Ins card shows individual deductible at 2,500 and 5,000 for family. How likely is it that my grievance would be resolved?

As the title states. I got a hospital bill (emergency services) for 4k, so I called insurance because I thought they made a mistake. My insurance card clearly states 2,500 deductible.

However, I was informed that the individual deductible is non embedded, and we must hit the 5,000 family plan before the insurance starts to pay.

Going back to the company SBC, it has a line, "‍Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the policy, the overall family deductible must be met before the plan begins to pay" … Which sure, makes sense now, but why did they print the card to show 2,500???

This is SO misleading. Apparently the 2,500 is for an employee – only plan.

Anyway. The CSR was clearly in agreement with me, and helped me file a grievance. How likely is this to actually resolve ? (anthem) Am I going to be SOL?

Side note, timing really BLOWS with 3 kids under 6 and Christmas right around the corner. Sorry, had to whine a little. 😅

submitted by /u/UbiquitousFreckles
[comments]

See also  Kenko Health raises $12 mn in Series A funding led by Sequoia Capital - Business Standard