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Weird insurance question!

If surgery is covered by insurance do they make you pay your entire deductible beforehand?? Or is that billed after? I know, weird question but Im not sure! :)

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  • I think it depends, honestly. My doctor's office required you to meet your deductible before surgery. If you hadn't met it by your final pre-surgery appointment, you had to pay the rest of it that day

  • So your deductible has to be met before the insurance will pay, so that for sure needs to be met prior to surgery (most doctors work this way). This is where it depends on the individual surgeon on wh

  • orionburn
    orionburn

    Unless you really have some bizarre plan it should be billed afterwards as normal. My surgery was 1/25 and I'm just now starting to get the rest of the bills in.

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I have to pay $1000 day of my surgery. I'll be billed the remaining $1000 after surgery. That's my 10% I have to pay. Insurance pays the remaining 90%


This confuses me because my deductible is a $1000 and out of pocket max is $3500. I know I have to pay something upfront just don't know if it will be $1000 or the $3500.

This confuses me because my deductible is a $1000 and out of pocket max is $3500. I know I have to pay something upfront just don't know if it will be $1000 or the $3500.


So your deductible has to be met before the insurance will pay, so that for sure needs to be met prior to surgery (most doctors work this way). This is where it depends on the individual surgeon on what they require. Let's say, after your deductible, you are responsible for 20% and the insurance covers the other 80%. The max out of your pocket would be $3500 before the insurance covers your surgery 100%. Some offices make you pay the max out of pocket and some bill you after. Just call and ask so they can tell you a for sure amount.


17 minutes ago, Mandybb said:


So your deductible has to be met before the insurance will pay, so that for sure needs to be met prior to surgery (most doctors work this way). This is where it depends on the individual surgeon on what they require. Let's say, after your deductible, you are responsible for 20% and the insurance covers the other 80%. The max out of your pocket would be $3500 before the insurance covers your surgery 100%. Some offices make you pay the max out of pocket and some bill you after. Just call and ask so they can tell you a for sure amount.

I went to my appointment today I asked and she said I can let you know closer to surgery. I know I will have to pay upfront but I got confused because the one nurse kept saying the deductible but then she said I'm not the insurance guru.

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