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Insurance Questions
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Anthoxerzes posted:
HI,

First of all, does the "meet your neighbors" still exist? I can't find it.

But here are my questions. I'm all of a sudden it seems coming down with can be classed as serious health problem. In this case, the kidneys. Can someone tell me what the co-insurance? Is it not what the card holder pays after the insurance pays their portion less discount and deductible? My insurance pays 80% of covered charages. A diagnostic bill totalled $3900. The insurance paid something like $2400, but I still have a $500 deductible and less the discount whatever that is, and I still got a bill for a little over $1000.

Second question: does the medical provider expect payment in full and right away? What if the card holder can't afford to pay the entire amount as one lump sum? then what happens? Can they seize your property and bank accounts? I've never had to deal with this type of problems before. But now it seems I need to know. All this is new to me and is scary both financially and medically.

thanks,
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MandyL1953 responded:
Hi,
Anthoxerzes - Welcome to active aging. I'm sorry that.you have developed kidney problems. I am definitely not an insurance expert.

Co Payment is what the patient pays after your insurance has paid it's percentage of their contracted amount for a particular procedure. Insurance companies contract with doctors, labs, hospitals, etc. The contract specifies how much they will pay for various procedures. My understanding is that the provider agrees to accept what the contracted amount is and write off the difference.

I would absolutely check with your insurance company to see if the provider participates with your insurance company. If they do participate, then they are supposed to accept what the insurance company pays - but of course if the insurance only pays a percentage of the bill, then you are liable for the rest.

But please call the inurance company - there you will get the answer for your situation.

Good luck.

Mandy


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