
www.Usenet.com
| <-- __Chronological__ --> | <-- __Thread__ --> |
hi, this is regarding the medical insurance, which my company pays. i've PPO. i recently had a minor 1-hr surgery to my finger. the doctor who performed the surgery was referred to by another in-network doctor. before i went to the doctor i called their surgery center and asked if the doctor is in-network and they said he was. after performing several tests (including blood sample) and scheduling my surgery the doctor said the surgical center is out-of-network. then i thought it might not be a good idea to change the surgical center as they had done all the necessary tests etc. i asked my colleagues and the dept. in our office that handles the med. insurance related actives how much would i have to pay for the surgery if its out-of-network and they said its 30%, i was fine with it. after the surgery i found out that the insurance company does not cover that kind of surgery, and its a 5 digit amount which i never imagined, a total shock to me. now i don't know where did i go wrong. probably even if i had read the book that explains the benefits i wouldn't have figured out that my provider doesn't cover that particular surgery. i was asking everyone just to avoid this situation. the terms that the benefit book contains aren't so simple. the benefits summary that our company gave us mentioned that for out-of-network my provider pays 70% and i went by that. i would have expected the doctor to know or atleast warn me. when i called the surgical center to find if it was in-network doctor, why didn't they tell me that the surgical center was out-of-network or why didn't the doctor tell me before he performed the necessary tests for the surgery. the entire system seems to have defects. perhaps everyone of us should have a 101 course on medical insurance. in the end i think its my fault for not finding it out, probably i should have contacted my provider but again will that work? btw, this is the first time i ever used my med insurance. it was a really expensive lesson. has anyone else been through this? thanks for reading -msm
| <-- __Chronological__ --> | <-- __Thread__ --> |