Charged for IUD removal
My wife is on my health insurance, with Anthem Blue Cross.
Under my plan, Contraception (specifically, what they describe as "Contraceptive Device/Supply", "Contraceptive Surgery – Facility", and "Contraceptive Surgery – Professional") are all covered with 0% copay, no deductible, and no prior authorization required.
She made an appointment with One Medical to ger her IUD removed (this is a specific option she selected when making the appointment). She went in, had it removed, with nothing else happening other than small talk with the doctor, then walked out. A month later we received a bill from One Medical, and also an explanation of benefits from Anthem Blue Cross, which both showed:
Charges of ~$250 for the IUD removal being fully covered by the insurance (with no copay, no deductible), and Charges of ~$150 for an "office visit", which is effectively being billed to us since we haven't met our deductible
Is this normal? The appointment was solely for the purpose of having her IUD removed, and that's all that happened in the appointment. I understand how deductibles work, but don't understand why there is anything separate from the IUD removal (which has no deductible or copay) that would be subject to any deductibles.
It feels very misleading to be told that "IUD removal is covered. no copay! no deductible! no prior authorization! You pay nothing!"… then later to be told "yeah we cover the IUD removal, but not the cost of walking into the building to get it removed".
Assuming this isn't normal or right, what should be our recourse? One Medical has responded saying coverage is the responsibility of our insurance. Insurance has (so far) responded to any questions by using boilerplate language to regurgitate information from our Explanation of Benefits and explaining deductibles to me. Neither has yet explained what is included in the "Office Visit" charge, and why it is considered separate from (and therefore not included in) the IUD Removal('s no-copay and no-deductible coverage).
Do we keep arguing with them? Is there any regulatory body that oversees this? What happens if we simply don't pay? (we aren't in hard financial straights, but this seems wrong on principle).
submitted by /u/beefninja
[comments]
