Several months ago my then pregnant wife called the insurance company for a quote.
For normal delivery they quoted her somewhere at $300-400. I'm thinking I can live with that. Now we get our medical bills that total close to $2000. I called my health insurance company and asked where they got that number from. They didn't know...5 minutes later...They did see the note on the account from several months ago stating $3xx.xx estimated. She then said that they quoted her based on paying our deductable and 100% coverage with no coinsurance. They said nothing about the coinsurance only mentioning the deductable and $3xx.xx. Knowing my coinsurance was 80/20 I'm thinking everything is going to be okay, not knowing the cost the hospital and OB-GYN charges for the delivery. Had I known that I can do the math (services-deductable)*0.2 would be my part. The insurance company said they cannot do anything about it since my policy says 80/20 not 100/0 but since they quoted me 100/0 can I do anything to make them honor their quote?

1/19/2006 6:34:47 PM

Quote :

"The insurance company said they cannot do anything about it since my policy says 80/20 not 100/0 but since they quoted me 100/0"

1/19/2006 6:40:16 PM

I think its unlikely to see a favorable resolution to this issue without a lawyer (and that will cost you more than its probably worth). It ispossible the Insurance Commissioner's office can intervene. You probably want to call them. They should be able to advice you of the laws concerning the matter.

If it is $2000, then they will allow you to settle up by making no interest gaining monthly installments over 1 year. Do you have state insurance? I got socked with a $1400 bill, and I delivered a kidney stone, not a baby.

[Edited on January 19, 2006 at 6:55 PM. Reason : /]

1/19/2006 6:54:25 PM

no not state insurance...thanks for the info

1/19/2006 8:07:58 PM

You're bound by your contract. I'm pretty sure that if you read it, you'll find an stupid telephone quote clause... not that they need it.

1/19/2006 8:29:59 PM

There are things you could argue, but I do not think any of them would work

1/20/2006 5:22:49 PM