Hospital doesn’t understand calendar year
I had a hip replacement mid October and have another one scheduled for Dec. 4. I scheduled them both this year knowing I would meet my maximum OOP on the first surgery. The hospital authorization team doesn't seem to understand that I have met my OOP and should pay nothing OOP this go around. They keep insisting that my benefits reset on Dec. 1. I have called my insurance 3 times to verify that they do not reset until January 1. I looked in my insurance plan's app at my benefits and it says calendar year. The only way I can think that the hospital got the Dec. 1 date is that the employer renews their contract that day but the insurance says since our plan is not changing our benefits are calendar year. This is so frustrating because I am only a few days from surgery and have no money to give them if they keep insisting on payment. I don't want to cancel because I know this should be completely covered.
submitted by /u/LimpSwan6136
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