I hit the lottery!

[rachellepeters]

Not really but I may as well have! This is long, so bear with me!

I am sooo excited right now and can't type fast enough :) Many of you know I lost a baby 17 weeks into a pregnancy in July...well I had crappy insurance (the joys of being self employed) and of the $15K+ bills, my insurance was only going to cover about $6k of it.

A couple weeks after this ordeal my BF added me to his insurance...his company allows it as long as we've lived together at least 12 months. WELL GUESS what, it back dated to the day before the hospital visit. It kicks in 30 days prior to when we faxed in the form...(wish we had done it even sooner than we did, but oh well). A couple thousand wasn't covered (the day before the day his insurance is effetive we had a $700 sono etc, plus the previous dr visits) but I've been watching the insurance online as we've submitted all the bills to the 2nd insurance company. He had a $750 deductible and we weren't for sure if the insurance company would throw a fit and deny the claims since this all happened on day 2 of my coverage, but it worked out fine! I'm soooo amazed. The one that just came in today..the one that had me the most depressed. Bill $10167....mine paid for $4100. HIS insurance is covering $7190! SOOOO I assume I will not get a $3000 refund for the overage (i wish) I assume it will just cancel out and they'll only pay the balance? No matter what, Seeing that huge chunk AS COMPLETED AND PAID, just made my day. I feel like I just won a million dollars!!!!!!!!!!! :) The craziest thing, is being self employed I paid hundreds of dollars for my insurance, for hardly any coverage....he added me to his plan for $4 PER MONTH! $4!!!!!!!!!! I have great health and dental now. It's amazing how different individual coverage is vs. group plans

[shelleyf]

Wow that is such awesome news. I am very happy that they paid and that the burden is off your shoulders.

[oceanbreeze]

I'm so glad this is taken care of and you don't have to worry about the bill anymore :) That was a real stroke of luck, take it and run!

[summermay]

First sorry about your loss. Congrats on getting your bills worked out.

Hubby is self employed, I haven't worked in a long time and we have NO insurance. Well I can sadly beat your total. I just got an $17,892 bill last week to add to the $4300, $9200 and $5700 hospital bills. Still have this months total to add to the pile. I qualify for nothing. Oh well it's only money. They got the lump out, nodes are clear and radiation treatment ends tomorrow.

[disabledvetswife]

As for a refund....did you pay the $10K out of pocket or did the doctor/hospital submit the bill to your insurance? Did the doctor/hospital accept assignment of benefits? Which insurance is primary - his or yours? Either way, a provider (or you if you paid oop) cannot get paid MORE than what was billed.

One insurance will be primary and the other will be secondary. The total paid cannot be more than the billed amount. It's just going to depend on whose primary and whose secondary as to who gets the refund.

[parkerlee]

Good for you!!

[3timesoccermom]

Where does he work??? Must be a great company to pay for those kinds of benefits.

It's sad enough to come home with no baby but when the bills start coming, ugh. I'm happy you got a break.

[notsyourbeezwax]

As for a refund....did you pay the $10K out of pocket or did the doctor/hospital submit the bill to your insurance? Did the doctor/hospital accept assignment of benefits? Which insurance is primary - his or yours? Either way, a provider (or you if you paid oop) cannot get paid MORE than what was billed.

One insurance will be primary and the other will be secondary. The total paid cannot be more than the billed amount. It's just going to depend on whose primary and whose secondary as to who gets the refund.

And having worked as a refund clerk for a large medical practice, I can tell you that the insurance companies will have fun figuring it out. Generally your personal plan will be primary, and your SO's plan secondary, but since yours is not a group plan, that may not be the case. Also, if the secondary insurance has a higher allowable for the procedures than the primary, the secondary CAN pay more than the primary allowed. Just watch what they are doing to make sure that you do not end up on the hook for anything. Anything can happen when 2 insurance companies are involved.

[newbiecouponmom72]

i was a medical biller before a stay at home mom and ususally what happens.. after both insurances have paid and you have paid your copay or deductable.. the hospital has to write off the rest of the balance. its called an adjustment.. the fees that the hospital can bill out are set and the allowable fees that the insurance companies are a set fee as well so anything that is left over is adjusted off by the hospital which means they eat that. after your copay or deductable from all insurances.. you should not have to pay anything usually.

[Queenkim98]

I can read the relief in your post!!! Thats great news.
I'm sorry about your loss.

Kim