SO I just got off the phone with the insurance company and I am a bit confused. I have Blue Shield/Blue Cross PPO insurance with a $6,000 deductible. I have already paid $3500 (for other medical stuff) Therefore, I have $2,500 remaining until I meet my deductible. The guy form the insurance company said that I would have to pay the $2,500 BEFORE the surgery (if I get approved) and that Blue Shield will pay anything after that. I am confused. I was always under the impression that I am obligated to the $2,500 but not until AFTER the surgery, when the bill comes????? Please some explain this to me.

Also, I am assuming that my next step is to go to a surgeon that is "preferred" by Blue Shield to set up a consultation, where the surgeon can then submit a request for approval from the insurance company? is this correct??

any help is greatly appreciated.!!!!!!!! :grouphug:

You will probably have to pay on the date of your surgery or at your last pre-op appointment, since this is an elective surgery and they know where you are at in your deductible.

do you have a co insurance as well? I have a deductable too. We have met our deductable for the year but also have a max out of pocket of 3000 individual. So if the 10% is high i could have to pay 1500 or more for surgery.

That's the way hospital's work now days. You must pay up front. It sucks but that's how it is.

sorry this took so long but i really appreciate everyone's replies..

i have to pay an $800 doctor fee and the rest of my deductible which is around $2,500 on the day of my surgery. this is alot of money but fortunately i will be able to take care of it.

i do not have a co insurance. i am on my mom's insurance from her work. we have pretty crappy insurance to try and cut the cost of bills. (that's how it was explained to me by my mom)

:]

I can understand paying the Dr upfront but most hospitals bill the insurance first then bill the pt after.