I have a HDHP through Aetna. About a year ago, I went to an in-network urgent care while on the road for work due to a cough and congestion. The urgent care had me pay 60 bucks, then a couple of months later they sent me a refund check. Aetna had paid for the visit at the contracted rate. I had not met my deductible yet at this time.
Last weekend I went to another in-network urgent care on a Sunday due to an ear infection. This time, the EOB shows I am responsible for the full contracted rate due to not having met my deductible yet. I basically just renewed the same plan and coverages as I had the prior year.
Any ideas about what would explain the inconsistency? Should I call and ask or just be thankful I didn't have to pay on the first urgent care visit? Do you think they paid in error that time? My plan HAS paid for things at 100% in the past that surprised me since I have a HDHP. For istance, I was seeing a nutricionist every two weeks for over a year and they covered all of those.
Should I poke the bear and call Aetna tomorrow asking why this one wasn't covered and the last one was? Or just pay it and count myself luck for not having to pay a year ago?
submitted by /u/No_Consideration7318