First things first, with my insurance, I have a $750 deductible that has been met and $3000 out of pocket max of which I am $600 away from meeting at the time this all started. My coinsurance is 20%. My ER copay is $300.
In the last month, I was seen in the ER, diagnosed with gallstones and had laparoscopic gallbladder removal surgery. All of it was done by in-network providers.
Leaving the ER, I was told I had to pay $220. The way I understood it was that it was the coinsurance, 20% of an estimate of the cost of services. A few days later, I got a bill for $600+. I didn’t sweat it because I figured after this, I will have reached my out of pocket max.
A few days later, I met with a surgeon who recommended gallbladder removal.
Arriving to the hospital for surgery, I was told I had to pay $1,300 before surgery could be performed. I assumed it was that 20% coinsurance again. I was confused because I should have hit my out of pocket max but I was also desperate to be able to eat normal food again, so I paid it.
Today, I had a follow up appointment and paid $45 at the beginning of my appointment.
I also got a text from the hospital today that another bill has posted for $630.
What gives? Am I understanding all of this correctly? Insurance is not a language I speak fluently but I’m also not a complete dummy either. Shouldn’t my coinsurance count towards my deductible and out of pocket max? Do I need to submit the receipts to my insurance for reimbursement? It’s all just so overwhelming to me. Please help.
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