Hey guys I’m getting elective surgery (joint replacement) in about a month. I’ll have the surgeon’s bill, the surgery facility’s bill, and the anesthesiologist’s bill. Plus pharmacy.
Anyway I got an email from the surgery center saying “Please be aware we will be collecting the remaining portion of your out of pocket, which is $4,110.90. The reason is because this portion is less than what the 20% co-insurance ($8,524.34) would have cost you, for the facility fee.”
When I look at my insurance website, I see ** Deductible Remaining: $1,610.90**
Until I’m responsible for 80% and I see Out-of-Pocket Maximum Remaining: $4,110.90
So the part of the coverage where I pay 20% covers about $12,500 of actual medical costs of which I would be responsible for $2500.
My question is, is my surgery center doing me a solid by getting me to my OOP max quicker, and saving me money in the long run, or will I somehow end up losing out?
I mean I’m all for reaching the OOM and getting everything else paid 100% but I just want to make sure this isn’t going to backfire on me.
Another thought is, isn’t is possible I’ll have more claims against my health insurance between now and the surgery? For example I still need to see my PCP to get cleared for surgery.
Thanks
submitted by /u/notathr0waway1
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Hey guys I’m getting elective surgery (joint replacement) in about a month. I’ll have the surgeon’s bill, the surgery facility’s bill, and the anesthesiologist’s bill. Plus pharmacy. Anyway I got an email from the surgery center saying “Please be aware we will be collecting the remaining portion of your out of pocket, which is $4,110.90. The reason is because this portion is less than what the 20% co-insurance ($8,524.34) would have cost you, for the facility fee.” When I look at my insurance website, I see ** Deductible Remaining: $1,610.90** Until I’m responsible for 80% and I see Out-of-Pocket Maximum Remaining: $4,110.90 So the part of the coverage where I pay 20% covers about $12,500 of actual medical costs of which I would be responsible for $2500. My question is, is my surgery center doing me a solid by getting me to my OOP max quicker, and saving me money in the long run, or will I somehow end up losing out? I mean I’m all for reaching the OOM and getting everything else paid 100% but I just want to make sure this isn’t going to backfire on me. Another thought is, isn’t is possible I’ll have more claims against my health insurance between now and the surgery? For example I still need to see my PCP to get cleared for surgery. Thanks
submitted by /u/notathr0waway1 [link] [comments]Read Morer/HealthInsurance