Baruatric Surgery Questions

Hello All,

My wife is trying to get bariatric surgery and we're trying to understand the quote that her insurance/the hospital gave us for how much we would have to pay.

Her insurance has a $2500 deductible and a $7500 maximum out of pocket. For bariatric surgery specifically, it splits coverage between professional services and a facility fee. For professional services it has a $5000 copay and then 30% coinsurance after deductible. For the facilty fee it has a 30% coinsurance after the deductible.

The quote from the hospital says that we will owe $2500 for the deductible and then $5000 toward professional services and another $2500 for the deductible and $30 toward the facility fee. So the total quoted is $10,030.

What I don't understand is why we are being charged the deductible twice and why we are being quoted $2500 more than the plan's maximum out of pocket?

Any insights y'all can provide would be appreciated, thanks!

submitted by /u/boilercat57
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