tom_the_doubter
New member
Someone explain this to me like I’m five because I’m not understanding.
For context:
-Insurance is UMR
-My plan year runs from July 1-June 30
-OOP Max for family is 6,000 and deductible is 1450 for Tier 3 benefits - 65/35. Had to go w/Tier 3 because we moved in the middle of my pregnancy and I refused to switch doctors. I received prior authorization, though.
I had my daughter in Oct 2022. After it was all said and done I owed 5,498 to the hospital, then I received another bill related to her birth for $566.
In early June of 2023 she has to have a surgery. Most of it was covered but I received a bill for 1,261 and another for 84 and some change. It was in network so Tier 1 benefits.
So my question, didn’t I meet my OOP max with my daughter’s birth? Why am I having to pay anything for the surgery? Maybe I’m just confused someone please help!
For context:
-Insurance is UMR
-My plan year runs from July 1-June 30
-OOP Max for family is 6,000 and deductible is 1450 for Tier 3 benefits - 65/35. Had to go w/Tier 3 because we moved in the middle of my pregnancy and I refused to switch doctors. I received prior authorization, though.
I had my daughter in Oct 2022. After it was all said and done I owed 5,498 to the hospital, then I received another bill related to her birth for $566.
In early June of 2023 she has to have a surgery. Most of it was covered but I received a bill for 1,261 and another for 84 and some change. It was in network so Tier 1 benefits.
So my question, didn’t I meet my OOP max with my daughter’s birth? Why am I having to pay anything for the surgery? Maybe I’m just confused someone please help!