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Sterilization insurance woes...
Just wanted to complain a bit about the hell my insurance has been putting me through after my sterilization in May. Supposedly, sterilization is free through my insurance. Unfortunately, the specific procedure my doctor performed - full removal of both tubes - is considered by my insurance to be a cancer prevention procedure, with a side effect of sterilization. Ok, fine, I have to pay 15%, it's worth it.
On top of that, though, there was a surgical assistant present who was out of network, so I have to pay 30% for her, and it doesn't count towards my out of pocket maximum. If she was a doctor, they'd cover her as though she was in network, and if she was a normal nurse she couldn't bill me separately at all. She's an RNFA, though, so I'm pretty much out of luck there.
As a final bit of fuckery, they're currently refusing to pay for any of my anesthesia, claiming that 'AMA guidelines state that additional anesthesia is not required for this procedure." OK, fine, but we aren't asking for additional anesthesia, we're asking for the normal anesthesia required for laproscopic surgery. I have an appeal pending for this part, and expect them to make it right, but as of right now I have a significant bill sitting unpaid.
It's just been such a hassle! Perhaps they'd have rather paid for a pregnancy?? Right now I owe about five grand for a procedure that I'd thought would be free. Even when/if they handle the anesthesia issue, that's still three grand of unexpected costs. I'm beyond over dealing with all this =/
Sorry, just wanted to bitch somewhere. My thanks to you all for giving me an outlet.
8
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8 comments
Feel free to reply to any comment by clicking the "Reply" button.Here is a suggestion: set up a payment plan with the biller and agree to pay $5 per month for 500 years (or whatever) as long as you are making payments your account won't be flagged as delinquent and sent to collections... I work in healthcare and I have seen this work for others - Ha!
FrostyJim
Level 8
Feb 3, 2020
1
You should have been told upfront and before the procedure what you're out of pocket costs would be.. I'd fight every single item of your medical bills... Including those out of network charges... Don't pay anything...
Cutiebeauty
Level 9
Aug 20, 2019
1
The reason I'm not making too much of a fuss about certain parts is that I didn't do my homework properly. I did call to ask if the specific procedures I had done (more than one) were covered, but I did NOT ask if that procedure was covered as sterilization, with zero copay. I consider that my fault, unfortunately, and I don't think I have a case for an appeal. I will be trying to push a little harder where the surgical assistant is concerned, and I will be fighting tooth and nail over the anesthesia portion. Expensive lesson =/
@synergy it's up to you.. I would not pay anything especially if they said it was covered.. And it's their responsibility to inform you of any out of pocket expenses that you're obligated to pay...
@synergy There is only so much homework one can do. Hospitals and insurance companies are excellent at hiding things in the fine print. and they don't volunteer anything.
I have a large hospital bill waiting. If I was uninsured the hospital would discount it 50% if paid in full. With insurance they offered me a 10% discount 
And your story needs to be shared as a fck you to slut shaming anti-choicers about ooh just get yourself fixed! yea then pay for it bitch! After taking forever to finally be approved for it.
demifeministgal
Level 8
Aug 19, 2019
1
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