r/HealthInsurance • u/Successful_Job5797 • Apr 10 '25

Employer/COBRA Insurance 30k Labor and delivery bill

Location: Baltimore My girlfriend had our son at Mercy Hospital in Baltimore. We’ve been going there the whole pregnancy no issues. We ended up getting a bill for 30k and they told us her insurance didn’t cover anything. She’s on her mom’s insurance plan which is blue cross Oklahoma. Apparently somewhere in the plan it states grandkids labor isn’t covered. Nobody told us or warned us the entire time we went there. Is there anything we can do or any legal action that can be taken? I understand we should’ve read into it more but we had no idea that was a thing.

My post got removed, is there anything legal I can do? Thank you

137 Upvotes

80% Upvoted

125 comments sorted by

View all comments

Show parent comments

1

u/yuricat16 Apr 11 '25

I think the previous commenter is agreeing with you that the SPD is the document OP wants, and that the literal contract between employer and plan is not widely available as the SPD is what is used instead.

1

u/LizzieMac123 Moderator Apr 11 '25

WHich one?

Jan is saying AI says the SPD is a simplified document (it's not, that's the SBC) and Outrage is saying the employer doesn't disclose the SPD which is also not correct.

1

u/yuricat16 Apr 11 '25

I was referring to Outrage, and I understood that comment to counter Jan’s claim and affirm that SPDs are used instead of the contract/EOC.

A few more words would have made it clearer, but I read it like this, noting my edits:

Summary plan descriptions are used in employer plans [to communicate coverage to members], because the actual contract rests with the employer and cannot be obtained unless there is a lawsuit.

I felt you deserved a response to your question, but I admit this now feels highly pedantic and like I’m belaboring a somewhat meaningless point. I really appreciate all of the work you put into this sub and the excellent and accurate information you provide.

Cheers!

2

u/LizzieMac123 Moderator Apr 12 '25

All good my friend- I admit that I don't know everything and it's my goal as a Moderator to be clear. I appreciate the feedback! No harm no foul in my book, friend!