Reporter Michelle Andrews explains:
Nathan and Sonji Wilkes thought they had covered all the insurance bases before the birth of their son, Thomas, seven years ago. Their obstetrician and the hospital near their Englewood, Colo., home were all in network. They checked with the health insurer that provided their coverage to estimate their out-of-pocket costs. The expected total: $400.
Thomas's birth was uneventful. But when hospital personnel circumcised him, he wouldn't stop bleeding. He was given a diagnosis of hemophilia, treated and placed in the hospital's NICU, where he received treatment to stop the bleeding and remained under observation for a day. A few weeks later, the Wilkeses got a $50,000 bill for Thomas's NICU stay. They learned that the unit, located on the same floor as the regular nursery and delivery rooms, was staffed by a company under contract to the hospital, and the company didn't accept the family's insurance plan.
"We just thought it was part of the hospital," says Nathan Wilkes. "We had no idea that it was even an option that the NICU could be in a different network."
The moral of the story? Check beforehand to make sure your hospital's NICU is "in-network."
This program aired on January 4, 2011. The audio for this program is not available.