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by jandrese 610 days ago
They don't know. Nobody does until the bill is processed. There are a thousand factors that might affect your coverage. This is the nightmare I'm living through right now. Even if you have the code and doctor and patient the help desk at the insurance company can't say for sure if they will cover it or not. That comes down to the discretion of the claims adjuster. You won't know if something is going to cost $100 or $10,000 until after it is done.
1 comments

> They don't know

It works every time I asked.

The provider or the insurance company? The provider can give you the cash price, but that's a made up number with no relation to reality. The Insurance company can give you what the standard discount would be on that procedure, but they can't say if they'll cover it, give only that discount, give nothing, or anything in between.
The provider. And yes, I negotiate.
The prices you're getting are fake, whether you know it or not. Because you're not the one paying.

This is why it's sometimes cheaper to have no insurance than insurance.