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

Recommended Posts

For those of you have January dates that were approved by insurance, do yall have deductibles that yall need to meet if so how are planning on meeting your deductible?

Sent from my SM-G920V using the BariatricPal App

Share this post


Link to post
Share on other sites

Lol im an insurance agent, so I know how the deductible works, I really wanted to know how people plan on hitting their deductibles with surgery dates so soon after the deductible resets ☺

Sent from my SM-G920V using the BariatricPal App

Share this post


Link to post
Share on other sites

Good thing our insurance starts over over every fiscal year. Our fiscal year begins July 1st. I have already met my 500$ deductible

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

I have Flexible spending through my employer. The maximum is $2600 for the year and they will deduct that money from my checks every 2 weeks. So I'm taking the $2500 and putting that down for my deductible. I will not have to come out of pocket at once.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

$2000 max for the year, but because mine will reset come Jan, I'll be paying it all up front. At least that's how I think it works.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

$2000 max for the year, but because mine will reset come Jan, I'll be paying it all up front. At least that's how I think it works.

Sent from my iPhone using the BariatricPal App

Yes you'll pay that to your surgeon

Sent from my SM-G920V using the BariatricPal App

Share this post


Link to post
Share on other sites

Yea I was trying for a december date because I had not only met my deductable but I had also met my max out of pocket for the year. I would not have had to pay anything for december date but now I have to pay 3500 because that is my max out of pocket and it includes my deductable. My copay is 20%. I am using FSA to pay for 1500 and the rest I will have to put on a credit card.

Share this post


Link to post
Share on other sites

Yea I was trying for a december date because I had not only met my deductable but I had also met my max out of pocket for the year. I would not have had to pay anything for december date but now I have to pay 3500 because that is my max out of pocket and it includes my deductable. My copay is 20%. I am using FSA to pay for 1500 and the rest I will have to put on a credit card.

I have 2500 deductible with a 2000 $ HRA, but my coinsurance is 10% and my Dr bills me so I'm not worried about my out of pocket max. But yes I wanted a December date as well because my deductible had been met and now ima have to weight until February for a date so I can use part of my income tax

Sent from my SM-G920V using the BariatricPal App

Share this post


Link to post
Share on other sites

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

Sent from my SM-G920V using the BariatricPal App

So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

Share this post


Link to post
Share on other sites

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

Sent from my SM-G920V using the BariatricPal App

So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

What is coinsurance?

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

Sent from my SM-G920V using the BariatricPal App

So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

What is coinsurance?

Sent from my iPhone using the BariatricPal App

The percentage of what you pay and what your insurance will pay.

Example: a silver plan is a 30/70 plan,

Meaning, the beneficiary pay 30% after their deductible has been met and the insurance plan pays 70%

Sent from my SM-G920V using the BariatricPal App

Share this post


Link to post
Share on other sites

How does this all work? I have surgery on 1/23 but my insurance starts all over for the new year. My dr said two weeks before surgery they collect the deductible (which is $500). My out of pocket is 3900, so am I having to pay the $500 as well as the 3900 to the hospital for insurance to cover?

Sent from my iPhone using the BariatricPal App

No, what is your coinsurance??? After you pay the 500 to your doctor, you'll pay what every your coinsurance is up to your out of pocket max after the deductible has been met. You can find out if your hospital will bill you so you can make payments on it.

Sent from my SM-G920V using the BariatricPal App

So I found out that 2000 is already given to us by the employer so I'll only be responsible for 500

Sent from my SM-G920V using the BariatricPal App

What is coinsurance?

Sent from my iPhone using the BariatricPal App

The percentage of what you pay and what your insurance will pay.

Example: a silver plan is a 30/70 plan,

Meaning, the beneficiary pay 30% after their deductible has been met and the insurance plan pays 70%

Sent from my SM-G920V using the BariatricPal App

Oh okay the lady said it's 80/20 so does that mean the insurance pays 80 of the out of pocket?

Sent from my iPhone using the BariatricPal App

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

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • 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.
  • 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

    ×