jersey care

[mrcream]

Thanks everyone for your answers. Yes so in fact my wife did have an additional primary policy from her father but that doesn’t stretch onto the new baby because his plan (or maybe all, idk) doesn’t stretch to grandkids. So she got JerseyCare to cover the baby costs in hospital. The Dr.s bill (with her father) was covered, the hospital for child was partially covered by JerseyCare the rest out of pocket from hospital BIZZARE.

B”H it was uncomplicated birth and more or less cheap compared to what would’ve been if C’v there was any setbacks. So I want to protect myself for next time just in case. I guess what @gmd said is best- Ask the doctor to hold off on billing until the hospital bills, Then Jerseycare as the secondary ins will cover the hospital bill and that goes towards the deductible, and then afterwards the doctor will bill which the primary ins should cover.

Is that best and smartest way to go about it? Pardon my ignorance fellow DDFers lol

[etech0]

Thanks everyone for your answers. Yes so in fact my wife did have an additional primary policy from her father but that doesn’t stretch onto the new baby because his plan (or maybe all, idk) doesn’t stretch to grandkids. So she got JerseyCare to cover the baby costs in hospital. The Dr.s bill (with her father) was covered, the hospital for child was partially covered by JerseyCare the rest out of pocket from hospital BIZZARE.

B”H it was uncomplicated birth and more or less cheap compared to what would’ve been if C’v there was any setbacks. So I want to protect myself for next time just in case. I guess what @gmd said is best- Ask the doctor to hold off on billing until the hospital bills, Then Jerseycare as the secondary ins will cover the hospital bill and that goes towards the deductible, and then afterwards the doctor will bill which the primary ins should cover.

Is that best and smartest way to go about it? Pardon my ignorance fellow DDFers lol

Did she get on JerseyCare that time, or just the baby?

[nucheiner]

I am hearing from people that there isn't much of a reason to pay medical bills in NJ. I see this as a serious ethics question. But practically, there doesn't seem like they have much leverage to collect. This may be a good avenue if you feel that the bill is erroneous.

[mrcream]

Did she get on JerseyCare that time, or just the baby?

Yes she was on it, and thus the baby gets automatically no?

[mrcream]

I am hearing from people that there isn't much of a reason to pay medical bills in NJ. I see this as a serious ethics question. But practically, there doesn't seem like they have much leverage to collect. This may be a good avenue if you feel that the bill is erroneous.

Interesting, this wouldn’t get sent to collections?

[etech0]

Yes she was on it, and thus the baby gets automatically no?

Yes, for sure for 60 days (though you need to notify them of the birth and might need to fill out an application for the baby after)

[aygart]

Interesting, this wouldn’t get sent to collections?

FWIU only doctors not hospitals

[Sam Finkelstein]

I am hearing from people that there isn't much of a reason to pay medical bills in NJ. I see this as a serious ethics question. But practically, there doesn't seem like they have much leverage to collect. This may be a good avenue if you feel that the bill is erroneous.

Yup, I know of a guy who ignored dozens of medical bills, till he got sued by a hospital. Ended up settling for about 25% of bill.

[notyettaken]

the hospital for child was partially covered by JerseyCare the rest out of pocket from hospital BIZZARE.

as far as i know if the patient they are billing for (in this case the baby) has jerseycare they CANNOT bill you at all. Makes no difference why jerseycare didn't pay. call your hmo (although the baby probably was on straight Medicaid so call them)


This is not an ethical problem they are not allowed to by law.

[Sam Finkelstein]

as far as i know if the patient they are billing for (in this case the baby) has jerseycare they CANNOT bill you at all. Makes no difference why jerseycare didn't pay. call your hmo (although the baby probably was on straight Medicaid so call them)


This is not an ethical problem they are not allowed to by law.

We once had an issue with out-of-state urgent care. Called HMO in advance to make sure it was covered, but turned out it wasn't (DROPR), and got bills for over a year afterwards. Eventually it was sent to collections, and I wrote to them that it's illegal to bill and we never heard back since.

[notyettaken]

We once had an issue with out-of-state urgent care. Called HMO in advance to make sure it was covered, but turned out it wasn't (DROPR), and got bills for over a year afterwards. Eventually it was sent to collections, and I wrote to them that it's illegal to bill and we never heard back since.

In this case they may have been allowed to bill.

What i wrote is for places that take Medicaid in state, or out of state hospitals that take Medicaid for their state have to accept OOS Medicaid for ER visits.

Places that don't accept Medicaid in state or anywhere OOS (besides ER) I've heard both ways.

[Sam Finkelstein]

In this case they may have been allowed to bill.

What i wrote is for places that take Medicaid in state, or out of state hospitals that take Medicaid for their state have to accept OOS Medicaid for ER visits.

Places that don't accept Medicaid in state or anywhere OOS (besides ER) I've heard both ways.

This was a hospital-affiliated urgent care.

[lakewood34]

Thanks everyone for your answers. Yes so in fact my wife did have an additional primary policy from her father but that doesn’t stretch onto the new baby because his plan (or maybe all, idk) doesn’t stretch to grandkids. So she got JerseyCare to cover the baby costs in hospital. The Dr.s bill (with her father) was covered, the hospital for child was partially covered by JerseyCare the rest out of pocket from hospital BIZZARE.

B”H it was uncomplicated birth and more or less cheap compared to what would’ve been if C’v there was any setbacks. So I want to protect myself for next time just in case. I guess what @gmd said is best- Ask the doctor to hold off on billing until the hospital bills, Then Jerseycare as the secondary ins will cover the hospital bill and that goes towards the deductible, and then afterwards the doctor will bill which the primary ins should cover.

Is that best and smartest way to go about it? Pardon my ignorance fellow DDFers lol

I thought jersey care has no deductibles and you don't have out of pocket costs as long as the provider takes jersey care. If you for example have a doctor that does not take jersey care and a hospital that does for births ( a common scenario) then you should have the doctor wait to bill and have the hospital bill first.This should take care of the deductible on the private insurance and they should cover the doctor who billed second as you have covered your deductible from the hospital bill.You  then can bill jersey care for the hospital .
However your case for jersey care only covering part of the hospital costs makes no sense as there are no deductibles on jersey care (of course the provider must take jersey care)