Money out of pocket day of procedure

[Natasha Estrada 36]

You could try contacting the department that handles managed care in your state. If the insurance has promised the hospital that they will pay the claim at 100% I really don't see what their issue it. Try sending an email to the hospital ceo.

[kimdlawson06 141]

It also depends on if you have the standard or basic plan, I know it is for Bcbs federal. Standard has no deductible. I will have to pay $400. $200 to the surgeon and $200 to the hospital.

[Beni 1,484]

You know the same thing happened to me the hospital insisted that I owed $1,000.00 at registration. We went back and forth a few times. I finally gave up and decided it would all get sorted in the end. I got to the hospital and my co pay was $250. I have bcbs fed. So all of the anxiety for nothing. I knew it wasn't a $1,000.00 but I think the hospital just spits out a canned answer to everyone. Not until the insurance approval is in and they run the account do they find out. Why, I can't tell you.

[kimdlawson06 141]

@"Beni" did you have a hard time getting approval? I'm not there yet but it won't be long!

[angierue 214]

I have Anthem BCBS with an $1100 deductible. I met that with my sleep study back in the beginning of October.

However, my surgeon is out of network and has had issues with my carrier in the past so requires his fee upfront ($3725). The hospital also required my 20% co-pay upfront as well ($2484). I paid all of that Monday at my post-op on Monday.

I knew all this from day one so had planned for it. Any portion of that the insurance ends up covering will come back to me.

Edited November 1, 2014 by angierue

[Beni 1,484]

Approval was very easy. It took 3 days. I did meet the 40 BMI and I had high blood pressure pre-diebetes and sleep apnea

[RedDirtRoads 64]

I have BCBS too. I have to cover out of pocket cost up too 1,500. This leaves me paying 288 to the surgeon and 978 to the hospital. They said it has to be paid before the procedure. I have pre-op lab next week and will give them all my flippin' money then . . . . :-)

[cdenney123 103]

I had a 10% deductable so it cost me 1600 bucks on top of the 1,000 out of pocket I had to get to for the year in order to reach that 10% covered. It was money I did not have but its better then the 20,000 oop

[tawnya71 37]

I have bcbs individual deductible 2800 then they start paying 80% until I hit 4800, then they pay 100% so basically I've pd 4800 for my surgery, but worth it.

[tamg26k 479]

I paid for my surgery out of pocket. I had to pay the surgeon and the anesthesiologist prior to surgery and I had to pay the entire hospital bill the day of surgery, prior to surgery. I wasn't allowed to make payments. It was a little upsetting seeing that the vast majority of people that go to the hospital for any reason at all are allowed to make payments if they owe a balance.

Still am extremely happy with my decision to have the surgery, no regrets, even if it takes me the next 2 or 3 years to pay off!!

[Jersrose43 837]

I don't believe in paying anyone up front for anything and your insurance will back you up on this.

The deductible is used as you seek services. So if you need an egd, ultrasound visits etc. That can eat it

You are billed after

Out of pocket coinsurance is same. First claim comes in gets the charges and once you meet the maximum for the year everyone starts getting paid in full.

I have a $4500 deductible and $4500 coinsurance. So max out of pocket this year $9k

I met the deductible with all the pre-op. Never billed a single dime in advance.

The egd ate up a portion of my out of pocket and the hospital for my sleeve got the final $3.000.

I am still waiting on that bill and it's been 4 1/2 months.

If I had to pay it all up front I'd have gone to Mexico, declared bankruptcy or never have it done

[Crystal88 85]

Well, I ended up not having to pay anything. Whew!!

When the hospital had called me (for about the 3rd time) to confirm my surgery, I brought it up, and the woman said that if I were going to have to pay something, they would inform me; said they try to be good about that stuff so I don't show up to a surprise! lol

[BLERDgirl 6,417]

I had to pay $400. The hospital allowed me to pay half up front and bill me the rest.

[healthychoice2014 13]

I had to pay $400. The hospital allowed me to pay half up front and bill me the rest.

What hospital and insurance do you have?

[Miss Mac 6,262]

My BCBS Federal Employee covered everything except $250, which was billed after the fact.