Provider making me pay Deductible & OOPM
Hello! I need feedback. I’m having surgery the end of the month. I have Blue Cross Blue Shield PPO $2500. My deductible is $2,500 and my out of pocket max is $5,500. I was given my total cost for the surgery from my provider which is right around $7,500. They are insisting that I must meet BOTH the deductible AND out of pocket max before my insurance picks up 100%. I’ve researched, called BCBS, both say it’s $5,500 that I must hit meaning, the deductible is included as part of the OOPM. The provider basically mocked me at my appointment on Friday saying I had to meet both numbers. They went ahead and collected my payment for the surgery – approx $7,500. They also sent me a photo of my $$ tracker on my health insurance plan which said I had paid $0 on my deductible this year and just a few hundred towards my OOPM. I’ve never heard of the deductible not being included as part of the out of pocket max. I have just about the most normal insurance that you can get. Is there anyone who can weigh in on this either way? I’m closer to cancelling my procedure bc I’m so irritated. Thanks!!
submitted by /u/Heavy-Boysenberry833
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