Yes I’ve had that too.
Anesthesiologists are notorious for not being in anyone’s network.
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If something was covered by insurance, then it should be going towards your deductible if it isn’t a copay. For my plan, copays and prescription costs don’t go towards your deductible, but lab work and procedures do. Is it possible your insurance plan website just isn’t up to date? I have BCBS, and it’s honestly a terrible website, so I always have to call if I want the real information about where I am so far in the plan year.
ETA: Oh, but if it was fully covered by insurance, it wouldn’t be counting towards your deductible if you didn’t have to pay anything. so if it was $0 cost to you, then you haven’t paid anything towards your deductible yet. The amount insurance pays doesn’t count towards the deductible
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Ok thanks everyone, haha, this is a real team project and I feel the love. @Bracken_Joy and @mountainmustache29 that makes things a lot clearer.
I’m going to call insurance again to clarify a few things. It honestly kind of sounds like having a deductible plan doesn’t make sense for us? IDK, am I missing something other than the HSA access benefit? Like is that tax advantage alone worth it?
Most of my expenses are co pays for appointments and drugs and then I have lots of labs and imaging but all that is always covered. I never pay towards those other than in the form of a copay. DH has copays and drugs and very little else. I do have crazy pants expensive surgeries every few years, but they are usually mechanical and thus pretty easy to get coverage for.
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Do they have plans without deductibles? I admit I usually go for cheaper premiums because I don’t go to the doctor very often. HMOs?
I think that whatever your plan is, it is probably a really good one because the fact that they are fully covering labs and imaging is pretty amazing. Like, I have a PPO which is supposed to be a “low deductible” plan, but until I meet the deductible I basically pay a negotiated price, and insurance covers very little. So I pay a good amount for any labs/imaging. Once I’ve hit my deductible, I pay a “coinsurance” which is a portion of the cost, until I hit the OOP max when I pay nothing. I wonder if you have a very low deductible, and you actually have already hit it which is why your labs/imaging is fully covered? It would definitely probably be helpful to call them and ask the specifics!
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Sorry, I think I wasn’t accurate 
this is literally day 1 of me doing this. I think we did have a deductible before? But it was lower or something and we didn’t have access to a HSA? I’m not sure but DH switched our plan (same provider) in the last few months and now we have access to an HSA but other costs are increasing.
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I wonder if this could be related to diagnosis as well? Because all of my labs and imaging are related to specific well-known/permanent conditions? Or maybe we have hit it already and it’s not showing online. Obviously I have a lot of reading to do! Our deductible is $3k, fwiw! I have no idea if that’s a lot or not. Oh and I think our plan is a really good one. It’s super inexpensive too. We’re really fortunate that dh works at a place that cares about their employees.
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I will say that in both my and Husband’s health plans, copays and drugs count towards deductibles. Soooooo that another one of those, it depends things.
Honestly your best bet is to get on the phone with the insurance company and ask them. I would hate for you to decide something based on our experiences here and it turn out to not be accurate for your situation.
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I wonder if your husband’s HR department has access to the full document for each healthcare plan? I have to request mine each year because I like to read alllll of the fine print for each plan before selecting. It usually has very detailed information about each and every procedure that is covered, how much the coverage is, etc
Also I wonder if they have like an employee health line type of thing? We have one through my work called Health Advocate, and they can answer all sorts of insurance questions. Of course the insurance company would be the one to call to ask about your specific usage for the year, but the health line often can help explain different facets of the plan.
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Oh wow, ok. Yeah it sounds like I need to call. I’m glad you said that! I think I’ll make a list of questions starting with what the hell counts towards our deductible and go from there.
Oh do you think?! That’s a great idea. I’ll ask him to find out because I looked online and the portal doesn’t have detailed plan information.
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The only stuff that doesn’t go towards our deductible or out of pocket max is our premiums. But so far we’ve only had healthcare at in network providers (I’m very strict about this) so I don’t know if out of network would change things. Looking at our plan documents, we have a separate out of network deductible.
I would gather your recent visits/tests/whatever, and call the insurance company asking why it’s not counting towards your deductible. Any possibility your providers didn’t switch your stuff over to the new insurance policy when the change happened?
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Ok, thanks for the specificity of the instructions. I can definitely get all that together and just go in an itemized fashion with the customer service person.
It’s totally possible they didn’t change our insurance, except for the PT because they actually changed their system so I had to give them all my info again. So theirs is definitely up-to-date.
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Calling to ask sounds like a good idea to me.
I have spent many an hour on the phone with my insurance customer service to figure out what each charge actually meant. They were very willing to sit with me and do a line by line explanation! And in many cases we found boring human input errors that explained why I had unexpected charges.
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$3k deductible is close to the legal limit of how low it can be and still be “high deductible”
We have a high deductible plan because my work gives me so much money towards the HSA that my total premium costs are like $30/year. If yours is doing something like that it might take the sting out of the higher bills?
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Good to know! It kind of didn’t occur to me that they’d be willing to assist me with it? So I’m glad it’s not uncommon.
This is interesting. I have to check but I think his work did give us HSA money, like $1k or something? It could even be more so that would change the accounting on it a lot.
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Oh, and I think maybe this is basic info that you already know but my husband is in health insurance and sometimes it stuns me the things I don’t know. Billing is excessively complicated, and highly political. If you get billed for something that doesn’t seem right, or you don’t think you should have to pay for - push back. They make mistakes alllll the time, and sometimes they just adjust things in your favor because they feel bad about it, if you get the right customer service person. In short, there are no rules and everybody loses.
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Definitely push back if you need to. I have amazing insurance and I actually really love my health insurance system. I think it’s the best you can get in the US. They billed me for a copay of over $2k for my D&E and I pushed back. They resubmitted it to themselves and brought it down to $250.
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Wow maybe I need to call on my D&C… is it too late if we already paid?
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Guava I think?
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