My new ins....ugh

So at work starting today we have no ins, and everyone hates it. THey took away our United Health Care HMO and we now have Emprire Blue Cross/Blue Shield. For family it says max out of pocket is $4k....so what Im wondering is how this works for this surgery, and anything else really. Ive always had an HMO wiht a copay and then it paid 90% of everything....here is how this new ins is laid out::

annual deductable $200 max family

out of pocket max inc;uding deductable   $4000.00

coinsurance   90%/10%


I just need to know if I have to be prepared to fork out $4k before my surgery, or if i get billed for it after wards or what....am I making any sense here lol? Does anyone else have this ins or something similar? Im so unhappy with this in, its over $100 per per mo plus the deductables, the Rx part of it has a $200 deductable too which sucks...where as the ins I did have paid for this surgery 100%! Thank you Citi very much for messing with my insurance....ugh....

Also, if anyone knows about that prescription part of it, like if I cant pay the $200.00 deducatble all at once, yet I need a prescrptn filled, do I get charged the reg price of the drug up to that amnt, or do I pay a percentage of it till I meet my deductable then pay the $30 per mo after that (price after decuctable is met)? I hope Im making sense here...Im terrible with ins....

I think it depends on the doctor--I recently changed Surgeons because one is closer to me. I now go to Virginia McGrath-Weavers office and the way it was explained to me was:\

Most people can't afford the Max out of pocket payment (most would not have surgery if it had to be paid up front), so what you pay is the surgeon's fee, which most offices has. Dr. Weaver's is 350, but this includes dietician consultation, classes, and support. Then, you pay the deductible(as required by the hospital). The rest is sent to your insurance company. They pay their part and you are billed the rest. Then, if you are like me, you call to make payment arrangements with the hospital LoL.

The surgeon's office that I had before Dr. Weaver told me I had to pay every thing up front, which is crazy. So, if you are in Memphis, I STRONGLY recommend Dr. Weaver and her staff. They are great in many ways(not only with the financial aspect).

-Jen

Thanks for the info....Im in north east tn actualy, my Dr is Dr Hodge. Thats how my gall bladder surgery went, i had to pay his $100 fee up front, then got billed for the hosp part of it which was only 200$.  If this is how they do it, the way you described, I can handle that....hopefuly thats how it will be. I mean seriously, how many people have $4k laying around lol?

No kidding! In fact, if it weren't for me getting some money from school loans I would have a hard time just scraping the money up for fees and deductible. Plus, I am putting money aside for healthy food, protein stuff, vitamins, and all of the other stuff that will be necessary to make this a success. It is tough transitioning, but every thing will work out better, eventually. I even cracked a joke and told my mom that our whole family should get WLS so that we could save money in the long run. When she asked how, I explained that all we would have to buy is a chicken leg and a solitary green bean and the family could eat for a week. LoL 

Before I had my surgery, my hospital called and told me my portion would be roughly $2,500 and would I please bring that when I came to be admitted.  Then I said that actually I was hoping my secondary would pick up what my primary didn't pay and they waived the $2,500 up front fee.  Of course I realize that everyone doesn't have secondary, but if you do, make sure they know it as well.  Now the hospital is having a hard time collecting from my secondary so I may still owe it.  But I had enough pre-op stress and I'm finding it easier to deal with it on the back end.  Good luck.