Out of Pocket Expense?

HelenD
on 11/1/06 4:31 am - Lanoka Harbor, NJ
I just seen my Dr. yesterday, and he gave me a list of things and Dr. to see. So today I call for my appt. with the Psych, and I asked if he accepts my Oxford Liberty, and he said the Insurance company won't pay it because there is nothing wrong with me. It's going to cost $200.00. Is this normal and what other out of pocket will I need.
JaneE.
on 11/1/06 4:47 am
Sounds like something I went through...one of my insurance requirements was a consult with an in-network nutritionist but the insurance company wouldn't pay for it since I would be having post-surgical nutritional care with my surgeon's on-staff nutrionist. Go figure!
Dawn414
on 11/1/06 5:12 am - Mount Laurel, NJ
I'd recommend having the doctor call the insurance company. Because it falls under the medical rather than mental health category (being bariatric in nature), the insurance companies don't necessarily cover as much, but they might be able to get at least part of it covered. That's what happened with me. They'll cover a portion of it, but not all of it. C'est la vie! GOOD LUCK. Dawn
Charlene O.
on 11/1/06 5:48 am - LITTLE EGG HARBOR, NJ
Helen: Did you call Dr. Goldberg? My eval was only $185. I paid out of pocket. Email me about this
HelenD
on 11/1/06 5:55 am - Lanoka Harbor, NJ
Yes i did I got an appointment for tomorrow @10:am he is the one that told me it would be 200.00.
RCassety
on 11/1/06 9:12 am - Lindenwold, NJ
both my husband and I had to pay the $200 out of pocket for the psych eval -- i have aetna and he has bc/bs horizon of nj -- and our surgeon is Dr. Kirkland in philly
Melissa W.
on 11/2/06 6:27 am - Hackettstown, NJ
You are actually lucky that it is only $200.00. Mine was 375.00. The other thing that insurance did not cover was the phsyc and it was 275.00 so I would gladly have paid the 200.00. I am just now home from surgery on Monday and I would pay double that to have it again. Good luck and now that Oxford other than those two things is awesome. We have the freedom plan and it was covered 100% other than theose 2 thing so it was awesome. Best of luck and keep us updated.
Michelle B.
on 11/2/06 7:34 am - Pennsauken, NJ
Hi Helen My psych evaluation was not covered initially, either - well, they did not accept insurance there, they only wanted cash or check! It was $200, too. I did submit a claim to my insurance afterwards and they paid me back $120. So I think it is very common. I have United Healthcare, by the way. Good luck
Barbara H.
on 11/2/06 8:00 am - Tuckerton, NJ
Mine out of pocket came to $30. (total) Doesn't your insurance have wellness coverage? Or let me ask you this......does Oxford Liberty cover weight loss surgery? What I did, because I was told by the doc that insurance doesn't usually cover the psych and nutrition ($500-just for the nutrution!) I called my insurance first and told my case worker that i was having the surgery....so she noted everything down, so when the psych bill got submitted they paid $120 and I owe the other $30 because he was out of network. That may work for you as well, someone at your insurance knowing what is coming ahead of time. Good Luck!
anna1916
on 11/2/06 10:37 am - Bellmawr, NJ
I paid for mine up front - I think it was $165 - but I submitted the bill on my own to my insurance carrier, and they paid most of it. I still had a few dollars of a deductible left.
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