Dealing with Insurance Companies
Having a child in the NICU brings with it so many emotions and
realities, and often times one of the most stressful ones has to do with
medical insurance. It won’t be long before the bills and phone calls
start pouring in, and while this is the last thing any new parent has
time or energy to deal with, it’s best to be prepared. Here are some
tips that might be helpful:
The first thing to do is to find your copy of your health
benefits book from your insurance company and start reading
it over. You most likely would have gotten this when you first
enrolled in your insurance plan, and sometimes a new one is
given each year with any updates and changes. Find it and
start looking at the specific sections dealing with
hospitalization charges, specialists, and in network versus out
of network charges. You will also most likely have a short
window to contact your insurance provider or employer to add
your new baby as a dependent. This must be done to be sure
they have coverage under your plan.
- Contact someone in the hospital’s billing department. They can
tell you if they accept your insurance and what your estimated
co-pays or out of pocket costs might be for the first couple of
days. Sometimes the NICU social worker also helps in this
area—be sure to ask.
- Start a folder right away labeled with your child’s name and
birth date, and keep ALL receipts, notes, forms, and bills in
this same folder. This keeps everything together in one place.
As a new parent and a NICU parent, your stress level will be
high. Don’t add to it by misplacing important papers or forms.
Make sure everyone dealing with the insurance knows that all
forms go in the folder—it will save lots of headaches down the
- Keep detailed notes. Whenever you talk to someone about a
bill or statement, write down a quick summary of what was
discussed. You can do this right on the bill if there is room, or
attach another sheet of paper if that works better. Include the
name of the person you talked to, the date and time of your
call, and a brief summary of what was discussed. This will be
helpful if later on you have to talk to someone else about the
-Once the bills start really coming in—don’t stress yourself out by
looking them over every day. Just open them, put them in your
folder, and designate one day a week to look over them. Nothing
is going to change in a week’s time, and by setting aside that
specific time each week, you spare yourself a lot of worry and
anxiety over each day’s mail.
-If you are having trouble paying the bills or not getting what you
need, see if your hospital or insurance provider has a medical
billing advocate that you can talk to.
-Know your insurance company’s appeal process. Sometimes this
information is printed right on the bottom or back of bills, if not;
check your health benefits book again. If you think a charge is
denied and it shouldn’t be, you will have to file an appeal. Often
time these are a lot of work—but it is necessary if you think
something isn’t being paid that should be. You may also need to
get detailed medical records on certain conditions or letters from
healthcare professionals like doctors—don’t be shy about asking
for these. In this day and age, doctors are well aware of the
difficulties found in some insurance policies and most likely will
work with you to try and get any issue you may have resolved.
-Lastly, find out if you qualify for any state or federal programs.
Often, the NCU social worker or discharge planner can handle
this. Each state has different criteria and regulations, but you
should check to see if your child is eligible for Social Security
Income, Medicaid/Medicare, WIC, or any other programs.