11/2/08 … Who’s Preferred?

Don’t you just hate it when you get news on a weekend and can’t do a thing about it until Monday? Big bonanza in the mail today. I received a stack of EoB’s plus five letters regarding the scans that Dr. Onc had asked for.

There was one letter for the MRI stating it was approved as medically necessary but that I was using a non-preferred provider so there could be additional financial responsibility. The other four letters were in a similar vein for the CT and PET CT scans.

I was confused about the non-preferred provider part because this medical group is well-known for accepting insurances. At first I was tempted to ignore it because I already know I’m easily going to hit my deductible this year, so what more financial responsiblity could there be?

Okay, here’s today’s lesson. I went on the website to try to figure this out and ultimately found the place where they showed my dedutible, plus my co-pay maximum for preferred and non-preferred providers. The co-pay maximum is $7,000 for preferred and $10,000 for non-preferred. Ouch! Does this mean my total out-of-pocket this year is going to be $12,000-$15,000 instead of the “mere” $5,000 I was planning? It’s on my to-do list for Monday to call and figure this out.

Oh look, my EoB’s show that I’d already reached my $5,000 deductible before the first surgery was even over. Yikes!

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