Insurance Coverage— Preliminary Steps

Hi all!

Although not planned, a moment presented itself for me to mention my potential surgery to my boss. I thought it would be unprofitable for me later if I didn't take it.

So now my boss knows surgery is probable before the end of the year and I will be needing to work at home post-op. Preliminarily, it seems fine so far.

So this leads to Insurance prep and scheduling.

First,

I went online to check my insurance coverage:

      1. I went to my job's "Benefits" online, and

      2. My insurance carrier's website

On my jobs benefit site:

-I verified my annual deductible-cap for the year (The maximum you will pay in deductibles annually.)

-What percentage of "out-patient" procedures my plan covers

-and other things like cost of generic prescriptions, etc.

In my Insurance carrier's site:

-I re-verified that Dr. West is indeed considered In-Network (YAY!)

-I discovered that Dr. Yes is considered Out-of-Network (not sure if this is really bad yet…)

I want to avoid big surprises later so I also went online to see if I could find articles about how to verify coverage (the smart way) with my insurance carrier. This was not easy to find.

So I decided I would call the person at Dr. West's office who handles cost and scheduling (we'll call him Eddie) to see if he could lend some Do's and Dont's before I call my insurance company to verify the coverage of these procedures. (Remember, if Dr. West is able to work on all three of the issues on my left foot that means it will be submitted as 4 different surgeries.)

So now I sit and wait for him to call me back. ;-)

Hasta luego!