Combined in and out-of-network annual out-of-pocket maximum not applying for United Medicare Advantage plan
My mom passed away a couple months ago, and I am dealing with her medical bills. She had a Medicare Advantage plan through United Healthcare. The plan had a combined in and out-of-network 2024 annual out-of-pocket maximum of $5,750. However, if I pay all the bills I am getting that I confirm match up to the 'your share' from explanation of benefits from United, I would exceed that max. United even confirms this here. How is it possible that one of the most basic features of health insurance, an annual out-of-pocket max, is just not getting applied?
And as a follow-up question, I already paid a $500 bill that I received about a month ago, although it turns out it was actually processed after a $4000 bill I just received. Assuming the out-of-pocket max actually gets applied and the $4000 bill exceeds it, does that mean I should not have paid the $500 bill? Will I be able to get that money back?
submitted by /u/Queue_Underflow
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