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Out of Pocket expense after insurance



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Wow. I wish mine was 100%. I am looking at insurance covering 90% of the first 10,000 and 95% of the second 10,000 plus meeting my deductable.

So From what I understand I could end up paying 1,500. Plus meeting my deductable. Which is not bad but I wish I had thought about that cost in the begining of this process. So I could of started saving 6 months ago instead of now at the end trying to figure out how to gather the money in 6 weeks.

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Do you pay the 10% based on the billed amount, or the negotiated rate your carrier has? THAT will determine whether you pay a lot or a little.

E.g. the billed amount for my surgery was around $40,000.

The network negotiated rate was something like $1500.

If you're responsible for 10%, that's a matter of paying $4k or $150.

Yeah, if you'd known sooner you could have taken advantage of a cafeteria program. That too might have made a big difference, but you would have had to have an idea what your total OOP would be.

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I understand that They had to wait to see if insurance would pay and all that but I just wish I would of thought about my cost before the last minute.

So that is one of the reasons I wanted to start this thread so others could posibly think about saving some money for the actual surgery even if insurance covers it. Like mine, Insurance covers just not 100% and as i see even if insurance covers 100% you still have to pay something.

For being a planner I feel I didn't plan very well.

I am just lucky my parents said they would loan me the amount I need to cover the cost so I dont have to postpone the surgery.

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