Highmark Raising Deductible After Birth
Hi, all! I could use some advice.
In December 2021, I had my first son. He was an IVF baby and my OBGYN recommended a lot of extra testing, which I expected and knew I would hit my yearly deductible very quickly. Once my son was born, he was covered under me for the first 31 days; same plan, same deductible.
Fast forward to this past May when I had my second son. He was also an IVF baby and, again, I maxed out my deductible very quickly – in February of this year. I called earlier in the year to obtain documentation for something and confirmed while I was on the phone that the baby would be covered once he was born. I was told yes, the baby would be covered under me for the first 31 days. Honestly, I didn’t prove with any additional questions because I assumed it would be the same – I was never made aware of any changes to my plan since 2021 regarding newborn coverage.
Fast forward again to last week and imagine my shock when the bills start rolling in. I check the paper EOBs (the electronic versions are weirdly not showing in my portal under recent claims) and it’s showing that these bills are amounts billed against my deductible. I’m confused, so I call. The agent I speak to says that even though my son was never officially added to my plan (he was added to my husband’s insurance once we had his birth certificate/ssn), I am still held to the family deductible which is double my usual deductible. I argue with all the points made above, but she keeps repeating that it doesn’t matter if he was added and we go around and around until she finally tells me to appeal and provides the instructions on how to do so.
I know all plans are different, but does this sound right? I just can’t understand how my insurance can move me to the family deductible when I never added another individual to my plan, especially when this wasn’t the case just two years ago.
Also, does anyone have any advice for the appeal? Things to say/include? Are they just going to tell me I’m SOL?
I appreciate any advice/input!
submitted by /u/niklovin0509
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