Maxed out my insurance benefits

[JustWatchMe 7,117]

Ouch!

I have excellent insurance coverage. Paid minimal out of pocket for banding in March and pay small amounts after insurance for each fill. I came home yesterday to find I owe $764 dollars from a routine 6 month blood panel ordered by my PCP in June. I was sure it was a mistake. The gross amount charged was $870. Nope. I called the number and they said my insurance benefits have maxed out for the year. Yikes! I have a fill scheduled with my LapBand office Tuesday and was planning a mammogram in November. I need to call the insurance office Tuesday to see what will and what won't be covered for the rest of 2014 but I did not need this bill right now. I was so happy that WLS was covered so well (major medical had my max out of pocket as $2500) but I never thought to check the other coverage. It might just be maxed out in certain categories like blood tests. I had a lot of that this year due to WLS. Trying not to worry.

[Luvin_Life125 558]

You may be in luck with the mammogram and some of your blood work. I believe with the healthcare regulations known as Obama care preventative services are covered at 100% by most policies and are not subject to the copays, coverage maximums, etc. call your insurance and ask about coverage for preventative care. I hope you can get this figured out and find a way to get the services you need. Hugs

[sunnkistme 76]

Read your policy carefully. Yours might be great until you reach a certain dollar amount and then not so great until you reach another dollar amount. The ACA requires that there not be a lifetime max paid by the insurance co. My not so great insurance is better this year than last year because this year there is an 8500.00 limit for our of pocket expenses.

[sunnkistme 76]

^{You might look at the policy year too. If your policy runs 1/1-12/31 there might be services that can wait until the new year.}

[JustWatchMe 7,117]

I spoke to BCBS today and it was only the "routine" category (exams, blood panels) that I maxed out until December 31. I can live with that. My mammogram is due in February which is a new year anyway and my LapBand visits are billed differently than routine so I'm good. Whew! Going for a fill today. Thanks everybody!