Question:
What exactly does this letter mean?

The letter from the ins co says "Her proposed surgery has been determined to be medically necessary which is covered under the plan. Plan benefits are PPO $500.00 deductible, 80% co-insurance, $1,000.00 stop loss. Please be advised that this is not a guarantee of benefits. All benefit determination is made at the time the bill is received and reviewed and coverage is in force at the time the expense is incurred" What exactly is my responsibility? I am in network. Do I pay 20% after my deductible has been met or just until? What does $1,000.00 stop-loss mean? Thanks for any insight.    — Marty R. (posted on October 13, 2000)

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