I had a baby in March and my maternity coverage was $5000 under my insurance policy. According to my earlier conversation with a customer service representative of my insurance provider, they are supposed re-price all my medical bills thru PPO network until my plan maximum is reached. However, in case of my pregnancy I received an outrageous bill of $10,433.80 from the hospital for their facility and services provided during the delivery, and at that time I had $1,432.76 left from my insurance coverage limit for this pregnancy. Instead of re-pricing this hospital bill, the insurance company just paid the hospital this remaining coverage amount of $1,432.76 and in their Explanation of Benifits they are saying that the remaining amount of $9001.04 from the hospital bill is my responsibility, and they have also denied my appeal to re-price this bill.

Did anyone face such problem and any suggestion for me to solve this issue with the insurance company?

The funny part is that if I did not have insurance, I could buy a delivery package from the same hospital at one-fourth of the amount I owe them now. Hence my insurance policy is working against me instead of helping me!!