I’ve reached my $1,500 deductible, that my insurance now covers 80% of this pregnancy and its needs…so that from here on out, if I rack up $5000 in charges, I’m still only obligated to pay $1,000?!

I just saved $4,000 (well, in my head).

I can’t explain what a relief this is and how mad I am at myself that I didn’t ask better questions/clarify sooner. The weight off my shoulders is huge and I can’t believe that we’ve now paid the ‘big bill’ of this pregnancy. Holy moly!!!

Whew, is all I can say.

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