Never told that this provider was out-of-network and now we received a massive bill…
My dad had spinal surgery back in February, and is still recovering from the effects of his condition. After the surgery, we were provided with a list of rehabilitation facilities by his case worker, and we only had a few days to pick one because the hospital wanted him out. Once we did, the case worker arranged everything, and he was transferred to that facility.
A couple of months later, he was discharged and started receiving home health care, and went back to work under an agreement where he could work from home… until he was fired a couple of months later. We had to scramble to get him health insurance on the marketplace before the workplace plan he had expired and he is working on applying for disability benefits since he is unable to look for a job in his current condition. After significant delays due to a hurricane that knocked out power for 8 days, we finally got him home health care with physical therapy again which started 2 days ago under the marketplace plan. He still has no income for the time being.
I know not all of that was germane to the situation here, but the point is, this has been a horrible year with seemingly no end to highly stressful situations.
Anyway, today, we received a surprise bill from the rehab facility for $5,721.49. This was unexepcted because we had been under the impression that it would be covered 100% because he had reached his out-of-pocket maximum. But we learned today that this provider was apparently out-of-network and this is why the cost applies.
We were never informed of this. The case worker at the hospital did not tell us, nor did the social worker or anybody else at the rehab place.
What do we do now? Is this our fault for not ensuring this place would be in-network, or do we have some recourse here?
It's worth noting that he had a horrible experience at this place too. He often went without eating much because he was served unappetizing meals, and he found the staff to often be unpleasant. We certainly never would have used this provider had we known it was out-of-network, and having to pay so much money on top of this feels like salt in the wound.
submitted by /u/someperson42
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