Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Insurance lingo hepl



Recommended Posts

Could someone please give me a mini lesson on insurance lingo. Like max out of pocket. Deductable. Etc.

Share this post


Link to post
Share on other sites

Deductible is when your insurance says you have to pay a certain amount before they will begin paying. The bills are applied to your deductible and once it is met, your insurance kicks in.

Co-insurance is when you pay part and your insurance pays a part of the bill.

Max out of pocket of when there is a limit to how much in a year you are expected to pay. When your portions add up to the max out of pocket, you don't pay any more for the year.

When amounts are applied, they are the allowed amounts not the full bill. The provider and the insurance company in their contract have an agreed upon amount that will be considered for all procedures. THAT is the amount considered not the full bill.

All amounts you pay are figured based on the allowed amount not the billed amount.

Hope that helps. Message me if you have any other questions!!

Share this post


Link to post
Share on other sites

@@shrinkingPeach thank you! This helps!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
    • jparadigm

      Happy Wednesday!
       
      I hope everyone is having a lovely week so far! 
      It's been a bit of a struggle this last week...I'm hungry ALL the time.
      · 1 reply
      1. BlondePatriotInCDA

        Have a great Wednesday too! Sorry you're hungry all the time, I'm pretty much the same..and I'm sick of eating the same food all the time.

    • ChunkCat

      Well, tomorrow I go in for an impromptu hiatal hernia repair after ending up in the ER over the weekend because I couldn't get food down and water was moving at a trickle... I've been having these symptoms on and off for a few weeks but Sunday was the worst by far and came with chest pain and trouble breathing. The ER PA thinks it is just esophagitis and that the surgeon and radiologist are wrong. But the bariatric surgeon swears it is a hernia, possibly a sliding one based on my symptoms. So he fit me into his schedule this week to repair it! I hope he's right and this sorts it out. He's going to do a scope afterwards to be sure there is nothing wrong with the esophagus. Here's hoping it all goes well!!
      · 4 replies
      1. AmberFL

        omgsh!! Hope all goes well!! Keeping you in my thoughts!

      2. gracesmommy2

        Hope you’re doing well!

      3. NickelChip

        I hope it goes well! Sending positive thoughts for a speedy recovery!

      4. AmberFL

        How are you doing? any update?!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×