health insurance for well check child exam

by seharkhan14 » Wed Nov 10, 2010 09:04 pm

I have united health care(ppo network). I have to pay $390 for my child second vaccination. Insurance paid about $400 for her first vaccination and insurance says that she had met her max of $700. why they have under estimated the procedure.
They should have sent me the letter stating that your child had met the max for the year. After that, you will be responsible for the whole amount for any procedure.
I dont have any job.

Please help me

Total Comments: 5

Posted: Thu Nov 11, 2010 04:44 am Post Subject:

How do you manage to pay PPO insurance premiums without a job?

Do you not know what the coverage limits are under your policy?

Something is amiss here, because most childhood immunizations are fully covered, and might not even be subject to a deductible. Is the vaccination for something unusual -- $400 for one, and $390 for another seems very odd to me. This has to be for something way different than DPT, Measles, Chicken Pox, or Polio. These immunizations are so common, and the cost is so low, that they are often provided free at community health fairs or clinics.

What's the real story?

Posted: Thu Nov 11, 2010 01:36 pm Post Subject:

The real story is someone doesn't really know what they are talking about.

Happens all the time, because people don't typically listen. I can't even begin to recount the number of times I've run into someone pissed about a certain coverage because they didn't understand it and never bothered to understand it so they just blame the insurance company for being terrible.

Posted: Thu Nov 11, 2010 08:21 pm Post Subject: BNTRS

This insurance was through my husband job and he left the company last week.
Answer to your second question:
This insurance company have under estimated the well child expense. They says that they will only cover up to $750 per year. Now, well child exam include doctor exam plus vaccinations. Single well child visit cost insurance about $400 and there are three well check exam per year(for 2010 for my daughter. 9 month, 12 month and 15 month visit for her vaccinations).So,it should be $1200 for the year by the insurance, which in reality is only $750.

Posted: Thu Nov 11, 2010 08:22 pm Post Subject: BNTRS

This insurance was through my husband job and he left the company last week.
Answer to your second question:
This insurance company have under estimated the well child expense. They says that they will only cover up to $750 per year. Now, well child exam include doctor exam plus vaccinations. Single well child visit cost insurance about $400 and there are three well check exam per year(for 2010 for my daughter. 9 month, 12 month and 15 month visit for her vaccinations).So,it should be $1200 for the year by the insurance, which in reality is only $750.

how I am going to pay all of the remaining amount

Posted: Fri Nov 12, 2010 10:06 am Post Subject:

This insurance company have under estimated the well child expense. They says that they will only cover up to $750 per year.



What state are you in, and what insurance company is this? And what kind of insurance is it?

This doesn't sound at all like either HMO or PPO, which are the most common forms of group health insurance provided by employers.

If what you have is merely a "Basic Medical" policy, then the $750 limit could be true, although it is woefully low. If you knew that the coverage was limited to $750 (which could be per child or per policy), you should have been a better "consumer" and determined what the expense was before you incurred it. The insurance company may have underestimated, but you have also overpaid.

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