Paying for surgery

[Timoyal 0]

Good Afternoon all,

I have a question for you guys. My insurance is gonna cover 80%, I have to pay 20% and a $2500 deductible. My question is do I have to pay all of this upfront. I trying to figure out how the heck I am gonna come up with the extra... and financing is out of the question...:thumbup:

TIA

[kagead 0]

Like you, my insurance will pay 80% but my deductible is only $250.

One thing you did not mention- do you have an annual maximum out of pocket? Mine is $3,000, so I know that the most this will cost me after all my copays and deductible is another $3,000. I have about 1/2 in savings and have already spoken with the hospital and they will work out a payment plan for the balance with me.

If you have started on the "program"- going to nutrition classes, having tests run, meeting with the shrink, etc. you will find that you are chipping away at your deductible through those visits. Your insurance company will have you pay those bills in full and will apply your payment to your deductible.

I just had my surgery on Monday, so I am waiting for those bills, along with the ones for my pre-op testing, to start rolling in.

Hope this helps-

kagead

[Timoyal 0]

Thanks for the response, I believe my maximum out of pocket is $4500. One more thing I thought that my insurance pays for the pretesting, psyh eval., etc...

[Bandmom 0]

It depends on the insurance. It covered some of my stuff as part of my coverage, and others I had to pay for as part of my deductible, and some went to co-insurance, and in the end, like Kagead said, it all added up to my out of pocket maximum. I am still waiting on the final bill from the hospital, as I got the one saying they billed my insurance X amount, and now I have to see what insurance pays, what they won't pay and what the hospital really expects after that. I know my best friend, got a bill showing they billed her insurance some ungodly amount, and then the insurance replied back that they were paying a specific amount, and she was waiting for the bill on teh reamining amount, and the hospital wrote it all off, said they collected what they could from insurance and the rest that was deemed "reasonable" charges was not enough to bill, so she was free from it! Many providers bill the top amount and then through contracts with the various insurance companies they actually only get a small percentage of that, so we shall see what they really expect from me!