Insurance Can Be Tricky

[ready4animprovedme 54]

So, I have a deductible of $350.00. I have met that. Insurance pays 80% and I am to cover the remaining 20%. Well I have a co-insurance of $2000 but due to doctor visits and other things I have it down to about $1200. Well I called to get an estimate on how much I'd owe and they told me $2200, which I don't think is right. I have Aetna. I'm wondering if they're just assuming that without looking in to MY particular insurance? There is financing available through the hospital but before I can get information from them I have to find out how much I'll be responsible for. I personally do not have $1200 lying around and with surgery approaching, not having things figured out is stressing me out to say the least.

[mufasas-mom 170]

only way to know for sure if to either call Aetna - plus the doctors office who is giving you the estimate - may not have your recent Aetna statement that shows what you have paid to date. Personally - I went to my companies intranet and logged onto our insurance - printed out what has been met already (deductible and out of pocket) - so there is NO confusion when i visit the surgeon's office closer it gets to surgery.

You have to do these things yourself to make 100% sure.

[ready4animprovedme 54]

I will agree with you 100%. Only way to know for sure is for me to call. I guess I was just getting different answers from different people and I was just a little confused. Thanks for your response

[mufasas-mom 170]

Each plan is SO different - I went through all this already, although True Results wouldn't give me a written estimate...which still pisses me off - I hate financial surprises..... I love surprises in general, but not those that cost me money!! But I am lucky and discovered that not only have I met my deductible, but have also already reached my Max Out of Pocket for the year...which means everything is covered at 100% for the rest of the year!! YES - I already confirmed this with the insurance company, as i have no co-pays.

take care and good luck! I have to wait till August to be banded....

[Scooterbug 13]

I will agree with you 100%. Only way to know for sure is for me to call. I guess I was just getting different answers from different people and I was just a little confused. Thanks for your response

If you have to call 3, 4 or 5 times to get the right answers you should do it. It seemed, at least for me anyway, I had to call the insurance company 4 times before I got a correct answer...and that's for even general questions I had for them.

[ready4animprovedme 54]

Each plan is SO different - I went through all this already' date=' although True Results wouldn't give me a written estimate...which still pisses me off - I hate financial surprises..... I love surprises in general, but not those that cost me money!! But I am lucky and discovered that not only have I met my deductible, but have also already reached my Max Out of Pocket for the year...which means everything is covered at 100% for the rest of the year!! YES - I already confirmed this with the insurance company, as i have no co-pays.

take care and good luck! I have to wait till August to be banded....[/quote']

Lucky you! I wish I had already reached my max out of pocket :/. That's awesome for you though!

Bummer on the waiting til August part. But at least you'll have plenty of preparation time! Good luck to you also

[ready4animprovedme 54]

If you have to call 3' date=' 4 or 5 times to get the right answers you should do it. It seemed, at least for me anyway, I had to call the insurance company 4 times before I got a correct answer...and that's for even general questions I had for them.[/quote']

Wowzers. Good thing insurance companies are so helpful :/. Thanks for your response, I shall search for my answers

[Maybe180 4]

Im pre-surgery and tonight at support group I met a lady who has Aetna. She was told lapband was covered. Then, half way through the "pre-stuff" they said "Oops, someone gave you bad information. Weight loss proceedures are excluded. Sorry".

I'm calling tomorrow morning, then again tomorrow afternoon and again right at 6pm when they close. If Im jumping through hoops for NOTHING I will EXPLODE!

[honk 780]

Im pre-surgery and tonight at support group I met a lady who has Aetna. She was told lapband was covered. Then, half way through the "pre-stuff" they said "Oops, someone gave you bad information. Weight loss proceedures are excluded. Sorry".

I'm calling tomorrow morning, then again tomorrow afternoon and again right at 6pm when they close. If Im jumping through hoops for NOTHING I will EXPLODE!

Call your insurance give your ID number and confirm coverage. Every policy is different. It really depends on your company and what they write into the policy.

[ready4animprovedme 54]

That is 100% true. It isn't so much based on the insurance company as much as it's based on your place of employment. Don't explode!

[Maybe180 4]

I just hung up with Vanessa @ aetna. She said its covered. I will call again after lunch.< /p>