Check your stop-gap coverage/out of area!
Nancy was injured in a fall in Ca in March. It required surgery and 2wks in hospital. When we returned to Wa., I started the usual discussions with the Ins. Co about payments. During one rather firm/long discussion regarding the disbursments of our deductable, $1500, and when the $3000 Stop-Gap Provision would kick-in. I was informed that the S-G ceiling does not apply OUT-OF-AREA????? We would be resposible for 20% of ALL COSTS of the Ca billings!!! I checked my policy and there it was. I called my Agent who was SHOCKED. We had quite a bit of discussion about coverage while traveling before I changed to Regence BlueShild from my former coverage.
They have assigned me my "Personal" benefits co-ordinator due to my persistant auditing of their payments and assignments to us. So far, as of today, she has adjusted the hospital charges in Ca , saving me $700 and a couple local billings for about $200.
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