Precertified? Read very carefully to be sure.

Lisa' surgeon 's office contacted our insurance plan prior to surgery to obtain precertification. The surgeon's office received a reply informing them that coverage was available. She had the surgery. We later found that the plan stopped paying at $2500.00 The precert letter did not mention that the plan had a limit that would be inadequate to pay for the requested services. It is a self-insured plan through my employer. We have unsucessfully appealed the claim denial and are now looking at $26,000 for the hospital and $12,000 for the surgeon unless they allow us the network discounts, which would help a little. We are considering our options.

OMG that is horrible. I cannot believe that your surgeon's office did not inquire more fully if they were not familiar with your insurance. This never ever should have happened. The insurance companies are dirty dogs aren't they? 2500 dollars that is insulting.