Hi all,

I am in the very beginning stages of this journey. I had began researching over a year ago, started and stored but I finally settled on making this decision become reality. But I am a bit confused, I was worried about how much Ill have to pay for insurance. My insurance doesnt come with any deductibles but all of my future visits will require a $50 copay which is fine. My insurance said they will cover to pay the hospital 1,000 and the surgeon $150. But where I get worried is that my max out of pocket is 6,600. So my question is, does that mean I'll be paying $6,600 for surgery??? Im so confused about this. I attached the paper I filled out with a representative.

My total bill for the 6 month pre op classes and 12 office visits (NUT, PT, psychologist, Nurse Practitioner and surgeon) And then there was the sleep study the CPAP machine and lots of labs...surgery, hospital stay, barium swallow and prescriptions. Well over $20,000. total. My portion would have been 25% ($5,000.), but I'd met my max out of pocket for 2016 already. Alas, there will be lots of follow ups for the next year.

I'm confused. Are you saying that your insurance covers $1000. of the total hospital stay and $150. of the total surgeons bill?

Your max out of pocket is pretty high so you will likely be obligated to pay that much toward your surgery. But you won't need to pay anything in advance or get a loan like people doing self pay ed to do. I suggest that you work out a monthly payment plan for an amount you can manage with the hospital and the surgeon and anesthesiologist as soon as you get your bills. Wait until after your surgery to do this because if you don't they will try to talk you into getting a loan. Even after surgery, they might try this, but DO NOT let them talk you into getting a loan. As long as you make your monthly payments the hospital can't send your account to collections.

BTW,I am a hospital administrator who believes that medical care is a human right.

How do I know if I've met my max out of pocket?? Im sorry if thats a dumb question, I just dont know much about insurance. Im in college and on my fathers insurance and only thing I ever have to pay is copays for doctor visits. & thank you for telling me that, Ive been reading others post about setting up a payment plan with the hospital if needed. I would much rather have a payment plan than taking out a loan.

Your insurance company will tell you. Call member services

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If your planing of doing your surgery. I will wait until next year because you will start a new year with the insurance. Your out of pocket its a lot. My husband did the surgery this year had to pay 2500 out of poket to cover everything. Still has some bill that made a payment arrangements. But you have to meet the whole out of pocket before or after surgery.

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