United Healthcare out of pocket expense

[lookg4me 0]

I have united healthcare and was notified today by my Dr's ofc and thru the insurance company that I have 80-20. Which they explained to me that I am responsible for 20% of eligible expenses? I can't seem to find out what my eligible expenses are. Are we talking 1000$, 5000$? Has anyone else encountered this? I just want to make sure I have my ducks in a row. Quack Quack:help:

[maryb 1]

I am UHC with 90-10. If they cover my daughter the cost would be $1500.00 in Houston, Texas. I was private pay at $15,000.00. If yours is the same it should be $3,000.00.

[jtrek 0]

It depends on the amount your sugeon bills the insurance and what they allow.

For instance say your doctor billed the insurance $13,500 and the insurance says the allowable expense for the procedure is $10,000 then you would have to pay $2000 of the $10,000.

The same goes for the amount the hospital or surgical center charges.

Sometimes it is hard to "guesstimate" because the insurance company won't tell you what they will allow on the eligible charges until the charges are actually submitted for payment. I know this because I was a medical insurance underwriter for several years.

[lookg4me 0]

Thanks Jtrek and Maryb. It's all so overwhelming in itself without having to worry about the debt accruing. Hopefully as I get closer to surgery date things will be clearer.:clap2:

[lookingout 0]

when my company gets taken over soon. If I don't have my band put in by them, do they cover the cost of fills? Anyone had this experience? What do ins companies normally do?

[Wheetsin 714]

I was covered by UHC 100%, but Iknow my surgeon billed about $30k and the allowed expenses were about $1600.

[Nana~ 4]

I think 80/20 is what I was and itwas 1200.00 but the will takeit in 50.00 a month payments I know cause I did it~