Insurance plan change for new born?

Question

I was in 100% coverage plan ,on 24-April my kid was born . As per IRS policy Insurance told me that i can change my plan and i have 30 days time period for the enrollnment of my kid and change of plan.

I enrolled my kid and changed my plan (from 100% to 90:10%) on 16th May with effective date of 24- April, Between 24- April to 15-May My hospital and my kid Dr filed the claim for $15000 and the insurance gave 100%.

After 16th Dr office filed another claim for surgery held on 24-April..Now my Insurance is paying only 90% and 10% i need to pay from my hand due to the change in plan.

Question:

Will Insurance will come back to and tell me to pay 10% of $15000 for the amount they already paid ?

Is this common amoung Insurance ?

Is that something i am doing illegal by not paying $1500 to Insurance?

Answer 1

Any change you make, has to be done effective the date of the event - the baby's birth.  So the change was effective April 24th.

Yes, they'll bill you for your 10% share.  

Yes, this is common in insurance.  

If you don't pay them, they'll take you to court, and win, and garnish your wages.  Yes, it's ILLEGAL to not reimburse them according to the plan.

Answer 2

It's possible that the change had not been processed at the time the claim was processed. If they catch their error, they could retract their payment and process it at the lower benefit level.

You did nothing illegal, it just takes time for all of this to get caught up at the insurance level.

Expect to be billed for your co-insurance.

Answer 3

The percentage they pay should be according to the coverage when the services were rendered, not when the bill or claim was sent.