self pay Self pay in Houston - covered in part because of hernia

[Bredred 45]

Hi All. I'm wondering if anyone has had this issue in the US. I'm a self pay and the hospital my doctor performs surgery at is not in-network with my insurance. My insurance excludes weight loss surgery, but they are subsidizing it in part because I will also be having a hernia repair. My concern is that, while my fee to the doctor and the hospital has gone down for the weight loss surgery, I'm going to be hit with a fee for having the hernia repair at a hospital that is out of network. Both the doctor's office and the hospital have assured me this is not the case, but I'm still worried. I don't know if this is the proper forum for this because I'm a newbie. Would I be better posting in the insurance section?

[Moe33 21]

Probably-someone might have had a similar experience. Everyone here is having or had it done in Mexico.

[Bredred 45]

Thanks. I wasn't sure if this was just self pay in Mexico or self pay in general .

[Pookeyism 1,143]

Hmmm...I had a tumor and it paid in part with self pay. What I did was chose a doctor and got the flat amounts Humana would cover up-front in writing, and then took it off the flat-rate for WMS, with a little extra because I had to have extra exploratory time in surgery to be sure the tumor had not spread.

[Pookeyism 1,143]

My only concerns would be having to return over and over to an out-of-network doctor if yo uhad issues with the hernia.

[Bredred 45]

Hmmm...I had a tumor and it paid in part with self pay. What I did was chose a doctor and got the flat amounts Humana would cover up-front in writing' date=' and then took it off the flat-rate for WMS, with a little extra because I had to have extra exploratory time in surgery to be sure the tumor had not spread.[/quote']

Thanks for your response. I have a contract with the doctor that includes hospital charges - I just don't want any surprises. The doctor himself is in-network so I'm not worried about follow up.