Health insurance debacle (Read 2226 times)

monster796

Health insurance debacle
« on: January 23, 2016, 03:54:17 PM »
Hello everyone,


I recently separated from the Military, a week ago to be exact. I was on terminal leave. My wife and I relocated to Arizona and we were assigned a new Primary care provider (civilian) as we are 1 hour away from the closest military base.

In Hawaii, our old provider told my wife she should get a birth control bar inserted after we arrived in Arizona. Our new civilian provider offers birth control but not the bar, so they told us to go to another provider that offers the BC. My wife just received a bill for 460 dollars and I was on active duty at the time of visit. We still had a month of tricare health insurance at the time. The procedure wasn't even done, the bill is for "new patient fee" and a pregnancy test for my wife. Any advice? Anyone experience this Fückery? Thanks!

monster796

Re: Health insurance debacle
« Reply #1 on: January 23, 2016, 04:17:13 PM »
I almost forgot to mention the bill was from the second facility in Arizona.

Q

Re: Health insurance debacle
« Reply #2 on: January 23, 2016, 04:37:54 PM »
Unless it was covered by tricare and the procedure done by a tricare doctor under your tricare insurance, you are stuck with the bill and must pay for it.

mauidog

Re: Health insurance debacle
« Reply #3 on: January 23, 2016, 05:15:55 PM »
Birth Control Bar?  I always thought bars CAUSED many pregnancies!  Who knew?   >:D

You should contact a TRI-CARE patient services rep and ask them.  Insurance policies and what they cover are often complicated.

It may be that the bill is covered, but all providers bill the patient first unless you are seeing an in-network provider.  It may be up to you to file a claim for payment.

Have the rep explain why you are not covered if that's their position.  Ask for specific sources in your policy and any coverage limitations they are citing.  Keep the names and phone numbers of everyone you talk to, in case it turns into a run around.

Insurance providers always put the phrase "any other insurance you have must pay first."  If they all do that, of course it becomes a catch 22 unless you have only one insurer. 

Even if the insurer agrees to pay, you may still have co-pay and deductibles to consider.  For instance, if you have an annual deductible of $500 or more, and this was your only claim in 2016, you have to pay regardless.

As Q stated, YOU are ultimately responsible for the bill getting paid.  Either do the work to get the insurer to make payment, or just pay it and move on.
An unarmed man can only flee from evil, and evil is not overcome by fleeing from it.   -- Jeff Cooper