When we signed up for a health coverage policy, the agent went over each issue. We explained we were okay with a high major medical deductible, but want to only have a co pay of $35.00 for the doctors, lab etc. We signed on. Does it sound reasonable for us to be paying $7,700.00 per year with a $7,500.00 deductible including the doctors visits? This would mean, we would pay out of pocket $15,200 before we even hit the ability to pay a co payment.
I am looking for a rational person to see if this makes sense! The agents just keeps saying "well, that's what you signed for"! The question is not if I signed, the question is: if this amount of payments are correct (for the doctors visit portion), no one would take this policy! Perhaps we have been posted in the system incorrect. For example: At $100 per doctors office visit, we would have to go 75 times in a year to meet this deductible (more than once a week). If this was explained to us, would any rational person buy this policy?
My policy # is **. I have the summary sheet from the agent showing that the deductible on major medical is $75.00, but the doctors office visits has only a $35.00 co pay, yet they have reversed all medical payments to my doctors for general check ups, after they paid them, telling me they should not have paid them because I have not met my deductible.
Can you be of any help? My sales agent sounds like a broken record and has been no help. We have had lab bills and doctor bills reversed by our insurance company after they paid the bills.
