insurance question

mamayenn
on 5/24/07 11:56 pm - cliffside, NC

I have Cigna Insurance. If anyone that has Cigna could give me some info on how they pay. What percent. Also, am I required to pay the balance up front or do they set up payments???

Jennifer K.
on 5/24/07 11:59 pm - Phoenix , AZ

RNY on 06/20/06

You would have to find out what YOUR Cigna insurance plan pays... each employer selects different plans.... as for paying up front - most surgeons will require their money upfront... if you have a copay/deductible for the hospital they may require upfront... if you have a coinsurance they cannot make you pay until they submit the claim to Cigna and Cigna will tell them how much you owe (after your surgery)... most hospitals will set up a payment plan for the coinsurance.

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

Donna B.
on 5/25/07 8:51 am - Somewhere in, VA

RNY on 07/10/07

Jennifer, Is this really true about coinsurance? The reason I am asking is that my insurance (Medcost) plan has a $300 deductible then I am responsible for 20% up to $3000 out of pocket max. I questioned my surgeon's nurse coordinator about having to pay up front and I understood her to say that I would have to pay the $3300 BEFORE surgery. Now I'm really curious! How do I go about finding out about this? Thanks in advance for your help. Donna

Life is short ~ dance like no one's watching!!

305/292/167/159
High/Surg/Curr/Goal

Cinderellen
on 5/25/07 2:00 pm - Winterville, NC

RNY on 03/28/07

I have Medcost and I didn't have to pay upfront. As I understand it, that isn't a policy of your insurance company so much as a policy of your doctor's. I guess they've been burned by people not paying their co-insurance before. Take care.

Ellen

Own it all, it's yours!

425/350/185/150 Highest/Surgery/Current/Goal

Jennifer K.
on 5/28/07 11:56 pm - Phoenix , AZ

RNY on 06/20/06

It depends on your insurance... typically it is against the contract with the insurance company to collect your co-insurance up front since they do not know how much it will be until they bill the insurance... however when it comes to the surgeon... their pretty much know what their percentage will be since they bill the same... versus the hospital... you may stay longer, shoter, take more pain meds than somebody else etc. I think thats a little much for your surgeon to be asking for $3300 up front... there is no way that your 20% would come up to 3000$ for just the surgeon and I would think they wouldnt have anything to do with the hospital bill. A quick call to your insurance should be able to clear up if the Dr can request that up front or not!

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

gordonfamily3
on 5/25/07 9:55 pm - Concord, NC

Lap Band on 06/13/05

First let me tell you that Cigna does require a 6 month supervised diet through you PCP. You might have already started it but if not I wanted to let you know and they will deny someone because it's not included. For the insurance: They are right your insurance policy is the one that tells the percentage you pay and such. Lets see if I can walk you through this. Lets say the RNY contract for your surgeon is $2000.00, you have a $200 dollar deductible and a $2000 out of pocket max. After your deductible is met they will pay @ 80% leaving you 20% to cover. Lets say you haven't met anything. $2000-200= $1800 x 20% = $360 + 200= $560.00 is what you would your surgeon. If your deducitble is met then you would just take the $2000 x 20%. Your $360 will go towards your out of poket to start meeting that total. Does this all make sense? Most of the time the hospital will bill you unless you have a co-pay then they will normally want that before you leave the hospital. Sorry so long and I hope this didn't confuss you by no means. Good Luck!!!!

Donna B.
on 5/26/07 7:08 am - Somewhere in, VA

RNY on 07/10/07

Thanks for the info on the insurance. I struggled to come up with the $3300 because I thought I would need to pay the hospital up front. I hope that's not true! I was expecting to have to pay the surgeon up front and was prepared for that but not prepared for paying the total $3300 up front! Guess I'll wait and see what they tell me. I thought hospitals usually bill you AFTER your stay so I was really confused by that!

Life is short ~ dance like no one's watching!!

305/292/167/159
High/Surg/Curr/Goal

A.D.
on 5/28/07 8:55 pm - Matthews, NC, NC

RNY on 03/14/06

Insurance is so different, I had Med Cost and they would not pay anything, my company is self insured and since they have the final decision the company said NO, so I OWE OWE OWE so off to work I go, out of pocket cost for me was around 26,000 YIKES. Worth every monthly payment.

insurance question

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insurance question