So, I need to have two separate surgeries for two different reasons. These surgeries and the reasons behind them are not life-threatening, thankfully, but they are necessary for me to get eventually.
My insurance benefits are, from what I understand about them, as follows:
My deductible is $250, after which my insurance will cover 90% of the remaining cost. My out-of-pocket maximum for my plan is $1300 every 3 months. It’s pretty funky in that way— I think it’s normally done per year, right? Not that I’m complaining 🙂 The out-of-pocket maximum is the important & relevant benefit here.
Both surgeries will cost me roughly $1200-$1300 each for the procedure itself (as in, $1300 per surgery, not total) after my insurance has its way with it. My insurance has a fun little price estimator on their site for most surgeries and procedures, which is how I know, very approximately, what to expect.
What I’m wondering is, since either surgery will cause me to reach my out-of-pocket maximum (just about), couldn’t I just… have both surgeries in the same 3 month time span (say, one at the beginning of the 3 month rollover period and one near the end of the 3 month period) and only have to pay $1300 out of pocket…?
Now, this is of course making the bold assumption that the surgery expenses that aren’t the procedure itself, like the anesthesiologist & the medicine prescribed post-surgery, are covered by my insurance too. I don’t know. But, say that I get super lucky and absolutely everything is covered, and I also get lucky enough to get them both scheduled within a 3 month time frame.. couldn’t I save about 1300 dollars? Am I missing something here?
I feel like this would be totally obvious to the average adult, and that I’m in the minority for not getting how this stuff works, haha. I’ve never had to plan out and pay for my own surgeries before now, can you tell? 😅
Before anyone asks, I don’t have any worries about not having enough time to recover between surgeries. They’ll probably be a couple months apart, if this plan & the scheduling thereof works out, plus they’re on different areas of the body. One is on the chest, the other is the lower abdomen. I have no worries about missing work, either, as I have a bit of an odd (but in this case, beneficial) employment situation— no frets there! Also, one final note in case you’re worried, I will not go into the negatives if I have to pay $1300 twice like God intended. It just would be very nice to save money.
My goodness, I’m quite sorry for how lengthy this post turned out to be!! Thanks in advance to anyone who reads this whole thing! 🙂
submitted by /u/surgerywurgery
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So, I need to have two separate surgeries for two different reasons. These surgeries and the reasons behind them are not life-threatening, thankfully, but they are necessary for me to get eventually. My insurance benefits are, from what I understand about them, as follows: My deductible is $250, after which my insurance will cover 90% of the remaining cost. My out-of-pocket maximum for my plan is $1300 every 3 months. It’s pretty funky in that way— I think it’s normally done per year, right? Not that I’m complaining 🙂 The out-of-pocket maximum is the important & relevant benefit here. Both surgeries will cost me roughly $1200-$1300 each for the procedure itself (as in, $1300 per surgery, not total) after my insurance has its way with it. My insurance has a fun little price estimator on their site for most surgeries and procedures, which is how I know, very approximately, what to expect. What I’m wondering is, since either surgery will cause me to reach my out-of-pocket maximum (just about), couldn’t I just… have both surgeries in the same 3 month time span (say, one at the beginning of the 3 month rollover period and one near the end of the 3 month period) and only have to pay $1300 out of pocket…? Now, this is of course making the bold assumption that the surgery expenses that aren’t the procedure itself, like the anesthesiologist & the medicine prescribed post-surgery, are covered by my insurance too. I don’t know. But, say that I get super lucky and absolutely everything is covered, and I also get lucky enough to get them both scheduled within a 3 month time frame.. couldn’t I save about 1300 dollars? Am I missing something here? I feel like this would be totally obvious to the average adult, and that I’m in the minority for not getting how this stuff works, haha. I’ve never had to plan out and pay for my own surgeries before now, can you tell? 😅 Before anyone asks, I don’t have any worries about not having enough time to recover between surgeries. They’ll probably be a couple months apart, if this plan & the scheduling thereof works out, plus they’re on different areas of the body. One is on the chest, the other is the lower abdomen. I have no worries about missing work, either, as I have a bit of an odd (but in this case, beneficial) employment situation— no frets there! Also, one final note in case you’re worried, I will not go into the negatives if I have to pay $1300 twice like God intended. It just would be very nice to save money. My goodness, I’m quite sorry for how lengthy this post turned out to be!! Thanks in advance to anyone who reads this whole thing! 🙂
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