Neurofibromatosis Support Group

Both times my husband has some removed we had to meet our $500 deductible & then pay 20% until we maxed out at $1500. The first one he had wasn't cosmetic...he had one in his knee that hurt. His last surgery was cosmetic. I guess it depends on the insurance. Hope all goes well :)

you hae to have a dr that willl work with you. It is all in the proper coding. I'm not familiar with medical coding but your drs office should know what to put down so the insurance will pay for it. good luck

Your problem is not your insurance company, your problem is your doctor. You must convince your doctor that the surgery is not cosmetic. If you can do that, there are codes he can fill in on the forms to get your insurance company to pay. Good luck and God bless.

Thank you.

I will have to talk to him , b/c like I said i have only had to pay $100 co-pay for everything last time. I was just worried about this time b/c of what happened to my sister. I should be getting it some time soon.

i agree with all, depends on your insurance.
Both times I had some removed, my doc (plastics guy) made sure to indicate that it was not cosmetic. I had some on my face that changed size & I had some on my chest that were all right on my bra line; those were painful!
I just had a 10% deductible.
Most insurances should let you dispute when they would pay.
Good luck!

When I had the ones on my bra line removed my doc wouldn't even turn it in to insurance! He made me pay up front. Asshole.

yeah it depends on your Dr and your insurance company.... call your insurance company and make sure your dr and the hospital are "In-network" that will help save money. your insurance company will be able to tell you what your deductable is ( the amount you pay up-front) You will probably have to pay 20% of all costs. and your insurance will pay 80% up to the "Max amount" you should recieve seperate bills from your Dr, Hospitol, Anesthesiologist, and maybe a Pathologist, or any other specialists.

last time i only paid a flat $100. I didn't recieve seperate bills. Ws it all included, or does it depend on the hospital? sorry for asking so many questions.

it may depend on the doctor and hospital. last year i had me doctor's bill, the hospital's bill, the anesthesiologist's bill, and the pathologist's bill. I would definetly talk to your insurance company though. they will be able to answer all your questions much better than any of us could. they will also be able to tell you if your Dr. & hospital are "in-network". take a look at your explaination of benifits . also check out the hospital's website. a lot of times in the event your insurence won't pay or something like that they will work with you and give you a sizable discount on services recieved and or help set up a payment plan.

it depends on how the doctors office "CODES IT" every surgery I have had has been covered by my insurance due to they way it was coded and with a letter from my doctor, Now he's where it get a little tricky, anyone who takes part of the procedure has to be in your net work, the hospital , the lab, even the anesthesiologist. If not you have to pay the out of net work fees. Hope that helped a little