Insurance Out-of-Pocket - Year Treated or Year Paid?

[Jenny in Florida]

I've been consulting with my friend Google and have already visited my insurance company's website, but I have struck out.

My bills for the breast cancer treatment are spanning two calendar years (2019 and 2020). Because of some confusion about coordinating between my insurance plan and my husband's, a whole bunch of claims and bills from last year are still working their way through the system. So, what I'm trying to determine is how deductibles and -- more importantly -- out-of-pocket maximums are calculated in this situation. 

For example: Let's say that I had treatments with one provider in 2019 that came to $45,000. I was notified earlier this morning that the claim had been filed with the wrong insurance plan. It has now been re-filed with the right plan and is being processed. Once I get the final bill and pay that balance, will it count towards my out-of-pocket for 2019 (year of service) or 2020 (the year in which payment was made)?

Edited January 25, 2020 by Jenny in Florida

[Annie G]

I thought it was based on service date, not when it was filed.  But I have nothing to back that up...just how I’ve seen it done when we’ve incurred expenses at the end of the year that weren’t filed/settled until the following year. 

[Frances]

I’m pretty sure it’s year of service. I know for our health savings account, which we use to cover deductibles and co-pays, it is definitely year of service. When my son had to go by ambulance to the ER once, we didn’t even get any paperwork from our insurance company until about two years later.

[klmama]

Any claims from 2019 should be covered by the insurance for that year, regardless of when they were filed.

[J-rap]

I'm pretty sure it's the year of service, even though I've occasionally wondered that myself when I don't even get the bill till 6 months into the next year...

[Jenny in Florida]

Okay, thanks everyone. 

We have actually met our out-of-pocket for 2019, and I can't imagine we won't meet this year's within a couple of months, so I suppose it doesn't make a huge amount of difference. I was just curious.

[Tap]

Date of service.