Will I Start Paying for my Breast Reduction Before or After Surgery?

Question

My insurance deductible is $5000. How does this work?

Ronald J. Edelson, MD · Answer

If your insurance has pre authorized your surgery but you have a high deductible, either the surgeon, the operating room, or both may want some form of pre-payment. It will depend on the surgeon and operating room policy. Personally, I wouldn't bring up the issue unless they do first. It'll just be our secret.

Miguel Delgado, MD · Answer

For patients that do not have insurance most offices require payment in full prior to surgery unless other arrangements have been made. If you have insurance, the insurance company will not cover any expenses until your deductible has been met, so again most offices will require that amount to be paid prior to surgery or the day of. Be sure you have pre-authorization from your insurance company before surgery. Your plastic surgeons office should be able to help you with this. Good luck.

Robert Brueck, MD · Answer

What this simply means is that the first 5000 for medical expenses simply coems out of your pocket so you would have to pay for this first.

Gregory Sexton, MD · Answer

If you have a $5000 deductible, that means you will have to pay $5000 before your insurance company pays a dime. In situations like this we require payment in advance, and refund any amount insurance pays.

Elizabeth Kim, MD · Answer

After your consult, the office performs a pre-authorization. If your breast reduction is covered by insurance, our office bills your insurance. Once the EOB (explanation of benefits) is received, we bill the patient for the amount they are responsible for. If you have not met your deductible (or have a sizable portion of it remaining since it is early in the year), you may end up contributing a significant sum. Also, look into your max out of pocket requirements with your insurance. Some insurance companies only cover 70% of surgery. Call your insurance company, they are usually very helpful with explaining what you may owe.

Tom J. Pousti, MD · Answer

Thank you for your question.

	Each office works differently in regards to performing surgery through insurance.  At my office, we bill the insurance and once the insurance sends us the EOB, we bill the patient "their portion".

	Check with your surgeon's office to find out their procedure.

	Best wishes.

Will I Start Paying for my Breast Reduction Before or After Surgery?

Answers (6)

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