Insurance decided to cover something after initially denying but I already paid. (NJ)
I was admitted to the hospital in March this year when I fell down the stairs at 8 months pregnant. In May, I was in the hospital again to give birth to my daughter. I received the bill for labor quickly and paid what I owed. I didnt get the bill for the March hospitalization until July. With the March bill, Insurance only covered some of it and my portion to cover was $2000. I paid the $2000. Between this and labor, I hit my OOP max and deductible for the year.
So I went and did a few medical appointments now that I knew my deductible was met. Now in October, I got a $300 bill from the dermatologist. I checked my EOB/insurance website and all the sudden, it said we didn’t hit deductible. So I called insurance and they said “oh we actually decided to make an adjustment on the hospitalization in march, covering an extra $1500 so you no longer hit your deductible.” They never notified me with a new EOB and I already paid the hospital $2000. They told me I would now have to call the hospital and ask for a refund AND I now have to pay for these new medical bills because my deductible wasn’t met.
How is this fair?/how does this work? I still have to call the hospital but I’m sure they’re going to fight me on a $1500 refund. And how does insurance not have to notify me on an adjustment?
Any advice on how to proceed and get my $1500 back would be greatly appreciated!
submitted by /u/Sweetpotatopancake23
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