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United health care wants me to pay a deductible of 12,000 for my whole family?for them to start covering us?

i really don't know how insurance works? my husband got united health care insurance from his job. at first i was so excited about going to the doctor... but after i found this out I'm so stressed. I'm 8 weeks pregnant, and really wanted to go see a doctor..so if i want to see a doctor i have to pay 4000 out of pocket so that i would be covered? and pay it each year? is this a rip off? any advice on what to do? i live in Texas.

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mellyhayes

Asked by mellyhayes at 6:56 PM on Jan. 10, 2013 in Money & Work

Level 7 (159 Credits)
Answers (8)
  • Call the insurance company and talk to them about exactly what is covered. That's not how my deductible worked.
    missanc

    Answer by missanc at 6:59 PM on Jan. 10, 2013

  • You would have to speak to the company to find out how your plan is set up. Plans can be really different depending on the company and the coverage that was picked. We have a $9000 family deductible (or $3000 for one person) before they will cover anything.
    JulieJacobKyle

    Answer by JulieJacobKyle at 7:04 PM on Jan. 10, 2013

  • Depends on what plan you have but normally you get one free exam a year per person and then you pay a copay for any other visits. Maternity coverage may or may not be covered with his plan you need to look at your coverages. He can get this from his HR representative also many doctors offices will tell you what you are responsible for when they look up your coverage.
    amandajoy21

    Answer by amandajoy21 at 7:08 PM on Jan. 10, 2013

  • His job should have offered different plans, the doctor will accept payments if the deduction is correct, but trust me, if you have to have a C-section, or more it will be very expensive, I think you need to talk to your husband about what is covered etc, sometimes the deduct is like an amount per person, so yours may not be 12,000. total.
    jerseydiva

    Answer by jerseydiva at 7:15 PM on Jan. 10, 2013

  • amandajoy21 - not all plans have co-pays.... PPO's will have deductible like the OP mentioned.... HMO's Have co-pays.

    We have a 5000/year, per person deductible with BC/BS for a family of 4.... but our family cap is lower than 20,000. Call and ask them what your deductible is per person and if is a family cap as well. Also, when you call see what exactly is covered for maternity... sometimes they cover more of that and you are not required to pay as much.
    Crafty26

    Answer by Crafty26 at 7:40 PM on Jan. 10, 2013

  • I have a copay with my PPO. I only pay the deductible if something major happens. I'd pay the deductible and then insurance would cover the rest, much like car insurance. Not sure about paying upfront just for coverage to start. I never had to do that.
    maecntpntz219

    Answer by maecntpntz219 at 2:20 AM on Jan. 11, 2013

  • It really does depend on the benefits for your particular plan. For that, you either have to call the ins company, or if they have a log in for you to check online you can do that. Basically many plans nowadays have a large deductible and then after you meet the deductible (say $4000), then you pay whatever the co-insurance is (say the ins pays 80% and you pay 20%).

    However... many plans also cover well child checks and physicals for adults, as well as annual paps, etc at 100% with no deductible. Maternity benefits can also be different depending on the plan. You really just have to talk to the insurance company.
    anime_mom619

    Answer by anime_mom619 at 12:43 PM on Jan. 11, 2013

  • My insurance was not covering a thing until you reach a certain level, not sure was that was so last year I dropped them, I know you cant do that, find out your options. Not sure what I will do this year.
    sunshine196

    Answer by sunshine196 at 2:19 PM on Jan. 11, 2013

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