Question for people who had the surgery WITH insurance.

[Iniysa 157]

I am coming up within the next few months on my surgery and I am trying to figure out how much the average person WITH 20/80 (any) insurance has to pay up front. I know it will be different for most people because different hospitals charges different amounts. But if you can give you the amount you paid to the hospital before going in for you own surgery, that would be amazing.

Thanks!

P.S. I have met my deductible.

[banditchic 83]

I hadn't paid anything towards my deductible yet when I had my surgery 7 weeks ago. I owed a total of $2500 out of pocket. I paid $700 on the day of surgery, and paying the rest off in monthly payments.

[Pixie Dust 526]

I haven't had my surgery yet but with our BCBS insurance, at most out of pocket (since I still have to meet my individual deductible) will be about $1000, for a $19,000 to $20,000 surgery. We will be billed after surgery.

[erics300 137]

I have a copay of $250 for the surgery but I also had to do an endoscopy and if they found anything it would be a $150 charge for the Biopsy and well of course they found something so as of right now I'm looking at $400.

[DebDUtah 67]

The amount you will owe is your annual maximum out of pocket at most. I am expecting to pay my out of pocket which is $2500 no more and this was confirmed by my insurance company. This amount is not even close to the 20% of the cost of service(s). Hope that helps.

[asmaclare 38]

I have medical mutual. They pay 90% of any surgery. I pay 10% but only up to $500. I verified this with them twice. I hope there are no surprises.

[Iniysa 157]

Thanks everyone, I have BCBS 80/20 with a $3000 out of pocket cap. I am really hoping it's nowhere near that. Guess I will call my hospital to ask if they let you pay it out.

Thanks and please continue to answer my original question, I am still interested in the numbers.

[valerie805 4]

Thanks everyone' date=' I have BCBS 80/20 with a 3000 out of pocket cap. I am really hoping it's nowhere near that. Guess I will call my hospital to ask if they let you pay it out.

Thanks and please continue to answer my original question, I am still interested in the numbers.[/quote']

I have BC in California had to pay my $2000 deductible, plus 80/20 so another $2000. I'm making payments to the hospital on the second $2000. It was more than I expected :-(

[Sassygirl06 962]

I have bc in California, but it's an ***. Didn't have to pay a dime out of pocket.

[misslady 130]

I have BC/BS TX and the physician fee is 80/20 so I will pay 574.00 up front to the surgeon. The hospital will be 90/10 with me having to pay 10% of hospital fee which is billed after surgery. I have met my 2500.00 deductible already. The sleep study and EGD took care of that and I am on a payment plan with that. Sleep study was not required but my PCP wanted it done based on symptoms I was having and yep I have really bad sleep apnea durin REM sleep.

[Iniysa 157]

I have BC/BS TX and the physician fee is 80/20 so I will pay 574.00 up front to the surgeon. The hospital will be 90/10 with me having to pay 10% of hospital fee which is billed after surgery. I have met my 2500.00 deductible already. The sleep study and EGD took care of that and I am on a payment plan with that. sleep study was not required but my PCP wanted it done based on symptoms I was having and yep I have really bad sleep apnea durin REM sleep.

I am BCBS TX as well. How did you find out the exact amount?

[misslady 130]

The finance person in the surgeons office called and told me and I need to bring it to the pre op appointment. That is a month before the surgery.

[bmbrush413 124]

I have Cigna, and since the hospital and all of the doctors involved are in-network, I pay $0 after I met my deductible ($3,000 - but I was already more than halfway there before the surgery).

[kmoore 97]

I have Cigna with an out of pocket max of $2500 and then 90/10. I had the $2500 met pre-surgery just based on all of the appointments and tests needed (surgery was October last year). The 10% owed came to just over $500 and that was billed to me. Never really understood how you owe money after you meet out of pocket max, but oh, well.

[DebDUtah 67]

Ok to clarify, deductibles are what you have to meet every year, this includes co-pays for visits/tests. There are different coverage percentages based on the procedure and where you are getting it done. So you have co-pays, deductibles, out of pocket annual maximums, lifetime maximums and of course exclusions. Once you reach your maximum out of pocket for a year, you are not responsible for any further out of pocket expense in a calendar year, this does not include co-pays, you still pay those (from best I understand, but could be wrong). If the procedure is not covered or covered with exception or exclusion then it is not covered by the maximum out of pocket. The best thing is to call the number on the back of your insurance card and talk to the utilization review nurse/department. They will tell you what you will be responsible for once approved.