Is Balance Billing as bad as it sounds?
I just started a new job and have 30 days to enroll in a new health plan. The options are Kaiser or United Healthcare. The UHC plan seems a lot better than the Kaiser plan (Kaiser has higher copays, bills coinsurance for some items that are ‘no charge’ using UHC, etc.) except for one section.
On UHC’s Summary of Benefits page under “Not Covered by Out-of-Pocket Maximum” it lists “Balance Billing” as one of the non-covered items. The Kaiser plan does not list balance billing.
From my research, it seems that Balance Billing means I am liable to pay for discrepancies between what a provider bills and what insurance pays. This sounds really bad, especially if there’s no out of pocket cap. I know there was a law in 2022 making some aspects of Balance Billing illegal, but not all.
I contacted UHC but the representative was very vague and it was hard to understand what he meant. I don’t think he was fluent in English so it could have been a language barrier. (I specialize in English Language Development and work with language learners for a living.) It was obvious he was trying to downplay the potential effects, but it wasn’t very clear what could happen in worst case scenario situations.
Is this a dealbreaker for an otherwise great plan?
submitted by /u/bananapineapplesauce
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