Question:
INSURANCE QUESTION FOR POST OP'S WITH 80/20 COVERAGE

WAS JUST WONDERING ABOUT MY DEDUCTABLE AND THE MONIES MY INS. CO. WONT COVER. IS THAT ALL GONNA HAVE TO BE PAID UP FRONT TO MY SURGERN BEFORE SURGERY OR IS THAT SOMETHING I WILL BE BILLED FOR AND CAN MAKE PAYMENTS MONTHLY? IT SEEMS THAT THIS WOULD BE SOMETHING THAT GETS BILLED OUT AFTER EVERYONE (SURGEN, HOSPTIAL, BLOOD WORK ETC.) SUBMITS THERE BILL TO INS. AND THEN THE OVERAGE GETS BILLED TO ME. NOT SURE THOUGH, NEVER HAD TO PAY ANYTHING OVER A CO PAY AT THE DOCTORS OFFICE BEFORE. SO I WAS THINKING I WOULD POST A QUESTION HERE AND HEAR YOUR INSIGHTS ON WHAT ALL YOU POST OP'S WENT THROUGH. THANKS!    — PHATBOY (posted on November 21, 2006)

November 21, 2006
Well, the answer to your questions is of course "it depends". Some Doctors/hospitals will estimate your portion and want that paid up front - others will submit thru the normal claim process and bill you after the procedure. You should ask your doctors insurance coordinator and you should also speak to the insurance/billing department at the hospital - Good Luck
   — jbassett

November 21, 2006
Hi JR, I had my surgery on July 26th of this year .I have Aetna PPO,and I had the 80/20. Where I had my surgery and with the insurance company,I had to have my money up front.They said that if I went over what my deductible, I would recieve the difference back.I haven't gotten anything back yet...so,I don't know how true it is, that you will recieve a refund. I had to have $1100.00 by the day that they did my pre-admission testing.I don't know how any other insurance companies are, but that is how Aetna handles it. I hope that helps. Good luck on your journey, I wish you all the best on your way to your new life.
   — renee44127

November 22, 2006
All are different. My dr and hospital didn't bill me until after surgery and I could make payments on it. I had open access plan and have had to pay about $3000 after insurance paid. I had the same hospital and dr as my friend and because she was on medicade, she didn't even have to pay anything.
   — geneswife

November 25, 2006
I'm not sure what my ratio is but I had to have about $1300 up front. Then I still get bills (not too big) from the hospital for different things.
   — Leisa