Dustin and his wife are out $300 because they decided not to have a doctor set his wife up with an intrauterine contraceptive after they ordered it. He says that insurance would have paid for the procedure had they decided to go through with it, but now must pay for something they don’t want to use.
I don’t think I’m in the wrong on this, but was hoping for the ol’ Consumerist weigh-in on this.
My wife called her OB to discuss possible birth control methods after our 2nd child was born. The nurse informed her that one option they could consider was the Mirena device. My wife said she wanted to think about it, and the nurse said that was fine, but to help with expediting the process she would begin the steps to order the Mirena.
What she said next seems to be key. The nurse indicated that the pharmacy (CVS Caremark) would contact my wife prior to shipping. It was at that point that my wife would have to give the final yes or no on whether she wanted to go through with the procedure. Shortly after talking to the nurse, we decided not to have the Mirena installed (probably a better term for that) and waited for the phone call from CVS. Instead, we received a call from the nurse indicating the Mirena had arrived. My wife told the nurse that we did not want it, and the nurse said they would take care of it.
Three months later we receive a bill from Caremark for $300 for the Mirena device. It should be noted my wife never went to the OB and never had the device put in. If she had, it would have been totally covered by insurance. After numerous calls, Caremark contends they did not have to call (despite what the nurse said) because we did not have a copay. So basically, by not putting it in, we are stuck with a $300 bill.
Our choice now is to a) eat the cost, b) have my wife perform an unnecessary medical procedure to have the insurance pay it, or b) figure out a way to have Caremark stop billing us.
Are we in the wrong? Should we pay the cost or have the procedure? The product is apparently still at the doctors office unused and unopened.
What would you do in Dustin’s situation?