TRICARE/Humana Military—Changing surgeons/doctors for post surgery follow up?
I am in New York state. Apologies if I chose the incorrect flair, I am new to this sub.
I have a PPO through my employer with a $1.5k deductible and $4.5k in-network OOP max. As of September, I have spent $900 toward my deductible and $2.1k toward my OOP max. I max out my health care FSA every year, and my employer provides an additional $200 in an HSA HRA. I currently have $275 of this money remaining for 2022, inclusive of the employer-provided HSA HRA. I am in the process of scheduling a voluntary hysterectomy and am torn on whether to schedule it for December 2022 or January 2023. I have already spoken with my insurance, and I am responsible for 20% of this procedure after my deductible is met. They did not provide me with any other cost information, just my benefits.
I am truly torn on whether to:
schedule the procedure for this year, eating up the remaining $600 and $2.4k of my deductible and OOP max, or;
schedule for January, which, depending on who in my life I ask and whether the surgery costs $4.5k or more, may or may not help me avoid medical expenses for the rest of the year.
My therapist took a look at my benefits and advised me that, should I hit my OOP max for 2023 with this surgery, I could possibly avoid copays and prescription costs for the rest of the year (I am a medically complex individual and pay a minimum of about $250/month for medical expenses between office visits and medication). My mom is pretty skeptical of this and does not believe that copays or prescription costs are affected by my OOP max being met or not.
I am also pretty attracted to the idea of being able to just swipe my FSA card in January and pay for the whole (or most of the) procedure up front, but that puts me in a tight spot if my mom is correct and I am still responsible for copays and prescription costs afterward.
If it matters, I have a $25 copay for my PCP and therapist, $50 for specialists, and the most expensive of my medications is $12.50 for a 30-day supply.
