How does billing work for the following situation?

Mother is on her own employers insurance, as well as husband's. Mother's insurance is a ppo plan.

Remaining family members are on the father's insurance (hdhp plan)

Mother's deductible has not been met on her plan. Mother has about 1700 remaining on her deductible, and approximately 5700 left on oop maximum from this plan. The current assumption is that providers bill the mother's insurance first, and her insurance sends a subsequent bill to the father's insurance (but not sure if this is necessarily correct).

Husband insurance has met family deductible, and nearly met family out of pocket limit of $5,000. Individual out of pocket is not met for the mother, however (about $4100). This is a hdhp plan.

Mother has her insurance as primary, with father as secondary. Newborn will be on father's insurance once born.

All providers and services will be in network.

How will services for the mother be billed? Has she met oop requirements given she has coverage from the second insurance policy?

How will services be treated for the newborn? Is there a way to have all services billed on father's plan and avoid the remaining deductible on the mother's plan?

Is it possible to get an understanding of what would be considered elective vs required in advance of the birthing? (nitrous oxide)

General thoughts oriented guidance of hearings recommendations from the providers and then following the guidance by obtaining over the counter medicine to avoid the inflated Healthcare costs from the hospital? (miralax, Tylenol, etc)

See also  Promoting Wellness: Employee Health Insurance Benefits

What things would be smart to get in writing from either the providers and /or either insurance company prior to the hospital stay?

submitted by /u/Z44MCoupe
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