Re: Enduring massive hospital expenses from surgery ATT:

[Guest guest]

I live in Wisconsin. I am under my parents insurance which is a

family plan and it's paid for by themselves because they are small

buisness owners. So they pay a lot a month and in return get really

crappy coverage because they could pay a couple thousand and have

better coverage but who can afford that. So we have a high

deductible and crappy coverage. That's about all I can tell you and

if you need to know anything else let me know and I can always ask.

Thanks,

April

> I am just curious if anyone else here has had surgery and has

> massive bills as a result of insurance not covering a lot of the

> expense. My problem is because I wasn't admitted to the hospital

> and it was considered a day surgery my insurance only covered 80%

up

> to $1200. Now I am stuck with owing the hospital $12,000 and I

> don't have even half of that. I don't work because I am a

fulltime

> college student. My parents want to help but can't afford to.

> I am very angry that if it was a day surgery then I should have

> been able to go home and if that was not suitable then they should

> have admitted me so that the insurance would have covered more

than

> what they did.

> Ok, so overall, I was wondering if anyone else got stuck with a

> lot of bills from surgery and how did you handle it. Any advice

> would be helpful because I feel lost and helpless.

>

> Thanks,

> April

>

>

>

>

[Guest guest]

-

It's AHC it's through a company called Mid-West National Life

insurance Co. of TN, which the company is actually in texas. It's an

individual family plan, there are no other employees covered under

the plan. (My parents don't offer it). I know our deductible is

$3000. I'm not sure what the maximum out of pocket expense is and

what is a co-insurance amount?

April

> > I am just curious if anyone else here has had surgery and has

> > massive bills as a result of insurance not covering a lot of the

> > expense. My problem is because I wasn't admitted to the hospital

> > and it was considered a day surgery my insurance only covered 80%

> up

> > to $1200. Now I am stuck with owing the hospital $12,000 and I

> > don't have even half of that. I don't work because I am a

> fulltime

> > college student. My parents want to help but can't afford to.

> > I am very angry that if it was a day surgery then I should have

> > been able to go home and if that was not suitable then they

should

> > have admitted me so that the insurance would have covered more

> than

> > what they did.

> > Ok, so overall, I was wondering if anyone else got stuck with a

> > lot of bills from surgery and how did you handle it. Any advice

> > would be helpful because I feel lost and helpless.

> >

> > Thanks,

> > April

> >

> >

> >

> >

[Guest guest]

April,

The co-insurance amount is the amount the insurance company pays AFTER the deductible has been met. Say the co-insurance is 80% and you have a bill for $100. The insurance company would pay $80 and you would pay the remaining $20. The maximum out of pocket is the amound you would pay out of pocket before the insurance company pays at 100%.

For example, we use BlueCross and BlueShield for a lot of our individuals. The out of pocket max is $10,000. BCBS pays 80% up to $10,000 leaving you with $2000 to pay of the $10,000 (or 20%). Anything after that would be paid at 100%. This does not include your deductible. So in your case you would be responsible for the $3000 deductible up front and once it's been satisfied the co-insurance kicks in (the 80% of 10K). So your total out of pocket expense would be $3000 plus the $2000 for a total of $5000.

If, at the time of your surgery your deductible had not been satisfied nor the out of pocket expense, then you would be responsible for the majority of the cost. If your deductible has been satisfied then you would only be responsible for the co-insurance amount on your plan (which is usually 70% or 80% but could be less or more).

See if you can find out what the co-insurance amount is and the out-of-pocket expense. If the insurance company paid 80% of $1200 then it's possible that your deductible had not been met before the surgery which means you will be responsible for the majority of the bill. What was the total cost of your surgery?

aprildr2 <aprildr2@...> wrote:

- It's AHC it's through a company called Mid-West National Life insurance Co. of TN, which the company is actually in texas. It's an individual family plan, there are no other employees covered under the plan. (My parents don't offer it). I know our deductible is $3000. I'm not sure what the maximum out of pocket expense is and what is a co-insurance amount?April> > I am just curious if anyone else here has had surgery and has > > massive bills as a result of insurance not covering a lot of the > > expense. My problem is because I wasn't admitted to the hospital > > and it was considered a day surgery my insurance only covered 80% > up > > to $1200. Now I am stuck

with owing the hospital $12,000 and I > > don't have even half of that. I don't work because I am a > fulltime > > college student. My parents want to help but can't afford to. > > I am very angry that if it was a day surgery then I should have > > been able to go home and if that was not suitable then they should > > have admitted me so that the insurance would have covered more > than > > what they did.> > Ok, so overall, I was wondering if anyone else got stuck with a > > lot of bills from surgery and how did you handle it. Any advice > > would be helpful because I feel lost and helpless.> > > > Thanks,> > April> > > > > > > >

[Guest guest]

Find out if you can get State Aid to pay for the remainder of the

bill.

> > > I am just curious if anyone else here has had surgery and has

> > > massive bills as a result of insurance not covering a lot of

the

> > > expense. My problem is because I wasn't admitted to the

hospital

> > > and it was considered a day surgery my insurance only covered

80%

> > up

> > > to $1200. Now I am stuck with owing the hospital $12,000 and I

> > > don't have even half of that. I don't work because I am a

> > fulltime

> > > college student. My parents want to help but can't afford to.

> > > I am very angry that if it was a day surgery then I should

have

> > > been able to go home and if that was not suitable then they

> should

> > > have admitted me so that the insurance would have covered more

> > than

> > > what they did.

> > > Ok, so overall, I was wondering if anyone else got stuck with

a

> > > lot of bills from surgery and how did you handle it. Any

advice

> > > would be helpful because I feel lost and helpless.

> > >

> > > Thanks,

> > > April

> > >

> > >

> > >

> > >