Insurance $2500 copay...anyone else have this?

[MizzouFan1 88]

Hi Folks,

I have Coventry insurance and they pay all of the surgery except a $2500 copay. Has anyone else had something similar to this? Is this owed to your surgeon or your insurance and have you been able to set up a payment plan? I have flex spending to cover a good chunk but my husband is also getting the sleeve about a month after me in May (same insurance but we won't have flex to cover his copay). So, total we will owe $3500 in copays to someone....any info would be much appreicated!

Thanks!

[Kindle 8,667]

In most cases I've heard of, (with any surgery/procedure) you will have to pay the deductible to your surgeon before surgery. But you may ask his office for clarification.

[Susysleever 265]

Wow. Bet you could get a <3 bypass cheaper than gastric bypass.

[CarolinaCutie 30]

I had to pay my $3500 deductible before the surgery. I think thats because it's considered "elective surgery"

[awold0 246]

Hi Folks,

I have Coventry insurance and they pay all of the surgery except a $2500 copay. Has anyone else had something similar to this? Is this owed to your surgeon or your insurance and have you been able to set up a payment plan? I have flex spending to cover a good chunk but my husband is also getting the sleeve about a month after me in May (same insurance but we won't have flex to cover his copay). So, total we will owe $3500 in copays to someone....any info would be much appreicated!

Thanks!

I had to pay my yearly deductible max out of pocket of 3500. Surgery was 18,000 and my deductible 3500.

[Kindle 8,667]

Hi Folks,

I have Coventry insurance and they pay all of the surgery except a $2500 copay. Has anyone else had something similar to this? Is this owed to your surgeon or your insurance and have you been able to set up a payment plan? I have flex spending to cover a good chunk but my husband is also getting the sleeve about a month after me in May (same insurance but we won't have flex to cover his copay). So, total we will owe $3500 in copays to someone....any info would be much appreicated!

Thanks!

I had to pay my yearly deductible max out of pocket of 3500. Surgery was 18,000 and my deductible 3500.

That is right, your surgeon may actually require you to pay your max out of pocket if it more than your deductible. A friend just had a hysterectomy and her deductible is $3500 but max annual out of pocket is $5000. Her surgeon required the $5000 before surgery. But again, check with your surgeon' office.

[elfnow 277]

Who you pay the money to may depend on whose claim gets processed first. You might owe it all to the surgeon, or you might owe a big chunk to the radiologist, the Anesthesiologist, and THEN the surgeon! Or the hospital might eat up the whole thing. Talk with your surgeon's office and ask how THEY want to proceed - They may want you to give them a payment up front, but hopefully they won't require the entire $2500 - because it's the insurance company who assigns that out-of-pocket amount based on which claims go through first.... and it can be a real pain to get the money BACK from the overpaid office in order to give it TO the office that needs the money. Just talk with the folks there about how they want to handle it, or call your insurance company and ask whether the copay might apply to the hospital or the ancillary providers (radiology/anesthesia) or how that will work.