Ruptured ACL... Stuck with the check

Tonyklem · Apr 3, 2006

Hey guys, about 5 months ago i ruptured my ACL. i ended up getting the reconstruction and i was under the impression that i would just be paying a $200 co-pay. just recently i've been getting bills that have already gone through my(dad's) insurance and the ins. company is barely covering any of the big stuff. I'm talking in the thousands.

The only thing the Hospitol could tell me is I could make payments... I thought that would work... but then they told me roughly what the minimum payment would be... ~$600 per month... Thats like paying for a house. I'm only 19 how am i supposed to afford that??? even if i had a job right now.

I don't kno what im supposed to do with these bills. I can't pay them, neither of my parents can pay them(divorced).

Is there anything i can apply for to get help with these? Both my parents have low income and i am currently unempoyed.

Anyone else in this situation before? What did you do?

(Just to give you guys an idea of what im dealing with, its right up around $12-13k in un-coverd expenses total(so far))

Thanks in advance for any help or suggestions guys.
Tony

jrg · Apr 3, 2006

i think i would be calling the insurance company. I just had my acl done in july, insurance paid everything but 3000, due to my deductible

robwbright · Apr 3, 2006

Contact an attorney . . .

mele63 · Apr 3, 2006

Something doesn't make sense. You were either covered on your Dad's policy or not. If you're covered, the policy has to pay much more than that.

Did the medical providers get pre-approval from the insurance company? They almost always check coverage first, so they don't get stuck with the bill.

Otherwise, there's no easy answer.....get a job and start making deals with the bill collectors. Otherwise, you'll have bad credit for a loooong time.

tnrider · Apr 4, 2006

sounds bogus - if you are still in school (high-school, college, or trade), you should be covered by parents insurance. have them rerun the insurance claim. i have had cases where it had to be run a few times before accepted - hospital usually screwed the paperwork. AND you have to look out for yourself as the hospital does not care who pays and the insurance company will be happy to not pay either... be your own advocate - don't just roll over on this!!! don't think they can sue for medical stuff in PA if you are making any payment -- like $5/month. but then i have not lived there for 10-years, you should talk to an attorny if it comes to this. ask the hospital to rerun the bill past insurance and ask for a justification if it is denied.

robwbright · Apr 4, 2006

Being an attorney myself, I can't advise you strongly enough to contact an attorney. Around here a consultation costs $75-$100 - unless the attorney will take the case on a contingent fee, in which case it will cost nothing up front.

Don't even begin to think that insurance companies are interested in "caring" for their insureds. It just doesn't work that way.

Allstate (otherwise known in the legal profession as "Allsnake") and Nationwide are generally the worst offenders.

In a recent case we had, the attorney for Allstate refused to use Allstate for his personal/family/car insurance.

In another case we have, a woman's house burned down 3 years ago and Nationwide has refused to allow or deny the claim to this date. They put her up in a rental property and quit making the rental payments, at which time she was evicted. Of course, in the long run, they will be paying a whole lot more than the claim was worth.

The insurance company will screw you over if they can (although, ironically, State Farm has treated me well on the 3 SMALL claims I've had).

My .02 worth. . .

Tonyklem · Apr 4, 2006

well heres the thing. the insurance covered small amounts of each thing. there was one bill for like 6k and they covered like 600. so technically they are "covering" me. i dont really kno much about insurance companies.

And if anyone is wondering, my insurance is through MEGA Life insurance. the only reason we have it is because my dad gets it through work (he is self employed as a contractor)

If i do end up NEEDING an attorny, my brother in law is currently in lawschool and his father is one of the biggest lawyers in Vegas. I might have give them a call.

The thing im confused about is:
since i am listed on the insurance, does that obligate the insurance company to cover most of the expenses? or is there usually a set amount of expenses they will cover. If i would contact an attorny what exactly woul i want to tell them or ask them. I'm not really sure what exactly i need to do here.

Thanks so much for the help so far guys, i really appreciate it.

mxgirl118 · Apr 4, 2006

when my little brother was in the hospital a few months ago the insurance said they would not pay more than 200 on a like 15000 dollar bill so we sent it back until they paid it and we only had to pay like 200 or somethin like that if that dosent work hire a lawyer

robwbright · Apr 5, 2006

You have to read the actual contract - it will spell out in SPECIFIC detail what they have to pay and what they don't. It's possible that what they are doing is perfectly fine under that policy.

However, many policies are very long, and include very difficult to understand language. Thus, the need for the attorney. If it was clear and understandable to the average person, attorneys would be doing something else.

Of course, the attorneys plan it that way so they have work - that's what the Bar Association, Medical Association, etc . . . are all about - keeping up the $$ amounts for the "professionals".

ziptiedEXC · Apr 15, 2006

Some insurance is better than others. When my wife started at Exxon, she signed up and paid for Cores insurance. It turned out to be almost useless. When she made manager, she was offered Blue Cross Blue Shield, and it has been excellent.

Ruptured ACL... Stuck with the check

Tonyklem

jrg

robwbright

mele63

tnrider

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robwbright

Tonyklem

mxgirl118

robwbright

ziptiedEXC

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