I am needing a surgical procedure and my insurance has a $7500 lifetime cap on it. The surgery generally can cost anywhere from 28k to over 40k depending on the surgeon. I know that physicians contract with insurance companies. Do hospitals do that as well? How will I know what I will be billed personally after all is said and done? Any help someone with this kind of experience can give me would be greatly appreciated!!
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yes, hospitals contract with insurance companies, also. You can call the hospital, and ask them what the contracted amount is for that procedure, and ALSO ask them what the contracted additional charges are for anesthesia, daily rate for the room, nursing care, etc. You should be able to get a pretty good idea what the TOTAL cost is, to figure out how much is going to be over the $7500 lifetime cap. You should also call the insurance company, to clarify that you haven't had it done before, so that you've got full access to teh entire $7500 - and see what other deductibles and copayments apply.
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