Headed For Surgery? Here Are 3 Questions You Need To Ask About The Insurance And Costs

According to the Centers for Disease Control and Prevention, there were 51.4 million inpatient surgeries performed in the United States in 2010. If you're headed for surgery, your health and well-being should be your top priority, not the potential medical bills you will accrue. Before you step foot into the hospital for your surgery, it is vital to take care of any financial considerations, including the cost of the surgery and your insurance coverage. Don't allow financial woes to hinder your healing process. Instead, here are 3 important questions you need to ask before going in for surgery:

Who Are All of My Providers?

Prior to receiving your surgery, it is vital to learn all of the names of any surgeons or doctors who will be providing you with care. Remember, in addition to your primary surgeon, you will also have several others doctors working on you in the hospital – including an anesthesiologist, additional surgeons and a follow-up physician.

Once you know all of the names of any physicians who will be providing you with care, it is vital to ensure all of these doctors are in your healthcare network. If you encounter a provider that doesn't accept your insurance, you may be held liable for the bill. Depending on the surgeon or physician, this could result in an extremely large bill.

If you discover a physician that isn't in your provider network, contact your insurance provider to see what can be done. For example, you can ask for a different physician, or learn what needs to be done to ensure the physician's services can be covered.

Is Everything Covered by My Insurance?

Now that you've inquired about the physicians and healthcare providers, it's time to understand exactly what your procedure will involve and what is covered by your insurance company.

Begin by speaking with your physician or surgeon. Ask them which procedures and tests are involved in your surgery. For example, if the surgeon discovers a problem prior to the procedure, will you require a new set of potentially expensive tests? Even if it's only a slight possibility, it is important to learn exactly what procedures and tests your doctor might need to perform.

Once you have a list of potential tests and procedures, contact your insurance provider. Provide them with a list of potential procedures and tests and inquire if they are all covered by your plan. In some cases, you may require pre-authorization from your insurance carrier before the surgeon is able to perform any expensive procedures or tests.

What Will I Have to Pay Out-of-Pocket for the Surgery?

Finally, when it comes to the financial aspects of surgery, chances are your biggest question is: How much will I need to pay out-of-pocket for the surgery, tests or after care? Your insurance provider will have all of the information you need to ensure you have enough funds to cover any costs.

Depending on your insurance plan, the costs could include a deductible and a co-pay, which will generally be a percentage of the total bill.

If you are concerned about the costs and potential out-of-pocket expenses, there are things you can do. For example, learn about any state or federal programs that can help you pay for your share of the medical bills. You can also work directly with your physicians to lower the costs of the medical bills. Physicians understand their patients have financial concerns, so don't be afraid to ask your surgeon, anesthesiologist or other physicians about lowering their fees.

From inquiring about potential coverage issues to making sure you are able to pay any out-of-pocket expenses, when it comes to going into surgery, there are several important financial questions you need to ask. For more information, talk with an insurance agent, such as those at Health Shop Inc.


Share