posted on Jul, 1 2018 @ 02:31 PM
originally posted by: sarra1833
For the first time in my 45 years, l finally have medical ins..
And I know nothing about it.
I guess the main 2 questions I have is this (it's UnitedHealthCare, btw).
1. If I get some procedure done (first time using card) and it's $500, do I have to pay the whole 500 since deductible is still $0 paid by me or does
United pay a bit, I pay the rest and "the rest" is toward deductible?
Depends on the plan (PPO, HSP, etc.), but generally, yes, you will pay for procedures up to your deductible amount, then you will pay the percentage
described in your plan after that.
2. If I can't pay my portion in any point in time, pre or post deductible, must I stop going to the dr/hospital until it's all current?
In a word, no. You can still continue to seek healthcare as long as you pay your premiums, but that doesn't mean you don't have to pay the bills, or
that providers won't turn you over to collections and wreck your credit.
3. If a quote of what the insurance says they'll pay is very littoe, do I just have to suck it up and accept it or can I fight it to get them
to pay more?
You'll pretty much have to suck it up. Negotiating with insurance companies is next to impossible. In fact, you've got a better chance negotiating
with the provider than you do the insurance company. The insurance company wasn't there, you were. That said, your insurance company IS supposed to
fight on your behalf to remove frivolous charges and the like. Unfortunately though, this whole game is a self-fulfilling prophecy...providers jack
up their costs because they know insurance companies are going to negotiate them down, then both them get more creative to the point it takes
attorneys to sort it out. Providers know how much they can push this before you'll get an attorney, and they'll stop just short of this amount.
They'll both also waste as much time as humanly possible giving you the run-around, so unless you have all day for weeks at a time to deal with all
the being put on hold, transferred to someone else, etc then it's not worth the time usually. They know this too and employ these tactics with
absolute brutal indifference.