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One other thing you should be aware of Sareitha Sedai Send a noteboard - 11/02/2010 03:25:07 PM
You might have 2 different cost structures for what's considered "preventative" care and other medical care. This would not fall under the preventative section I wouldn't think, so make sure you're looking at the right set of numbers. You might have a different copay (and then again, you may not), and you might have to pay a percentage of what you're having done (typically 10-20%, depending on what type of policy you have). No matter how high the costs of what you need done, you should only have to pay up to the limit of your deductible for any covered procedures.

Okay. This is very useful. I still need to obtain a written copy of the policy, but it will be more understandable now.

In general, procedures are either covered or they're not...if your doctor decides they are medically necessary AND they are typically covered by your insurance, then insurance will pay their portion regardless of what the tests show. The one area that's greyer is in seeking emergency care for non-emergency situations. Don't do that Try to make sure your doctor/his staff is familiar enough with your insurance to have a sense of what is and is not coverable. BUT don't take their word for it. Find out what tests are going to be recommended for you and then look in your insurance booklet/online information to see if you need pre-approval or anything like that, or speak to someone in customer service at the insurance company if you're not sure. If they are telling you something's covered and you don't see it in your booklet/online explanation, try to get it in writing before doing the procedures. So for example, for someone of my age, preventative mammograms are not covered, but if my doctor had a medical reason to request one, my insurance pays for it.

*nods*

Don't go to a hospital. Your best bet is to find a good GP that can refer you out to specialists as needed. Do you know anyone locally that you trust enough to ask them if they have a doctor they recommend? You could also ask your counselor/therapist for a referral.

Heh, unfortunately I stopped doing therapy because I couldn't afford the copays. (Well, I could probably have managed, but I hate spending money when I don't have a consistent, reliable source of income.) And after a ton of unsuccessful phone calls, though, I've decided to try the social connections strategy... I don't know any townies, but my bf does.

Good luck. I'm coming at this from the perspective of someone with control-freak tendencies who has been in a similarly-financially-strapped situation, so the things I'm recommending may very well be overkill. But it helped me to know in advance what the limit of my financial liability was going to be, and to have that in writing in case there was a denial or the story changed after I had the stuff done That never happened to me BTW but I had heard too many horror stories to take that chance.

Thank you! Yeah, even aside from peace of mind that things will be covered in some form or another, it's very useful for planning.


I hope it helps

One other thing that occurred to me and you should be prepared for is that since your parents get all the policy information, it's very likely that they will get an "Explanation of Benefits" (EOB) for every doctor's visit/test/procedure that you get. This will list who you saw, what you had done, what the cost is, how much insurance is covering and how much you're responsible for paying (they won't get the bills from the doctors/facilities, those will come directly to you, but they'll know how much your bills are going to be). It won't give them the results of tests or your diagnoses or any details about your conversations with the doctors or anything like that, but they'll have enough information to worry/be mad/react however they will based on how or if you've prepared them for what they're going to see. It might also be clear from what you're having done what you're being tested for (if the tests are specific enough and/or your parents are knowledgeable enough). Just FYI.

I am not telling you this so you'll decide not to go through with your plan to find a doctor and seek answers (it sounds like you've decided you need to do that, and I trust your judgement there, so I would NOT let this factor into that decision). I just want you to be realistic in deciding what and how much you want to share with your parents, and at what point in time. If you don't prepare them in advance somewhat, you are probably going to get some pretty upset phone calls once those EOBs start arriving.



If you are from Betelgeuse, please have one of your Earth friends read what I've written before you respond. Or try concentrating harder.

"The trophy problem has become extreme."
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I have a medical costs question too... - 10/02/2010 03:08:14 PM 781 Views
If you look at your policy - 10/02/2010 03:27:15 PM 437 Views
I'm all for being a control freak when I can. - 11/02/2010 03:07:37 PM 396 Views
One other thing you should be aware of - 11/02/2010 03:25:07 PM 405 Views
Yes... that's very useful information. - 11/02/2010 03:46:17 PM 235 Views
I was afraid of that - 11/02/2010 03:52:49 PM 360 Views
You might want to call your insurer and talk to them about who to see. - 10/02/2010 03:34:53 PM 356 Views
Do you think an actual person would have better referrals than the website? - 11/02/2010 03:14:01 PM 410 Views
I do, and sorry for the delay. - 15/02/2010 02:11:55 PM 396 Views
I don't think we'll be able to do you much good. - 10/02/2010 03:36:57 PM 376 Views
For CU, that list seems to be really outdated. - 11/02/2010 12:13:06 AM 345 Views
I didn't read all the replies before I posted mine.Woops. *NM* - 11/02/2010 01:54:59 AM 201 Views
and as far as the frustrating part... - 11/02/2010 01:58:39 AM 228 Views
Hmmm. - 11/02/2010 03:17:50 PM 218 Views
Most doctor's offices - 11/02/2010 03:32:55 PM 386 Views
But it's embarrassing. <whine> - 11/02/2010 03:50:40 PM 344 Views
I'm sure - 11/02/2010 03:58:29 PM 344 Views
Sareitha pretty much covered it! - 11/02/2010 04:53:25 PM 386 Views
Mine was a little as well. - 11/02/2010 12:46:45 PM 369 Views
I just know a worried person should not pay a damn cent... - 10/02/2010 03:53:19 PM 409 Views
This is frustrating. (Meant as reply to main thread/everyone.) - 10/02/2010 04:05:57 PM 367 Views
Oops, I replied in the wrong place. - 10/02/2010 04:07:15 PM 240 Views
Well - 10/02/2010 04:10:12 PM 343 Views
Re: Well - 11/02/2010 02:13:08 AM 211 Views
Why? Should I not have to think about how to pay for my dinner tonight? - 10/02/2010 04:23:31 PM 354 Views
The Dole or hardship funds should help people who can't afford food - 10/02/2010 04:28:49 PM 259 Views
I agree, the needy should be helped. - 10/02/2010 04:32:45 PM 343 Views
I don't agree with your characterization of commonly proposed healthcare solutions. - 10/02/2010 04:42:06 PM 392 Views
I don't think he's mischaracterizing anything so much as responding to Jens' point directly. - 10/02/2010 04:54:55 PM 445 Views
<3 - 10/02/2010 05:06:29 PM 257 Views
As a response to Jens' point, it works, but he used very general language. - 10/02/2010 07:37:20 PM 223 Views
Furnace? Health? Erm... - 10/02/2010 08:04:03 PM 247 Views
no - 10/02/2010 08:40:12 PM 235 Views
I didn't like the example - 10/02/2010 08:46:24 PM 350 Views
that's why I pay for health insurance *NM* - 10/02/2010 08:58:06 PM 102 Views
So do we? *NM* - 10/02/2010 09:13:28 PM 192 Views
exactly - 10/02/2010 09:22:14 PM 281 Views
Precisely - 10/02/2010 08:00:39 PM 221 Views
There are several good reasons for that. - 10/02/2010 04:48:59 PM 377 Views
I understand you're not being serious, but... - 10/02/2010 04:37:12 PM 246 Views
Have you never looked at the boatloads of information that your insurer has surely sent to you? *NM* - 10/02/2010 04:19:09 PM 98 Views
I've never been sent a thing from them... - 10/02/2010 04:28:57 PM 379 Views
Do you or your parents hold the policy? - 10/02/2010 04:35:00 PM 228 Views
My parents do. - 10/02/2010 04:44:29 PM 411 Views
policy info.... - 10/02/2010 04:52:29 PM 337 Views
Thank you! - 11/02/2010 03:25:42 PM 215 Views
In my case... - 11/02/2010 01:53:32 AM 246 Views
*nods* - 11/02/2010 03:32:44 PM 333 Views
Your doctor's office should be able to answer most questions for you - 11/02/2010 02:36:10 PM 209 Views
Once I get one. - 11/02/2010 03:36:19 PM 224 Views
Well that should be your first step - 11/02/2010 04:49:00 PM 272 Views

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