She said she often waited on hold for long periods and had to explain the situation over and over.
“I was met with a lot of ‘Let me transfer you to this person’ or ‘I can’t help you,’” she said.
At one point, she said, she was told that because she had signed a financial waiver before the procedure, the insurer wouldn’t cover anything. She said she doesn’t remember signing such a waiver.
She also contacted the Pennsylvania Insurance Department. A representative told her that because her plan was grandfathered, it was not required to cover IUDs. The representative suggested Anderson file a complaint, which she did.
About four months after the insertion procedure, her insurer agreed to pay $9,052 of the bill, leaving Anderson with a balance of $5,606, which she said she is now disputing.
Anderson said she was relieved the insurer agreed to pay part of the bill but remains frustrated at the lack of transparency about her plan’s coverage.
“I have the privilege of being able to advocate for myself,” she said. “But I can only imagine if you don’t have the time to spend hours on the phone, where you would be.”
Severino Wynn said Planned Parenthood is seeing more patients with billing problems related to IUDs. When insurance doesn’t cover the devices, patients can try to negotiate with providers, ask if they qualify for sliding-scale fees or payment plans, or file complaints with state insurance regulators, she said.
“It’s about being tenacious and not giving up,” she said. “It’s not fair to have to fight so hard for something that is part of basic health care.”
For Anderson, the experience was not just frustrating but also costly. She said she had to rely on her family for financial support and now is wary of seeking medical care.
“It’s scary to think about what can happen if you’re not constantly advocating for yourself,” she said.
She is now considering filing a complaint with the state’s Office of Administration about her plan’s lack of transparency.
“It’s been very frustrating and very stressful,” she said. “I’m just trying to navigate it as best as I can.”
The Takeaway
If you are considering an IUD or other contraceptive device, it’s important to check with your insurance company about coverage before the procedure. Make sure you understand your plan’s benefits and any potential out-of-pocket costs.
If you encounter a billing problem, don’t be afraid to advocate for yourself. Contact your insurance company, health care provider, and state insurance department for assistance. You may be able to negotiate the bill, set up a payment plan, or file a complaint to seek resolution.
Remember, you have the right to access affordable and comprehensive health care, including contraception. Don’t give up until you find a solution that works for you.
And if you need help, organizations like Planned Parenthood can provide resources and support to help you navigate the complexities of the health care system.
Ultimately, your health and well-being are worth fighting for, and you deserve to receive the care you need without undue financial burden.
about the situation.
A woman was shocked and frustrated when she received a hefty medical bill from Geisinger, and no one had checked her insurance coverage beforehand. She reached out to her doctor’s office expressing her dismay at the lack of due diligence.
Despite her efforts to inquire about financial assistance, she felt brushed off by billing representatives, even after explaining that the bill amounted to more than 20% of her annual income. The stress of the situation eventually led her to seek therapy.
After being connected with Geisinger’s financial assistance office, she was offered a self-pay discount that reduced the bill by $4,211. However, the remaining amount was still more than she could afford. In a final attempt to resolve the issue, she was told that she could receive a 50% discount on the remaining charges if she made a lump sum payment.
In the end, she agreed to pay $5,236 in total to settle the bill. This experience serves as a reminder for patients to be proactive about understanding their insurance coverage before undergoing medical procedures. It is important to read the benefit booklet, contact the insurer, and inquire about out-of-pocket costs.
It can also be beneficial to clarify any coverage exclusions and check if the insurance plan complies with the ACA rules. Patients should advocate for themselves by asking specific questions about procedures and seeking online resources to estimate costs.
When dealing with medical bills, it is crucial to be persistent in seeking discounts and negotiating lower rates with providers. By being proactive and informed, patients can avoid unexpected financial burdens and navigate the complexities of healthcare billing more effectively.
The “Bill of the Month” series by KFF Health News and The Washington Post’s Well+Being has been instrumental in helping patients understand and reduce their medical bills since 2018. If you have a challenging medical bill experience to share, consider reaching out to contribute to this ongoing investigation.
