Stressed about doctors bills

United States
July 17, 2008 10:04am CST
So, I'm almost 10 weeks pregnant, I had my first appointment which was just bloodwork and filling out papers. I got a bill in the mail for $98.00 that my insurance didn't cover. Our office pays a TON of money to have this insurance company, it's deducted from my pay which is about $300/mon. I would rather have the $300 than be paying for this insurance, but as it stands the office will not allow me to have that money for anything other than paying for insurance. My husband and I do not make a lot of money, if we are lucky we will reach $20,000 this year. We dropped out of college in our 2nd year because the tutition prices raised in the middle of the semester by $10,000 that they wanted us to pay and we said no. We couldn't afford it. Now, we are paying on $30,000 of student loans and only 1 semester of college credits will transfer to any other institution because it was a private Christian college. It's really frustrating because we have no idea what to do, we feel trapped. Now with pregnancy costs and the fact that they will add up, we just have no idea where to turn to - we are already living with family which is made to seem like a burden because every other day it's "So when do you plan on moving out?" I'm very stressed, anyone have any supportive things to say or offer any advice?
3 people like this
11 responses
@snivelbec (135)
• United States
17 Jul 08
I used to be a benefits analyst and maybe I can help. First thing - the plan that your company offers - is this a cafeteria plan? If so, then you are probably only allowed to change plans at your company's "open enrollment" which for most companies is sometime in Oct-Nov for the following calendar year. If not, ask your HR/benefits department whether and when you are allowed to change plans (assuming your company offers more than one plan). If you are allowed to change plans, perhaps you can find one where maternity care is covered in full. I would also check your EOB (Explanation of Benefits - issued by your insurance company on a per-claim basis) v. your health plan documents. In other words, make sure your claim was processed properly. You'd be surprised at the number of mis-processed claims. In the last couple of months I had a $1500 claim initially denied by our insurance company because someone responsible for data imput screwed up on the benefit expiration date. Is it that your health plan doesn't cover maternity care, or is it that your plan has a deductible prior to your benefits kicking in?"I would rather have the $300 than pay for this insurance," bad move. I definitely understand, when you look at your paycheck, that you imagine how much better life would be if you just had the $300. But try to think long term: Without medical insurance - one accident, one emergency room trip, a couple of days in a hospital - will wipe you out, guaranteed, especially if you have so little to begin with. Your first step should be to drag out your insurance documents and review what is and isn't covered under your plan. If you have questions, do not be afraid at all to pester your doctor's office, your insurance company, your HR person - whomever and whatever it takes. None of these folks are infallible and unless you get into the habit of scrutinizing every insurance transaction which takes place on your behalf (and most people don't), it's an excellent way to end up paying more than you are supposed to.
• United States
17 Jul 08
You are definately onto something here!
• United States
19 Jul 08
It's a family business - there are 4 employees total and the owner picks the health care plans. There's no HR office and no open-enrollment period.
• United States
23 Jul 08
I hope you are checking your responses. Pls message me if you can. Sorry, I've never messaged anyone so I'm not sure how it works but I will check back over the next few days.
• United States
17 Jul 08
Try a loan through Prosper.com; these loans are funded through private individuals, so the rules of the game are a little different than a traditional loan. Yes, it is a loan, but it may help to consolidate some of your other debts. Also, you may need to turn to WIC (Women, Infants and Children) for help. That is what they are there for. Student loans can be deferred, and some can even be forgiven depending upon what career you are in. That is worth checking on.
2 people like this
• United States
19 Jul 08
While it is good information, I refuse to take out any more loans. Loans = debt, and I do not want any more debt. We have looked into WIC - which told us that I would have to be deemed "high risk" by a doctor before I would be accepted into the program. Student loans can only be deferred if you are a full-time college student and considering that I don't have a "career" at the moment due to the inability to complete college, I doubt that would work. But thanks anyways.
@valeria1 (2723)
• United States
17 Jul 08
I am sorry for all this. But I was talking to my husband about it. I am from Brasil and there the doctors are not that expensive. He is French. In France you have all free from your Social Security. I said to him you know if every american went out of the country for doctors this absurd of health system in USA would finish! The ticket plus hospitals and doctors outside of USA is quite cheap. You shold investigate about it!
2 people like this
@Virgie60 (556)
• United States
17 Jul 08
Hi! I have many medical bills too. I have gone through the Access program to get some help with them. My husband & I even though work very hard do not make enough to pay the medical bills of two children having auto-immune disesases. Also you can talk to the Accts. Manager and explain your situation and she will give you paperwork to fill out to get your bill lowered possibly. I hope that you can get some help. And by the way Congratulations you're having a baby!!!!! Please be happy about that. I always say that if I have to pay on medical bills for 10 years than so be it. At least I try to pay something every month and that counts.
@Galena (9123)
17 Jul 08
can't really think what to say, other than it's damn near criminal that some so called developed countries don't have a national health service. I'm glad that if I need medical care I can get it, If something concerns me I can make an appointment to see a doctor, and not be charged for his time and expertise. I only need to pay for a prescription, rather than the cost of my medication. my contraceptives are free. I am glad that if I have an accident, I can just go to A&E and get it sorted. people here complain about things like waiting lists for non emergency surgery, but at least it's there for us when we need it, regardless of whether or not we can afford it. I don't have to weigh up if an illness or injury might be okay if left without medical treatment. it's shocking and shameful that people have to try and find money to pay for their medical treatment. what happens if you just don't have the money? my partner was very ill last year and in hospital for 6 months. he now has twice daily visits from his medical team, which a friend who works in the NHS tells us cost about £50 each time. this is twice a day. there is no way on Earth we could afford to pay for his treatment. however we've both paid taxes as workers, and the NHS is there for people that need it.
1 person likes this
• United States
17 Jul 08
Well today is your lucky day, it seems as if many have given you responses! I myself do OBGYN billing and can tell you as a pregnant worker that only boodwork,non stress test and ultrasounds are billed out on date of service. All of your visits will be billed at the end of the pregnancy. That is after you have your baby. The 2nd comment before mine, that analysist person hit it right on the nail, YOU SHOULD MAKE SURE IT WAS PROCESSED CORRECTLY! I put it in caps because they are right, many people make mistakes. Blood work should be covered under your plan. Ususally all insurances will pay for those types of services as well as have a decent maternal coverage. I would go call the billing office and then make sure that they proccessed it correctly and if so and your insurance isn't paying for it, you can always file for a grevance with your insurance company. Bascially it telling them that you are in a finacial hardship, which it sounds like your in. Also what kind of insurance do you have? Also don't get too stressed about medical bills, most of the time they are processed wrong and there for require alot of back and fourth on the phone. Take down names of people who you speak with like 7/17/08 2:45pm spoke w/sara @ insurance company so that way if things dont go as mentioned, you should speak to a manager and let them know you spoke with so and so on this day and time and she says blah blah blah. They should always honor the mistake. If not i would call the attorney general office and file a complaint. It is a lot of calling and paperwork as well as back and fourth so hang in there and you can win! Oh yeah anytime someone isnt able to help you, you should always ask for a supervisor and if they cant help call the next big wig of the department or even head of the department. Sometimes the doctor themselfs can help elevate but i would try going through the billing department first. then call your insurance company all the while taking down names and notes. I hope this helps
1 person likes this
@sedel1027 (17854)
• United States
18 Jul 08
You should look into what your insurance cover and do the bare minimum. When my nephew was born neither my brother or his wife had insurance. They went through Catholic Charities to have my nephew. I think they paid for everything. You should be on WIC to help cover the cost of food. You probably qualify for Welfare as well as low income housing. Start looking for a new job. $300 is insane for just 1 person on an insurance plan. Plus, I don't think they can force you to carry insurance.
@sedel1027 (17854)
• United States
18 Jul 08
Also, call your loan provider...you can have the loans deferred for at least a year just based on being low income!
• United States
19 Jul 08
They don't force me to carry insurance - but if I don't have the insurance then I don't get the $300 either. So I might as well have something covered right? Also, We have looked into WIC but we will not do welfare or government housing as they require you to not have any money in savings (which we do) and if you do then they take it away. They basically keep you in poverty and while we don't make a ton of money we do have a plan to get out of debt and within 5 years all of it should be gone. It's just right now it's a struggle because we are trying to do our best with what we have and it just seems like it's never enough.
@cher913 (25890)
• Canada
18 Jul 08
hey cher, you mentioned that you are going to a christian college? if you are a christian, i would have to say dont worry! hubby is our primary bread winner and this year, we will be lucky if we get over $20,000. i am on sick leave and will probably not go back to work. i have a few odd jobs on the side, like scrapbooking for people, make and sell cards etc. we have a teenager and an 11 year old (both girls) and without our faith, it would be impossible.
• United States
19 Jul 08
We went to a Christian college - until they raised prices forcing us to leave and just have a ton of debt with no degree to help us out. Without getting too technical on the term Christian, yes I am one. I think I just had a break-down yesterday. After I put things into perspective it's not too entirely bad, I just needed to be slapped a little and told to look at the positive.
@jonesy123 (3950)
• United States
19 Jul 08
Pregnancy can be expensive without the proper insurance coverage, but billing errors can be rampant. I had to resolve so many billing mistakes, it's unbelievable. Not all were pregnancy related, but there were mistakes,too. It doesn't hurt to do your own research and to speak up. During my second pregnancy the ultrasound was billed under the wrong code and not under the pregnancy ultrasound code. It should have been free for me, but no, now the insurance company wouldn't cover it and the doctor's office wanted the money. I wouldn't have it and had to figure out on my own that they entered the wrong code! For my first pregnancy I had to go out of network as the network OB/GYN was an hour away. The doctor's office overbilled for the ultrasound and the insurance company said, we only pay the portion for what we think the ultrasound should have cost. The doctor's office insisted that the price was fair but gave us the option to call around and inquire about prices at other places. We called like ten places and they were all at or below the insurance company price. The OB/Gyn adjusted the price, which greatly reduced our bill. The local hospital tends to bill the wrong insurance company and then claims we wanted to pull one over them by giving them the wrong information (why do they make a copy of the insurance card?). They also send bills to the wrong address and gave my daughter another middle name. And they always seem to bill the insurance company twice, because they tend to get the first bill wrong. Then we either have to pay more in co-pay or get money back.... I could go on. Definitely review everything for correctness, make note of whom you called when and who you spoke to as well as what was said. Try to negotiate payment as well. Your doctor will want to have his payment before the delivery or at least a certain percentage. That bill can be $3 to $4k, although you probably only owe a percentage or that. At least it was for us, when we were out of network. Sit down with the billing person and work something out now. They just want to make sure they get their money. They'll talk with the insurance company and figure out how much you have to pay. Then they'll work out a payment plan with you. You should definitely study your insurance plan in detail and know what is covered, what the co-pay and co-insurance is. You need to plan accordingly. The hospital doesn't ask for up-front. After all the bills are in and the insurance company made a decision, they will want their money, but don't be afraid to ask about a payment plan that meets your financial needs. They may first say no, but go ahead and press them for it. They rather see money come in that way than have to come after you to get it. In regards to your student loans. You can negotiate with those people, too. There is an adjustment option for financial need. It never hurts to ask. And if the first person says no, just keep trying. And as hard as it is, you may have to apply for public assistance. Right now you have to think of your baby. Therefore, any pride issues you may have in that regard have to take a backseat to your baby's need. Make no mistake, babies are expensive to clothes, diaper, and feed. From what you tell us about your situation, you will most definitely qualify for some sort of assistance, and for your baby's sake, you should go for it. You'll be able to get back on your feet and get your life together. Good luck! You guys will be kept in my prayers!
@alpha7 (1910)
• France
18 Jul 08
No investment on education is a loss,although getting pregnant with this could be so worrying and stressful,why not try your hands on some online buz. while you are at home and leave him to continue with what he's doing .Two resources are better off than one. I will advice that you go for health assurance that can cover you for this as well.
@agihcam (1915)
• Philippines
18 Jul 08
First of all, Don't take it seriously ( too much ), having stressed at your condition can affect your babies. Based on this scenario, you should be very pro-active to have some informations or knowledge about how much your insurance can cover when you gave birth to your baby? Right now it is only check ups and minor test for you and your insurance has lots of excess, what if the time that you give birth, I think it is more expensive. Based on your deduction monthly, they should have huge coverage for pregnant employees.