Major surgery raises questions, such as concerns about your diagnosis and treatment. New patients may worry about paying for your care. You may be uncertain what your insurance covers. Most patients want to know what to expect from their insurance company before going into surgery.
Dr. Kuether’s staff can help you understand your benefits. We accept most private insurance and worker’s compensation claims. No matter what your level of coverage, we can help you. We may be able to arrange discounts and payment plans.
Some types of brain and spine surgery are scheduled well ahead of time. If Dr. Kuether is treating you for carpal tunnel syndrome, neck pain or back problems, you’ll likely have time to investigate your coverage and get pre-approvals.
Speak with your insurance company to learn about your benefits. Your insurer will let you know what portion of your treatments are covered and what portion is your responsibility. If you have disability coverage, you may be able to collect benefits while you recover from surgery.
Ask your medical or disability insurance company the following questions before you schedule a surgery:
* What is my policy’s maximum payout? Does this procedure fall within that limit?
* Does my policy pay for post-surgery home health care or rehabilitation? What is my prescription drug benefit?
* What is my disability benefit? How much will I receive each week?
* How long after surgery until my disability coverage starts?
There are three basic types of health coverage. Each type handles patient care differently. Most plans require copayments and some have deductibles. Here’s an overview of how each type of insurance handles referrals.
* Health maintenance organizations: An HMO pays for medical care when you visit a doctor within the network. Most require a referral before seeing a specialist. You’ll have to pay your expenses if you visit a provider outside the network.
* Preferred provider organization: A PPO allows you to choose your doctors. If the doctor you see is not a preferred provider, you’ll pay more than if you see in-network physicians.
* Point of service: A POS generally requires a referral to see a specialist. You can visit an out-of-network doctor, but you’ll be responsible for a higher portion of your expenses.
A ruptured brain aneurysm is a life-threatening crisis that requires prompt treatment. If you have a health crisis, you won’t have time to query your insurance company. Insurance companies handle payment for emergency care differently.
We understand no one wants to worry about medical expenses when they need an operation. We’ll do our best to make it easier by helping you understand your plan and coverage.