Partial insurance coverage

[Brent Shaub]

Hello, Hear Peers.

My insurance covered $39,000 and left me with $1,500 for my Med-El CI.  When they said they'd cover it, I assumed they'd cover all of it.  Has anyone else needed to pay a copay?

Thank you
Brent

[Lauren]

Insurance in the US can be tricky, but generally if you haven’t met your out of pocket, you would likely owe up to that amount. 

Your best source of information will be your insurance’s customer service. They are the best to walk you through your coverage’s intricacies, go over the EOB with you, and explain where that charge is coming from.

As for your question… I didn’t owe anything for either of my CI surgeries. I’d met all out of pocket obligations prior to the surgeries and had gone through the usual checks (surgeon, surgical center, anesthesiologist, etc) to make sure anything billed would be in network and/or covered.

[Brent Shaub]

Thanks, Lauren.  I'm checking in with them now.

[Brent Shaub]

I went ahead and paid it.  They didn't tell me there was a copayment when they first told me they had authorized it.  At least they covered $39K of it.