Re: Surgery costs (after insurance)

[Guest guest]

I think you are right in my case as well, here is what my plan says:

" Annual deductibles, charges in excess of reasonable and customary

charges, and pharmacy copayments will not apply toward your maximum

out-of-pocket expense limits. "

So, if I go out of network, they just pay 60% of what is reasonable

and justified or whatever. So, I bet I'd end up with a $5000+500

deductible, plus some decent chunk of the rest of my bill.

Since I'm looking at an estimated $30,000 in Chicago total for a

osteotomy and a lefort (I I think). Guess I need to beat my

orthodontist (figuratively) into finding another OS.

> When figuring the percentage insurance may cover, be sure to find

out what

> the percentage includes. I have Blue Cross of Oregon. IF insurance

deems the

> surgery medically necessary, we would have a maximum $2,000 out of

pocket

> expense. Then, insurance would pick up 70% of the doctor's costs,

but ONLY

> on the portion considered " usual cost/customary rate " (about 30% of the

> total).

>

> Upper/Lower: $16,008

>

> $8,498 (doctor costs)

> $1,785 (insurance benefit)

>

> Lower: $11,662

>

> $5,081 (doctor costs)

> $1,067 (insurance benefit)

>

> I decided I didn't need this stress and took out a second mortgage.

We'll

> see what happens!

>

> I get my spacers on March 7 and braces March 14...surgery probably

in about

> a year.

>

> Diane

>

> >From: " rakushka " <rakushka@y...>

> >Reply-To: orthognathicsurgerysupport

> >To: orthognathicsurgerysupport

> >Subject: [Orthognathic Surgery Support ] Re: Surgery costs (after

> >insurance)

> >Date: Tue, 01 Mar 2005 17:31:29 -0000

> >

>

>

>

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