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BubblesOhSoSleeved

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BubblesOhSoSleeved    129

BubblesOhSoSleeved
Posted

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

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No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

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So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

What is coinsurance?

Sent from my iPhone using the BariatricPal App

The percentage of what you pay and what your insurance will pay.

Example: a silver plan is a 30/70 plan,

Meaning, the beneficiary pay 30% after their deductible has been met and the insurance plan pays 70%

Sent from my SM-G920V using the BariatricPal App

Oh okay the lady said it's 80/20 so does that mean the insurance pays 80 of the out of pocket?

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Yes and you'll be responsible for 20%

Sent from my SM-G920V using the BariatricPal App

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BubblesOhSoSleeved    129

BubblesOhSoSleeved
Posted

Ohh okay thank you for explaining this!

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Lol no problem

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NiecyBelle12    5

NiecyBelle12
Posted

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

Sent from my SM-G920V using the BariatricPal App

So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

What is coinsurance?

Sent from my iPhone using the BariatricPal App

The percentage of what you pay and what your insurance will pay.

Example: a silver plan is a 30/70 plan,

Meaning, the beneficiary pay 30% after their deductible has been met and the insurance plan pays 70%

Sent from my SM-G920V using the BariatricPal App

Oh okay the lady said it's 80/20 so does that mean the insurance pays 80 of the out of pocket?

Sent from my iPhone using the BariatricPal App

Yes and you'll be responsible for 20%

Sent from my SM-G920V using the BariatricPal App

Is that 20% of the maximum out of pocket? Example: My maximum out of pocket is $1000, is it 20% of that?

Sent from my SM-N920P using the BariatricPal App

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BubblesOhSoSleeved    129

BubblesOhSoSleeved
Posted

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

Sent from my SM-G920V using the BariatricPal App

So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

What is coinsurance?

Sent from my iPhone using the BariatricPal App

The percentage of what you pay and what your insurance will pay.

Example: a silver plan is a 30/70 plan,

Meaning, the beneficiary pay 30% after their deductible has been met and the insurance plan pays 70%

Sent from my SM-G920V using the BariatricPal App

Oh okay the lady said it's 80/20 so does that mean the insurance pays 80 of the out of pocket?

Sent from my iPhone using the BariatricPal App

Yes and you'll be responsible for 20%

Sent from my SM-G920V using the BariatricPal App

Is that 20% of the maximum out of pocket? Example: My maximum out of pocket is $1000, is it 20% of that?

Sent from my SM-N920P using the BariatricPal App

No its 20% of the procedure...up until you hit your max. So let's say your part of the procedure is 5000 after the deductible and after insurance pays...you'll pay up to 1000 and then insurance covers the rest. Also your deductible is included in the your of pocket max. So subtract your deductible from your out of pocket max and that's what you'll be left with after the insurance pays their part

Sent from my SM-G920V using the BariatricPal App

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NiecyBelle12    5

NiecyBelle12
Posted

Oh okay. Thank you so much for clearing that up.☺☺

Sent from my SM-N920P using the BariatricPal App

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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