May not be able to have surgery

Question

I may not be able to have surgery if the neuro still thinks I should, for my "brain slump".  The reason is that I have a different insurance than I had before and I read on a website a lady stating that her stay was about $160,000 and her surgery itself about $150,000. So there for it is a total of $310,000!!! That means my out of pocket expense would be about (or more) $62,000!!! (insurance covers 80%) That is the cost of a small house! I don't have $62k laying around in the bank! I had no idea I would be feeling like this and know what had to be done to feel better or I would have saved some money - it wouldn't be near that but at least I would have a small amount.

All I want to do is feel better and get this taken care of! My 30's are gone! I have passed by each age and not been able to enjoy one bit of my 30's! (I am almost 38)! And now the last 3 years of my life even worse!!! I just don't know what to do. Anyone else run into this? I am sure there has to be a certain amount paid down or before hand...idk I am just assuming.

redkim · Answer

Most insurance like yours will have a max out of pocket.  You can also sometimes negoiate on what you pay.  My sister does this.  She tells them instead of making x payments she will pay all up front if they reduce the amount.

selmaS · Answer

I know how u feel..I was just to the dr for my extreme pain I had over the weekend and I am calling my insurance to see what is covered and what is my expense to see if I can afford the tests the dr wants done.....we should not have to worry about these things.....

But, u  have a DH there that will help u make it all happen so follow his lead, relax....no life insurance needed.... : )

Stay positive
"selma"

xmelax35 · Answer

Thank you so much. I remember my chiari surgery I didn't have to have anything up front but it was covered at the time (diff insurance). Now it just scares me what I read about the cost of the surgery and I was like oh noooo! My husband said we would see about making payments and even if it is a small amount every month (what ins doesnt cover). He said "you will get your surgery". (well if I don't make it through surgery, my life insurance is there, ha ha ha - just kidding, I am sure I would be fine). I just know I don't want to live with this excruciating pain all my life. I am ready to take my real life back. The pain is getting unbearable. I hope that whatever he does to fix that previous surgery complication, that it helps and I am feeling a lot better.

selmaS · Answer

I also had to pay upfront for a colonoscopy for an amount not covered by insurance I was told to bring cash or a check!!!

I feel they got enuff from the insurance and did not need to collect this from me....but what can we do?

U should be able to get on a payment plan with ur dr for surgery...they set this up b4 u schedule....talk to the dr and his staff b4 u write it off.

"selma"

xmelax35 · Answer

I live in Ohio (just a little south of Columbus).

n40066 · Answer

wow...that's so crazy!  i've never heard of anyone having to pay for services up front like that!  where do you live if you don't mind my asking?

xmelax35 · Answer

I just figured it was with any other surgery that ya had to pay something upfront.  For instance Back about 9 years ago when I had my hysterectomy, the gyno had me pay up front for what they said the insurance probably would not cover. Then they said if I owed more they would bill me or if they owed me they would give me a refund. They did end up giving me a refund. I believe I paid like 900 dollars or something like that ahead of time and they gave me a small amount back.

Thanks again. I will give them a call.

n40066 · Answer

i have never had to pay one penny up front!  call your ins. co and talk to them.  they will be the best ones to ask!

thieb9 · Answer

I would def check with your insurance company before making any decisions. My out of pocket maximum is 1000, part of that I have to pay to the hospital the morning of surgery but anything after that is 100%

xmelax35 · Answer

Thank you for that information. It is very helpful and I will check on that. :D

pamk5 · Answer

On most policies there is a feature called "out of pocket max"  that is the amount you cost share to reach 100%.  Usually deductible plus 80/20 to an additional 2,3,4,5K out of pocket then covered at 100% for the remainder of the year.  Call your insurer or pull out your policy and see what this feature is on your policy.  

Hope this helps!