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Can anyone hlep me understand my insurance?
I'm always confused by this Insurance thing. I have Blue cross blue shield it's a PPO. The office visits are good I don't really have a problem with it.
I am confused when It comes to a MRI. I don't know if it's a different deductible for my MRI's. It says my deductible is $2500 but i don't know if there's a different number deductible for the MRI cause it never seems like they pay enough!
It says I have met $1100. of my $2500 deductible. but then it says I have met $164. out of my $4000 out of pocket expense. My doctor says i should to another MRI before the end of the year so I can come close to meeting my deductible.
I had to pay like almost 700 dollars out of pocket after the insurance paid for my last MRI but my most recent statement says I still have met $230 of $4000.
I am confused when It comes to a MRI. I don't know if it's a different deductible for my MRI's. It says my deductible is $2500 but i don't know if there's a different number deductible for the MRI cause it never seems like they pay enough!
It says I have met $1100. of my $2500 deductible. but then it says I have met $164. out of my $4000 out of pocket expense. My doctor says i should to another MRI before the end of the year so I can come close to meeting my deductible.
I had to pay like almost 700 dollars out of pocket after the insurance paid for my last MRI but my most recent statement says I still have met $230 of $4000.
The whole medical cost and insurance thing is complicated. Heath costs are just too high. Instead of raising people's premiums ( yes I know premiums are high) through the roof all these deductibles and coinsurances are added.
They reward those who only use their Primary Care Physicians which is fair. It is a tiered system after that. Doctors and Hospitals these days are barely making it. I saw this when Veterinary Medicine went high tech. When Veterinarians started buying Ultrasounds and lasers vet bill went way up.
There is a price for all this technology. Most of us did not notice medical bills so much when insurance companies paid most of it. There will be more deductibles and coinsurances added to everyone in the coming years.
I pay a $700 a month premium and that is a bargain. My medications would run me $1200 + a month.
Alex
They reward those who only use their Primary Care Physicians which is fair. It is a tiered system after that. Doctors and Hospitals these days are barely making it. I saw this when Veterinary Medicine went high tech. When Veterinarians started buying Ultrasounds and lasers vet bill went way up.
There is a price for all this technology. Most of us did not notice medical bills so much when insurance companies paid most of it. There will be more deductibles and coinsurances added to everyone in the coming years.
I pay a $700 a month premium and that is a bargain. My medications would run me $1200 + a month.
Alex
I'm in the same situation. I never fully understand the statements, I never meet the deductibles (or meet them in December right before the plan is renewed), and I feel I'm paying more now than I every have. But, thank goodness I do have insurance, right?
One thing to consider - some places have a different cost for patients who don't have insurance. My co-worker ended up paying the out-of-pocket, reduced cost up front because it was cheaper than submitting through insurance!
One thing to consider - some places have a different cost for patients who don't have insurance. My co-worker ended up paying the out-of-pocket, reduced cost up front because it was cheaper than submitting through insurance!
I have BC also and those explanation of benefits statements confuse the heck out of me. I'm with you - if I have paid so many bills this year how could so little be applied to my deductible.
Our doctor visits and pharmacy costs don't count toward the deductible amount.
Give them a call and ask for a thorough explanation of how those dollar amounts are figured. They can tell you what it all means.
good luck, Lu
Our doctor visits and pharmacy costs don't count toward the deductible amount.
Give them a call and ask for a thorough explanation of how those dollar amounts are figured. They can tell you what it all means.
good luck, Lu
I do not know your specific plan. All BCBS's are different State to State ( they are not one company) and then the plans are different. Mine for example has a $1200 deductible for Doctors visits. Then there is a deductible for hospitalization and another one for tests and a coinsurance. It all comes out to $12,000 I have to meet before a 80/20 plan kicks in. Every year it goes up $3000 and every year I do not meet it. You have to read the fine print of your plan, every plan is different. I worked in the insurance industry and it is hard for me to follow. When I worked in the industry we had a manual the size of a phone book.
The rule of thumb is with most insurance (not all) you pay 1/3 of the MRI cost. The good news is MSAA has help for paying for MRIs if you meet their needs standards and I think you should. I would look into it before you set up the MRI. I had to pay $1000 last year for brain MRI. This year when my MS Specialist wanted brain and spinal MRIs I asked if it was really necessary and he said no.
I always ask if tests are necessary and usually the Doctors tell me they really are not. I also ask how much a test will cost me ahead of time. Your insurance should answer this. Then I set up payment plans. Many places will do this but not tell you upfront they do this. If it is a hospital they will tell you you have to pay at the day of the test but if you tell them you can't they will sometimes take partial payment.
Healthy care is expensive. I stretch out my car repairs, the same with medical. Just because a Doctor suggests it I do not rush in and do it anymore than I do every repair my mechanic comes up with when I have an oil change.
I am sorry you have this worry. Google MSAA.
Alex
The rule of thumb is with most insurance (not all) you pay 1/3 of the MRI cost. The good news is MSAA has help for paying for MRIs if you meet their needs standards and I think you should. I would look into it before you set up the MRI. I had to pay $1000 last year for brain MRI. This year when my MS Specialist wanted brain and spinal MRIs I asked if it was really necessary and he said no.
I always ask if tests are necessary and usually the Doctors tell me they really are not. I also ask how much a test will cost me ahead of time. Your insurance should answer this. Then I set up payment plans. Many places will do this but not tell you upfront they do this. If it is a hospital they will tell you you have to pay at the day of the test but if you tell them you can't they will sometimes take partial payment.
Healthy care is expensive. I stretch out my car repairs, the same with medical. Just because a Doctor suggests it I do not rush in and do it anymore than I do every repair my mechanic comes up with when I have an oil change.
I am sorry you have this worry. Google MSAA.
Alex
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