Advantage plans & co pay for in hospital care ... - Page 2

Bri36 · ‎02-20-2017

That's great it all worked out to your advantage

As you've been told many times, your plan is specific to you and your area and when you signed up.

esmerelda · ‎03-10-2010

The complaint I hear about advantage plans is you are limited in your choice of doctors.

@151949 Hypothetically...if you needed treatment in Texas, would your advantage plan cover that?

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Keepin' it real.

151949 · ‎03-09-2010

Of course all insurance will cover emergency treatment everywhere but my ins. has what is called a passport option so we can travel with it.Important to us because we are snowbirds.

For example - a couple years ago we were in New York. I went to grab a dock to get out of the boat and the boat jerked and I got a huge chunk of wood ramnmed into my hand. We went to a 24hr surgi center but they just numbed it with novacaine and sent me to the ER as it was going to need surgery to remove it. Had the surgery that evening , stayed in the hospital overnight so they could give me IV antibiotics & went home in the morning. Paid for all but the copay for the hospital room -$300.

esmerelda · ‎03-10-2010

@151949 I'm not talking about care while traveling. I'm saying...let's say you have a condition that needs specialized treatment only done by a couple of doctors in the country. One is in Texas, one is in California. Would you be covered if you went there for treatment?

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Keepin' it real.

151949 · ‎03-09-2010

@esmerelda Did you read what I said about my knee surgery ? The surgeon got in touch with the ins co and got the out of network procedure pre approved. I only had to pay the in network fees.

CLHS68 · ‎03-23-2010

I have an advantage plan & so far it has been the right choice for me. I have a question maybe one of you can answer. I will be going for surgery in a couple of weeks & although my doctor & hospital are in network. I am being told some of the doctors will not accept insurance (the one giving anesthesia). I was told I would have to pay him. I ask insurance if I could send it in and get some back & she told me I could. But in the book it sounds like they won't pay me. Do any of you have experience with this?

esmerelda · ‎03-10-2010

@151949 No, I hadn't read that. There's a lot I don't read.

what does TKR mean?

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Keepin' it real.

GenXmuse · ‎05-15-2016

Well, I guess you showed all those naysayers out there. Well done.

151949 · ‎03-09-2010

TKR = total knee replacement

151949 · ‎03-09-2010

@CLHS68 Sorry I don't have an answer for you on this because here in Florida it is illegal for them to do this. If you have to use anesthesia or radiology at an in network facility and you have no choice to use someone else who is in network - they are required to pay the same as if he is in network. I would just pay it and then turn it in to be reimbursed.