Question:
What I am supposed to pay? Any clue?

I have Cigna PPO. There is a 90/10 coverage rate with a $500 dedcutible. Both my surgeon and the hospitial is in network with my insurance. I am not sure what I will have to pay. So far I have not scheduled my surgeon's appointment but I am finishing up on all of my medcial tests for approval. If approved can anyone tell me in the ballpark range on how much is going to come out of pocket?    — Danielle B. (posted on January 20, 2004)


January 20, 2004
At the time I had my surgery, I had Cigna EPP. I now have Cigna PPO with a $250 deductible. If I had to pay for the surgery I had in 2002 with the policy I have now, I would have had to pay $250 deductible plus 10% of ($5000 surgeon's fee and $20,889 hospital fee) which would have been $2589 additional costs. Hope that helps.
   — Cathy S.

January 20, 2004
You will have to pay your 500 dollar deductible and 10 percent of what the insurance company feels is a reasonable charge for the surgery. Most policies have an out of pocket max that you will have to pay for all out of pocket charges throughout the year. If you OOP max is say, 2000. That is the most you will pay for co-insurance (the 10%) for the entire year. So, it really depends on what your insurance company feels is the reasonable and customary charges for the procedure you are having. But the most you will have to pay would be the OOP max that is defined in your policy. If that much. Rebecca 10/03/01 265/140
   — RebeccaP

January 20, 2004
Wow, I confused myself with that one. Call your insurance company and see what your out of pocket max is, and if they can give your the reasonable and customary charges for the procedure. (for the hospital and surgeon) You should be able to figure it off those numbers. If you need help, feel free to email me.
   — RebeccaP

January 20, 2004
Sorry for the triple post...instead of R&C..use contracted rate. Your insurance company can tell you all of this. Call them.
   — RebeccaP




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