"New Health Insurance" not so good when using Emergency Room

[BrownDead]

I'm in Plan U2. My wife was in car accident and was taken to the emergency room. I thought our "new" plan covered emergency room at 100%. Not so, because I keep getting bill after bill for this and that. Even after I have met my family deductible. I'm up to over $1400 dollars in multiple Hospital and Radiology bills, and they seem to keep coming. Has anyone else experienced a costly emergency room visit that the bills never seem to stop ?

 

[Indecisi0n]

Nope. ER has always been 100% no issues. The new/old plan use to be pay 20% for non emergency visits but was revised back to 100% covered. Two thumbs up for teamsters.

 

[Mugarolla]

Nope. ER has always been 100% no issues. The new/old plan use to be pay 20% for non emergency visits but was revised back to 100% covered. Two thumbs up for teamsters.

Maybe in your plan. But for the majority of us who got thrown into Teamcare still have the 80/20 coverage for the ER.

 

[Indecisi0n]

Maybe in your plan. But for the majority of us who got thrown into Teamcare still have the 80/20 coverage for the ER.

I have teamcare.

 

[Wally]

What's a U2 plan?

 

[UpstateNYUPSer(Ret)]

The OP does not say whether his wife was at fault or not----at any rate, either policy (hers or theirs) should cover the balance of any unpaid bills.

 

[upschuck]

Something is not right here.

As you can see there is a maximum out of pocket of $1000, and also pays 100% on day of accident. Call them, and start the appeal process.

 

[superballs63]

The OP does not say whether his wife was at fault or not----at any rate, either policy (hers or theirs) should cover the balance of any unpaid bills.

Not that it matters at all

 

[BrownBrokeDown]

I have teamcare.

Not the same one then. From personal experiance, ER is 80% unless the Dr codes it as life-threatening. Grade 2 concussion was not life threatening. Fully body skin allergic reaction to a child, but it did not affect breathing, was not life threatening. 80% paid.

 

[czalinsky]

Something is not right here.
View attachment 18982
As you can see there is a maximum out of pocket of $1000, and also pays 100% on day of accident. Call them, and start the appeal process.

Where did you get this from?

 

[upschuck]

Where did you get this from?

Teamcare's website

 

[oldngray]

https://www.myteamcare.org/

 

[Mugarolla]

Something is not right here.
View attachment 18982
As you can see there is a maximum out of pocket of $1000, and also pays 100% on day of accident. Call them, and start the appeal process.

He said his wife. He is married. Maximum out of pocket expense would then be $2000. It is $1000 for individual, $2000 for family.

 

[UpstateNYUPSer(Ret)]

Not that it matters at all

Yeah, it kinda does-----if it wasn't her fault all of her medical bills would be paid in full.

 

[Mugarolla]

Yeah, it kinda does-----if it wasn't her fault all of her medical bills would be paid in full.

And then some. Pain and suffering.

 

[cosmo1]

Yeah, it kinda does-----if it wasn't her fault all of her medical bills would be paid in full.

Maybe, eventually.



Been there, done that, Dave.

 

[UpstateNYUPSer(Ret)]

He said his wife. He is married. Maximum out of pocket expense would then be $2000. It is $1000 for individual, $2000 for family.

Maybe, eventually. Been there, done that, Dave.

Me, too. Lady ran a red light and T-boned me at an intersection. Son was in passenger seat----he had to be straight-boarded because the impact pushed the hearing aid in his right ear to the point where there was blood coming out of that ear. All of our bills were paid and they were quick to offer a financial settlement for "pain and suffering".

 

[cosmo1]

The "maybe, eventually" I stated referred to an accident in which my wife was hit by a drunk driver.

His 'sketchy' insurance company and my company argued over stuff long enough that some bills were referred to my Teamster's plan until everything was sorted out.


Life isn't always smooth outside the BOG.

 

[upschuck]

He said his wife. He is married. Maximum out of pocket expense would then be $2000. It is $1000 for individual, $2000 for family.

That is for each individual member in the family. One member of family cannot have more than $1000 out of pocket.

 

[Mugarolla]

That is for each individual member in the family. One member of family cannot have more than $1000 out of pocket.

Incorrect. If you have individual coverage, you are the only one covered, your out of pocket limit is $1000. If you have family coverage, spouse, children, your out of pocket maximum is $2000.

It is not defined per person for family coverage. It is the total out of pocket expense for all family members combined that you may have to pay.