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Copay, Deductible Mumbo Jumbo...



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Can anyone help me with how I must pay my deductible an so forth. I have Cigna as well. Cigna said I will have a hospital copay of 250 a deductible of 200 and my Out of pocket is 1500. Do all these monies have to be paid in full before surgery can take place?

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My Dr is the only one that requires the co-pay to be paid upfront. In previous hospitalization I just waited for the hospital to bill me.

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Customarily hospitals will ask for copay and deductibles in advance. I have heard some places that make you pay the out of pocket in advance. I was lucky that my hospital didn't require prepayment. But do be aware that you will have to eventually pay the full out of pocket, my out of pocket is 2,500 and it looks like I'm on the hook for that.

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The hospital copay of $250 may or may not be due on admission - call the hospital and ask. Your deductible of $200 is from any Dr visit - if you have been for sinus problems, injury, anything - you may have met it or will meet it before surgery most likely. Also, there is usually a max deductible per family say maybe $400 or 600 so if others in your family have satisfied that it may be met before surgery. Your out of pocket (opx) is the max you will pay yourself, I met mine with my hospital stay from surgery personally. Sometimes it includes your deductible but it may not. Normally it does not include your copay. So on the high end you may pay a max of $1950 out of your pocket and low side $1750. This is if you do not have individual copays for each Dr's visit. Those are normally due at each visit. You deductible and opx are normally billed to you, it's best to ask your Dr if you need a $0 balance with him before surgery. Now I have to ask you say "I have Cigna as well." Do you mean you have 2 insurances? If you do, your amounts may be lower.

Can anyone help me with how I must pay my deductible an so forth. I have Cigna as well. Cigna said I will have a hospital copay of 250 a deductible of 200 and my Out of pocket is 1500. Do all these monies have to be paid in full before surgery can take place?

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No I just have Cigna and those are the figures they gave me in respect to the surgery. Now for my 6 mths sup. doctors visits I won't have to pay my copay per my doctor. Anyhow Cigna rep said copays don't count towards out of pocket total.

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I have Cigna. My deductible was $1925 with an Out Of Pocket of $3300. My policy also has a $250 hospitalization clause which I did not have to pay. The most you can expect to pay is your Out of Pocket. Once that is satisfied you will be covered at 100%. My policy did allow for my co-pays to be applied to my deductible and OOP. Call Cigna to find out for sure because each policy will be a little different.

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I have cigna.. my deductible was 300 &.out of pocket Max is 2000...so my dr requires I pay my out of pocket to him a week before surgery..the hospital will bill you later..well idk about all hospitals but Baylor will for me..

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It all depends on where you have it done. My doctor didn't ask for anything up front (he said he usually isn't the first to file). The hospital made me pay my $150 copay upfront ( I have a 80/20 with a 1500 deductible, 3000 opp, 150 hospital copay).

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I didn't think that legally they could ask you for the co-pay in advance. It must vary from state to state. I say this because what the doctor charges might be different from what the insurance pays and what you'd actually be responsible for. My doctor said the surgery would be at least $25,000 so I expected to pay the 10% of that as per my insurance. However I only had to pay about $1,000 out of pocket instead.

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I have Cigna and I am hoping that with the doctor bills I already co-paid and the pre-op dr visits will help with the co-pay due at the time of the surgery. I have Medicare Part A ( because I am disabled ) and hope that takes care of part of the hospital bill.

Just taking it day by day.

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