Jersrose43

I am not ignorant of my insurance. Completely the opposite. You must be lucky and not have a large out of pocket. I know how much everything costs and what I will pay at every moment. And that is why I will never pay a penny, nickel or dime up front. If I am cash pay then that's different. But with deductibles it's all about who gets the bill in there first. I am not willing to give a hospital or doc several thousand when the anesthesia and radiology will get in first. I will owe them that money. So I pay when I get an EOB or a bill and never up front. That happened to me once 5 years ago. I was $4500 away from the deductible so i paid $1000 to the hospital up front with promise to pay $1000 a month after. Well surprise I got was anesthesia doc charged more than hospital stay was allowed. No joke. The anesthesia charges were $18.000. And the hospital allowed from insurance was $4800. Anesthesia was out of network so they got paid and wanted my deductible, and guess who got his bill in first? Needless to say hospital got fully paid and took me 90 days to get a refund from them. Anesthesia took a lot longer to come to an agreement and a formal filing of complaint with the medical board for excessive fees. I paid them nothing. They put it on my credit report I filed another complaint and lawsuit.

I have a $5000 deductible and when surgeon said I had to pay him before hand I told him to stuff it and found a new doc. All the visits and prep for surgery have come pretty close to eating the deductible I won't pay anyone a dime until i see my EOB from my insurance to tell me how much and who got charged the deductible.

You can't appeal an employer exclusion It's a benefit exclusion. Just like no benefit for chiropractic care. Necessity isn't a consideration. The benefit is not there. You can appeal a denial of a precert regardless if a claim has been filed. But this isn't an option here as it's excluded. Your employer is the one who excluded it. Try to get on another plan such as a spouses coverage

Some doctors know what it takes to get approved - have you discussed with their insurance people?

Most of Cigna business (and Aetna, united) are as health service companies not true insurance. So they offer a plan to an employer and employer decides what is covered or not. There are thousands of versions of OAP. I am sorry your employer won't add it. But you should consider looking into your hubby's plan and if covered get on that one. This way no problems with loans. Good luck

You know Aetna, united and Cigna all customize their plans for the specific employer. So it's your employer who is refusing. Couple options Get on hubby plan if possible Go on the healthcare.gov pick up a plan temporarily for yourself for a year. Get the surgery and drop it. It may be cheaper than a loan nj the long run

I hate to say it but the problems are likely due to the healthcare.gov site not transferring your info correctly. My friend had same happen to her in nj and they still can't straighten out. Hospital can always submit precert via fax and paper (used to work in one) but it's too cumbersome to do Good luck.

Hi what hospital and doc did you use?

Hi what hospital and doc did you use?

Am having surgery with bessler in next couple months. Waiting on insurance approval. How did it go?