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OT: Going to murder someone...

Forum: May 2014 Playroom


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  • 1 Post By inyourhonor

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March 17th, 2014, 02:58 PM
MommaBean18's Avatar Gabe & Mason's Mommy
Join Date: Sep 2013
Posts: 1,041
So I got a bill from our pediatrician for $300 and I called them asking what the heck it was for since I was just about to finish a payment plan that was for a lot less than that! They said that it was another bill that our Insurance denied the claim for and to call them.

So I called our insurance company and asked why it was denied. The lady said that it was because my deductible got switched from $300 to $1,600! ***! When the heck did that change? The insurance lady said that our provider changed our plan and to call them.

So I called Sound Health and Wellness and they said "Well you got changed because you didn't do anything to lower your deductible." No one told me I had to do anything to lower it! They said they sent something out in the mail back in October. I never got anything, no one called to check or inform me of the change. I didn't even get a snail mail of information on it! I was so agitated! So then I ask her if she could send me the form again so I could get it taken care of and she said it was too late to lower my deductible this year, and that it had to be done in the Fall. Again, WHAT?! Who is in charge of informing people around here because I am wayyyy out of the loop! Enter the waterworks here, she says she'll email someone and get back to me later on this week on if I can turn it in late or not...

I'm now crying because I'm so freaking agitated! Has anyone ever encountered this before? I don't know about you, but I expect to be informed of my responsibilities before I'm thrown under the freaking bus! If you guys don't hear from me for a while, it's because I've murdered someone and I'm in jail...

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March 17th, 2014, 03:04 PM
Mega Super Mommy
Join Date: Jul 2008
Posts: 4,767
Is your insurance through an employer or is it a private individual plan? Pretty much every insurance plan does enrollment in the fall where they inform you of changes, tell you your options, etc but I've never had one effectively auto-renew with changes that didn't require you to acknowledge your acceptance of them! Deductibles on many plans increased materially this year due to changes mandated in the AHA. I know ours went up substantially.

I just can't imagine that you wouldn't have to acknowledge your acceptance of that kind of change in writing somehow!

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March 17th, 2014, 03:13 PM
Nel's Avatar
Nel Nel is offline
Mega Super Mommy
Join Date: Jan 2007
Location: Alberta, Canada
Posts: 3,014
That doesnt seem like a change they can just make with out informing you properly yet continue to take your money... Seems sketchy

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March 17th, 2014, 03:25 PM
MommaBean18's Avatar Gabe & Mason's Mommy
Join Date: Sep 2013
Posts: 1,041
It's through my employer. I would have thought I'd have to sign or at least e-sign for something, but I've got nothing over here :/

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March 17th, 2014, 03:25 PM
Mega Super Mommy
Join Date: Apr 2012
Posts: 2,387
Wow I would be so mad too! Doesn't seem right...maybe you can fight it somehow?

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March 17th, 2014, 08:05 PM
LUSHaye's Avatar Mega Super Mommy
Join Date: Jun 2013
Location: Colorado
Posts: 1,000
I would fight it. Every year (or so) I get sent stuff from my employer regarding insurance info, and I don't even have insurance through them. It's about rates, etc, and whether or not you want to continue your coverage or not. They changed stuff last year and as far as I know, people had to re-enroll in their plans because things in the policies were changing. I would raise hell about it. You didn't agree to it, you weren't informed of it, you shouldn't be paying for it.
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March 17th, 2014, 08:11 PM
Mega Super Mommy
Join Date: Jul 2008
Posts: 4,767
I would raise h@ll about it! Your employer majorly fell down on the job somewhere along the line of notifying you about major changes to your coverage. You should not be held responsible for their failures. That said - it may be very difficult to actually change policies now unfortunately:/

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March 17th, 2014, 09:36 PM
PointDefiance's Avatar My job is life itself.
Join Date: Feb 2011
Location: Everett, WA
Posts: 3,567
Umm a $300 to a $1600 dollar change!? I'd be making some heads roll! How awful! I hope they can get it changed for u =\
Thank you Jaidynsmum... for the lovely siggy!
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March 18th, 2014, 06:38 AM
inyourhonor's Avatar Platinum Supermommy
Join Date: Apr 2008
Location: Metro Detroit
Posts: 17,592
First off, you don't want to murder anyone, orange isn't a good color on anyone.

Second, I'd be pissed as hell also. I know we got our insurance information back in Oct I believe, or possibly Nov. It stated that our insurance was only changing a bit, by bumping up co-pays and our premiums, but not drastically. So they said you can change your plan, or not. If you don't want to, do nothing. So we did nothing.

I'd definitely be raising hell to get this figured out. Most insurance stuff comes in large envelopes, stuff you can't miss. I know when I get that kinda stuff and it sticks in my mind till we actually look at it. I hope you get it settled and figured out!
MommaBean18 likes this.

Killian Rivers born April 17th at 36 weeks

Killian's Birth Story
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March 18th, 2014, 09:47 AM
Super Mommy
Join Date: Mar 2013
Location: North Texas
Posts: 705
During my open enrollment, I automatically get checked off to renew the same plan unless I manually change it. I always get annoyed because the open enrollment packet that comes in the mail always shows up just before or AFTER open enrollment closes. So I just learned to do everything online from the get-go.Sorry you are having so much trouble. I would be pissed too. I was annoyed recently cuz I received an ER bill for $475 saying my deductible or co-insurance wasn't met. Well, I have no deductible or co-insurance. So to fix it, I have to call my insurance so they can get it corrected for me.

Lucas Xavier is here! Born 4/24/2014 at 10:47pm
7 pounds 6 ounces
20.5 inches long

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March 18th, 2014, 10:06 AM
girlsofsummer's Avatar Us two became we three <3
Join Date: Jul 2012
Location: Pittsburgh (Go Steelers!)
Posts: 2,366
My mom works in HR for a hospital system, and they recently went through a similar change -- do so many of these things or your deductible would be bumped up. But they gave many months notice and many notices via mail, email etc. Your case does not sound like due diligence on the part of your employer.
Mirielle Margaret born 4/24
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