Insurance Bull questions.

azith28

So I've just discovered the unpleasent way (with a bill) that my HMO changed the first of the year and that I'm now responsible for a deductable and even after that is met , 10% of the cost of lab and outpatient procedures.

The current bill and changes piss me off, but is not an amount i am too worried about. It was just lab work. However I have scheduled an outpatient procedure that i was not expecting to have to pay more then a copay for, So now im wondering if I want to cancel it. How do i find out how much this is going to cost me? I'm pretty sure the doctor is not going to know since shes not doing the work, and the people i just spoke with about the bill didnt know, so who is the best person to speak with at the hospitol to speak to, to get an estimate of some kind.

Thanks

Bowen

Your insurance company, they should have an 800 #. So long as you know the name of the procedure, they should be able to give you a rough idea of the out of pocket cost.

Darkewolfe

If you have a helpful HR department, they can often help mediate between you and your insurance company as you try to hammer out whether there was a problem.

schuss

Also, ask for the hospital's billing department. They should have people experienced in this, as well as can give an honest estimate of what your insurance is going to charge.

azith28

I got the info i needed, even if it was like pulling teeth, and with lots of strings attached being specific about it being an 'estimate'. not happy.

schuss

azith28 wrote: »

I got the info i needed, even if it was like pulling teeth, and with lots of strings attached being specific about it being an 'estimate'. not happy.

Welcome to the world of medical billing.

amateurhour

Once you get the actual amount you owe the hospital, don't hesitate to call them and say "this is a lot of money and I don't have that so let's work something out" Don't be an ass or anything (I'm sure you wont) I can't tell you the number of friends I've had that got some 3-5K medical bill and just called the place and said "I want to pay, but I don't have that kind of money" and either got a one time 50% payment in full or 75% spread over installments (1-2 years)

azith28

It's not even a lot of money, this is more a general pissed off thing because the reason i was going with this insurance was that they didnt have deductables, just a flat copay, and now i have a deductable and this 10% bullshit and that makes me pissed that i was paying for the most expensive insurance option my company offers and while i admit that i probably got something in the mail that i ignored, they sure didnt make a big deal over the change to make sure we understood what was happening. I'm not pissed because it would break me, im pissed that i have to pay anything at all.

and i might as well say it because i know who to blame. Thanks Obama.

AspectVoid

azith28 wrote: »

It's not even a lot of money, this is more a general pissed off thing because the reason i was going with this insurance was that they didnt have deductables, just a flat copay, and now i have a deductable and this 10% bullshit and that makes me pissed that i was paying for the most expensive insurance option my company offers and while i admit that i probably got something in the mail that i ignored, they sure didnt make a big deal over the change to make sure we understood what was happening. I'm not pissed because it would break me, im pissed that i have to pay anything at all.

and i might as well say it because i know who to blame. Thanks Obama.

Actually, you should thank your HR department. Part of what they do is negotiate a deal for insurance for your company each year. Obviously, your HR department failed you since not only did your insurance change, but your HR department failed to inform you of the changes and allow you to select a new coverage.

Deebaser

in-network coinsurance is pretty standard now.
There's no sense fighting it.
Thanks Obama

Djeet

Our corporate rates were going up 10-20% each year for 4 years pre-Obamacare, necessitating re-jiggering of copays, deductibles, and max OOP every year (usually you wouldn't notice unless you had an existing condition, though the drug, office and emergency care copay would move around a bit each year); no one in the organization had a major change in health so these increases were "organic" and not due to increased claims. Your company could've been grandfathered in on the old plan but premiums would've likely gone up by a not insignificant amount. If your company wanted to minimize employer-portion of premiums going up they'd have had to switch to a new plan which would've changed copays and deductibles and whatnot.

Usually corporate is going to re-evaluate health insurance coverage plans on a yearly basis when they get notification from their insurer that rates are going up (they never go down). If you can find out the anniversary date of your coverage you can be better prepared for how things are going to change for next calendar year.