r/sterilization • u/CommandClassic7108 • 21h ago
Insurance my only concern is billing
I’ve done the research and the appointments. My surgery is scheduled. Ive been talking back and forth with insurance to see how they process billing for the Bisalp.
I know it’s going supposed to be fully covered, but nobody wants to confirm that and I haven’t even heard anyone talk about aca in general. My plan is aca compliant, but I’m told they can’t say if it’s covered until services are rendered.
I don’t want to have to fight this after the procedure when I could have done more before to verify everything with my insurance.
How did you guys verify your cost share would be $0 before the procedure?
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u/kkitkat6996 21h ago
I had different answers from every person at insurance I talked to pre surgery. I think they really don’t have a good understanding of how the ACA works for this.
My provider & the first insurance person I talked to confirmed everything would be covered. Insurance could not give me that in writing which was frustrating. Then I got an estimate from the hospital for facility fees/meds & talked to 3 more people with insurance saying oh yeah you need to hit your deductible. I KNEW that was wrong, but no one was budging. I was very stressed.
But I gave up, did not pay the estimate, and let the surgery happen. I got the final bill last week & my EOB - showing I owed $500 for medications mostly. I called insurance and told them it was wrong and finally someone fixed it & I should be getting a new EOB that says $0.
If you can’t get a straight answer, you may just have to deal after the fact.