I will preface this by saying I'm not stressing over this or worried in any way, I'm just posting this to illustrate things for someone else or to give some talking points for the others. I knew what we were in for because both my mom and wife work in healthcare.
So my wife recently gave birth to our first child. He's happy and healthy and we are enjoying our new life. Everything was great for her delivery. She did get an epidural and we stayed 2 days afterwards in the hospital as is the norm. We have decent insurance that has a deductible at $8500 per person with 100% coverage after deductible is met. In most other areas, they also cover a fair amount but maternity is not one of those areas. All of this is to say that we knew 100% going into this that we would owe $8500 and no more. We had already paid a global maternity fee to the OB for about half of the deductible, which meant we were looking at another 4ish thousand.
2-3 days after we got home from the hospital, the first bill arrived. Now I suppose that if you want to get technical, this wasn't actually a bill. Granted, it looked exactly like any other bill that this healthcare group sends out so you could be forgiven for thinking it was an actual bill. The piece of paper did contain the word "estimate" though, which was the indication that it was the hospital completely shooting from the hip and hoping to collect some money. This "estimate" assured us that they had looked at our insurance and the amount that we would owe them was $13000, with none of the charges itemized or explained. (Remember, even if we had not paid a dime toward our deductible, the max we could owe was $8.5k) Enclosed were instructions on how to start making payments toward our balance, which I discarded of course.
Within a couple more weeks, another piece of paper arrived. This time it was from an anesthesia group. No explanation was attached other than the fact that they had talked with our insurance and the amount we owed them was $12000. Now you may be thinking, "uh-oh they may be out of network and you're going to be on the hook for that." Well it just so happens that our insurance company already has the EoB available online. So I start perusing and what do I find? They've already paid out the anesthesia bill and we owe $0 toward it.
I know we often give insurance companies a lot of grief over the ways that they inflate healthcare prices but I do just have to briefly say that our insurance company has always been very quick to go to bat for us whenever issues like this come up.
All of this is just to give another example (I know, not very necessary at this point) of how hospital systems in the US can be so predatory toward patients. Two days after people bring home their first kid is well within the baby-fog when you don't know up from down. I can so easily see how unsuspecting parents might freak out and think that they actually need to start making payments. Its so sad as well because the actual care and attention my wife received was utterly wonderful. All of the doctors and nurses were so great but on the back end the hospital billing services treat people like this.
So there you go. Know your actual insurance benefits and don't let healthcare groups intimidate you.
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