Out of Pocket vs. Deductible .. HUH ???

Today was the day ... YES I will do it today.

I will take a morning off from work to call the Insurance companies and the Doctors billing office to find out just what these bills mean.

Would someone just tell me in PLAIN english who I owe what and to whom I may owe it.

After compiling the statements for testing done on son #1 and an xray that I had done (referencing toe vs. ottoman in earlier blog post) plus #1 sons ER visit I am literally swamped with pages of bills and "Explanation of Benefits" statements.

Where to begin to make sense of it all.

I call the one that seems the most alarming first. The Emergency room bill.
This came as the Explanation of Benefits statement that declares #1 son is not a member of their health care plan therefore we get to eat that little visit.
0_0
Woahhh back up the bus, how could he be the only member of the family that we decided not to insure ?!?!?
Ehhhh kid you are 17 you take care of it now, we are tired of carrying you ! (insert sarcasm here)

I call the BC/BS people that sent me this explanation.
Apparantly the hospital opted to bill my husbands former employers health insurance instead of his current one.
Oh heck it's only been 2 1/2 years since he has worked for them .. I just can't understand why they wouldn't foot the bill this one time !!

Sooo this morning I call the hospital billing to fix that mess.
I talk with Cathy and explain to her what has happened. I also informed her that the new insurance card was given to the ER when I took my son in and they scanned it so I am not sure how they could have billed the former insurance company.
After some clicking away on her computer she SIGHS loudly.

"Yes indeed you did give them the new card .. I can see it was scanned and entered.
I have no idea why they billed the former company, sometimes I don't know what they are doing over there but I will let you know that I have taken care of it now. Please disregard the 1100 dollar bill that will probably show up in your mailbox today"

Ty Cathy. 0_0

Onto the Doctors group billing and our now current Health Insurance plan.

Apparantly we have these Deductibles and Out of Pocket expenses.
They are listed separately and they show different amounts per person and per family.
One says we have met the family deductible while another line says we have not yet met the individual deductible for #1 son, but yet we still have thousands to go to meet the out of pocket expenses per individual and per family .. confused yet ???
So was I.

I call the insurance company and talked with a woman and requested that she go very slowly .. baby steps .. and walk me through this nightmare.
After repeating back to her several times what she said to me for clarity sake .. I think I get it now.
It is not as bad as I originally thought it was going to be, but we still owe a hefty chunk in deductibles. We took the most expensive health plan through my husbands job .. you know the one that touts the best coverage for a higher employee copay .. but even the best coverage doesn't come without your share of the bill anymore.

Onto the Doctors billing office and we realize there are still some charges that have not been billed yet because they haven't heard back from our insurance company.
Rest assured they will come , but at least now I THINK I am prepared for them.

So just when I get #1 son's billing straight in my head .. the husband goes in for testing of his own this week.

Ahh but this time I am armed with information.. ready to take it on full throttle.

I think !!!!!!