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Insurance Out of Pocket Maximum MommyBearTo4 Fenton, MO, United States 344 posts
May 8th

Before we conceived we called the insurance and discussed our coverage being that it is completely different than our last baby (new insurance)
my question is this:
I have a maximum out of pocket of $2,000 so Iv been paying on my labs and ultrasound bills up to this point. (My dr is under global billing so I won't get those until after delivery)  the labs so far have easily equaled up to 600$. That I have paid after coverage. That is taken off the 2,000 out of pocket correct? 
When I called insurance months ago, they assured me with the dr bills, labs, ultrasounds, AND delivery that I won't come out of pocket More than $2,000 in one year since that is my coverage plan. 
dumb question I know- but will the bills just stop? Will I have to dispute each one? Or call the insurance after the $2,000. 
TIA 
i plan to call and order my breast pump tomorrow thru insurance so I'll ask questions then. Just wanted your take on it also! 

Addi&Aria'smama 2 kids; 1 angel baby; Florissant, Missouri 8261 posts
May 8th

The bills should stop when you hit $2000 which is easy to do with a baby. 

MommyBearTo4 Fenton, MO, United States 344 posts
May 8th

Quoting Addi&Aria'smama:
The bills should stop when you hit $2000 which is easy to do with a baby. 


Thanks. I do agree that it adds up quick. I was curious if the insurance companies keep good track of what we pay out of pocket or if I have to do all the work. 
I am OCD so I will do the work anyways. Just don't want to be disputing a ton of bills after she's here. Lord knows I'll have enough to do ;) but I'll do what's necessary. 

Double Jeopardy 1 child; 1 angel baby; Seattle, WA, United States 19373 posts
May 9th

You have to meet your deductible and out of pocket maximum before your health insurance pays out 100%.

Double Jeopardy 1 child; 1 angel baby; Seattle, WA, United States 19373 posts
May 9th

Quoting MommyBearTo4:

Thanks. I do agree that it adds up quick. I was curious if the insurance companies keep good track of what we pay out of pocket or if I have to do all the work. 
I am OCD so I will do the work anyways. Just don't want to be disputing a ton of bills after she's here. Lord knows I'll have enough to do ;) but I'll do what's necessary. 


My insurance does a really good job at it. They don't track co-pay but anything that they don't pay and not discounted, they either place under deductible or out of pocket.

Drew90 2 kids; 2 angel babies; Hodgdon, ME, United States 7232 posts
May 9th

I was still billed,  but when i called the billing department they told me the insurance company was handling it, that they were just sending me copies of the bills. So don't be surprised if they keep sending them lol.  The only bill they never sent me was from the actual delivery. 

mrs.white8389 TTC since Jan 2016; 2 kids; 1 angel baby; Florida 2628 posts
May 9th

Quoting Double Jeopardy:
You have to meet your deductible and out of pocket maximum before your health insurance pays out 100%.


This! You could have a high deductible and you have to meet both before the bills stop. 

our insurance is a $0 deductible and $1900 family out of pocket max. To have a baby I would have to fully pay my out of pocket max by 21 weeks as that's what is required by my doctors office, so they know insurance is fully covering everything and you won't dodge the bills.