Danny and his wife Linda, who teaches fourth grade at a public school in Canton, Ga., got their health insurance through the state’s Blue Cross Blue Shield plan. Because Danny had torn his Achilles tendon earlier that summer playing basketball, the family had already blown through their $5,000 deductible. Linda’s doctor and their local hospital were both listed as in-network providers, so the Postells didn’t expect they’d have to pay any more out of pocket for Luke’s birth.
But then a stream of mysterious bills started rolling in. Why hadn’t anyone told them there’d be a $1,746 fee for an initial neonatal visit? What is the $240-per-day charge for Luke’s “supervision of care”? Wasn’t this all”“$4,279 in the end”“supposed to be covered by insurance?
Danny, who knew something about medical billing from his work as a pharmacist, quickly discovered the cause. While the local hospital was considered an in-network provider, the neonatal intensive-care unit at that same facility was not. Once Luke was whisked across that invisible line, wham: everything was out of network. “You’d think someone at some point would have told us that,” Danny says.