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Health insurance deductible issue

Framingham, MA |

I have purchased harvard piligrim health insurance plan through mahealthconnector in march 2010. I have 2 persons in the plan (myself and my son).
As per plan, In-network deductible information was given as, $2000 per individual and $4000 per family.
We recently had surgery for my son and total bills came around $3000 on his name. Out of which $2000 should go to individual deductible and remaining should be paid by my plan. But insurance company (harvard piligrim) billed me the whole amount
(around $3000) towards my deductible. When i called both insurance company and mahealthcoonector they are saying i had family plan of $4000 deductible and no question
of individual deductible in family plan. This is the way they are cheating me and making me responsible for the bill. Can you help me.

1)I don't think both deductibles have to meet. 2)They didn't mention anywhere in the plan saying both deductibles have to met. I have read the plan thoroughly. They simply gave $2000 per individual and $4000 per family.

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Attorney answers 1


I believe they are correct. Both the family and the individual have to hit the deductible. In your case, your son hit the deductible, but the family did not.