Insurance question

If this question makes no sense please forgive me.  I just have so many questions swirling in my head and when I call the insurance people I never seem to be able to ask  it right or they never seem eager to answer me...anyway, my question is this.  I have a 400 deductible and a 2000 out of pocket max expense a year.  I have to pay the deductible ahead of time and then the doctors finance office said I could make payments on the 2000 during the time of surgery.  My question is if I make the $2000 in payments to the doctors office how will my insurance company know to apply this toward my deductible or do they not apply this toward it?  It is all so confusing to me.  Does anyone else have UHC Choice Plus Plan and know how it works exactly???  Thanks so much for any help!

Ok, I don't know how your insurance works, but I can tell you how mine did.   Last year I had carpel tunnel surgery, so basically I had to pay the deductible on that surgery, which ended up being the max I had to pay out for one year.  When it came time for my WLS, I had already paid out the max so I just paid for my co-pays to see the doctor.  I was out no money for my WLS itself, the hospital and everything that goes along with that was paid.    NOW..  if I had NOT had the first surgery, I would have had to pay the max on the WLS and basically the bill comes in, the insurance pays for anything but what your out of pocket is, which leaves a balance with the doctor.    And you work out the payment for that.   That is how CIGNA worked for me last year...   I hope that helps a little...  

HUGS

Hello again and thanks so much for your reply.  It does help.  I am more worried about out of pocket being way more than we can afford.  We just bought our first home after 17 years of marriage and that along with feeding animals and high utility bills it's just been crazy.  I just hope they let me work out a payment plan...of course if the insurance doesn't approve me then all of this will be for nothing but I still just want to ask all kinds of questions and know what I am up against. 

I have United Healthcare and just had my surgery on March 19th. Here's how mine worked. I paid my deductible at time of surgery. I will be billed the balance after insurance pays. The amount that I have to pay (which would be the rest of my max out-of-pocket) is then made in payments by me. Sounds like the same you will be doing.   Now the amount I pay out-of-pocket will already be applied for the remainder of the year with the insurance company even though I have not paid it all yet. As far as the insurance company goes they don't care if you've paid it or not. The doctor is the only one who has to worry about you paying your bill.

Wow, Laura thanks a bunch.  It sounds kind of like what they said when I called UHC, I am just totally scatterbrained lol  My deductible is 400 and then i have to pay 2000 out of pocket so if i had to do the same as you the amount I would have to pay before surgery would be the 400 correct?  and then the 2000 I go to them and try to work out payments...I hope that is how it is anyway.  Thanks again!  If you don't mind me asking how much was your psych exam out of pocket and also how long did it take you to get approved with UHC...I hope you don't mind all the questions!  Thanks in advance!

I don't mind the questions at all! I had all sorts of questions when I came into this. But my deductible is 200 and that is all I paid the hospital before surgery. Where are you planning on having yours at? I was at Baptist. It really depends on the hospital. But they will normally work out payment plans with you. I spoke with a financial advisor from the hospital a few days before my surgery was scheduled and she helped me with all the details.

Call UHC and ask for the mental health department. I had to get an authorization number from them before I could go for my psych eval. But I didn't have to pay anything other than my co-pay. It's already been billed to my insurance and they covered it 100%. But if I HAD to pay for that without insurance it was $100. Atleast that is the amount they billed my insurance for.

Feel free to ask as many questions as you want! I will answer what I can. And I'm sure someone here would have an answer to some of the things I don't know.

Thank you so much!  I am actually starting to really believe in myself and thinking that maybe I could possibly actually do this and go through with it.  For a little history on me...My dad had the surgery and so did my sister.  I was against it...I've always thought it was bad to do it...it took me a long while to realize it was just another excuse to not put myself first and really think about how much happier I could be to live in the world again and not just inside my house.  I really hope this works out.  I actually am hoping for Centennial with Dr. Houston since that is who my dad went to and I've met him and since I am scared to death of hospitals in general I thought that would be for the best. ...but I don't really know what his fees are or what he expects up front...I do know that his financial department did say that after the 400 I have to pay that they would work something out with me on the rest so we will just have to see...I still have to get accepted...cross my fingers!.... I have heard many wonderful things about him as well.  Your replies are so helpful and I appreciate it so much! 

No problem! That is what we are all here for.... to give and receive help and support! I went throught a rough time trying to get approved. But there are many who have had no trouble at all. I'll keep my fingers crossed for you! I didn't think I'd be able to go through with it but I did it! And I'm so greatful that I did. Good luck!

I had my surgery with Dr. Houston on 02/24 and they required me to put down a $250 deposit.  I actually had no co-pays and the surgery was covered 100% but they wanted that in case something happened with the insurance.   I would call and talk to Holly she could give you all the details on what Dr. Hosuton will require.    

Thank you so much jharrington and congrats on your surgery!  Everyone I talk to that has gone to Dr. Houston or who knows of him mentions Holly and how wonderful she is.  I haven't had the chance to talk to her yet.  Thanks again!