Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Deductible met now what?



Recommended Posts

Had my office visit today with my surgeon and scheduling my EGD, frontera and evaluation. I was told today that my deductible is met, does this mean I will still have out of pocket costs with BCBS, has anyone had to pay both out of pocket and meet deductible? I asked if I was going to talk to someone about costs so I can prepare and I was told it wasn't necessary, so I guess I am confused because my insurance company told me I had 80/20 and I am responsible for 20%, but was told different today by the insurance coordinator.

Share this post


Link to post
Share on other sites

Typically once you meet your deductible, your insurance will start covering a certain % of future claims allowed amount and the rest is due from you until you meet your out of pocket max. For example, my policy has a $3000 deductible and then they cover claims at 80% (meaning I am responsible for the remaining 20%) until I meet my out of pocket max of $5000. So I am responsible for all claims up to the first $3000 of my medical expenses for the year. Now that I have met that $3000, the insurance pays my medical claims at 80%. Once my 20% reaches $5000, my insurance pays all claims after the $5000 in full with no payment due from me. Does that help?

Share this post


Link to post
Share on other sites

Typically once you meet your deductible, your insurance will start covering a certain % of future claims allowed amount and the rest is due from you until you meet your out of pocket max. For example, my policy has a $3000 deductible and then they cover claims at 80% (meaning I am responsible for the remaining 20%) until I meet my out of pocket max of $5000. So I am responsible for all claims up to the first $3000 of my medical expenses for the year. Now that I have met that $3000, the insurance pays my medical claims at 80%. Once my 20% reaches $5000, my insurance pays all claims after the $5000 in full with no payment due from me. Does that help?

Yes it does, thanks a bunch????

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

    • Doctor-Links

      HGH For Sale
      hgh for sale at our online pharmacy
       
      Human growth hormone (HGH) is a small protein which is made in part of the brain called the pituitary gland. It travels in your bloodstream all over your body to make your body grow.
      HGH is very important in the body. It is needed for children to grow normally. It helps make sure there is enough muscle and fat in the body. It keeps our bones healthy.
      Buy Rybelsus online, Rybelsus tablets
      You can order for wegovy at our online pharmacy
      Check for the prices of 0.25mg, 0.5mg and 1mg at our online pharmacy and buy ozempic.
      · 0 replies
      1. This update has no replies.
    • Doctor-Links

      hgh kaufen  in unserer Online-Apotheke  
      Menschliches Wachstumshormon (HGH) ist ein kleines Protein, das in einem Teil des Gehirns, der Hypophyse, produziert wird. Es wandert in Ihrem Blutkreislauf durch Ihren ganzen Körper, um Ihren Körper wachsen zu lassen.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×