Annual cap reduced

[JanRenae]

Oregon
I am a dependent on my husband's insurance through his work. After multiple doctor appointments and tests I was diagnosed with breast cancer. From the beginning of the year all insurance statements put our annual cap at $25,000.00 we were also verbally quoted $25,000.00 annual cap. Then just a few days before I had a double mastectomy they suddenly started stating verbally and in writing only $15,000.00 annual cap. When we called to try and straighten this out they said that the $25,000.00 statements were all a mistake. If you read the fine print in the handbook it says almost as an afterthought that a dependent added after a certain date has an annual cap of only $15,000.00, but this is after it says $25,000.00. Now I am totally out of insurance for the year. The surgery bill has not even hit the insurance company, and I have a lot of follow-up care to go to. Is there anything we can do?

[Zigner]

Originally Posted by JanRenae

Oregon
I am a dependent on my husband's insurance through his work. After multiple doctor appointments and tests I was diagnosed with breast cancer. From the beginning of the year all insurance statements put our annual cap at $25,000.00 we were also verbally quoted $25,000.00 annual cap. Then just a few days before I had a double mastectomy they suddenly started stating verbally and in writing only $15,000.00 annual cap. When we called to try and straighten this out they said that the $25,000.00 statements were all a mistake. If you read the fine print in the handbook it says almost as an afterthought that a dependent added after a certain date has an annual cap of only $15,000.00, but this is after it says $25,000.00. Now I am totally out of insurance for the year. The surgery bill has not even hit the insurance company, and I have a lot of follow-up care to go to. Is there anything we can do?

You will need to follow the terms of the plan.
Are you saying you wouldn't have the surgery if the cap were $15,000?