Ct Scan Copay

Your copay is usually a very small amount compared to the total cost of that office visit. Coinsurance: Coinsurance is the percentage that you pay for a covered service, after the deductible has been met. Let’s say a CT scan is covered with a 20% coinsurance, and the scan costs $1,000, you will pay only $200 for the scan as long as your. $0 copay 1: Diagnostic services (such as sleep studies, CT scans) Up to $100 in an office 1. Up to $150 in a hospital 1. Chiropractic Care $30 per treatment; up. Learn more about how to estimate your costs before you get your care. You may pay up to 36% less.

Basic Option
Preventive Care	Nothing for covered preventive screenings, immunizations and services
Physician Care	$30 for primary care¹ $40 for specialists¹
Virtual doctor visits by Teladoc^®	$0 for first 2 visits $15 all additional visits
Urgent Care Center	$35 copay
Prescription Drugs	Preferred Retail Pharmacy: Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $55 copay² Tier 3 (Non-preferred brand): 60% of our allowance ($75 minimum)² Tier 4 (Preferred specialty): $65 copay² Tier 5 (Non-preferred specialty): $90 copay² Mail Service Pharmacy: Available to members with Medicare Part B primary only. Visit the Medicare page for more information. Tier 1 (Generics): $20 Tier 2 (Preferred brand): $100 copay Tier 3 (Non-preferred brand): $125 copay Specialty Pharmacy: Tier 4 (Preferred specialty): $85 copay² Tier 5 (Non-preferred specialty): $110 copay²
Maternity Care	$175 inpatient $0 outpatient
Hospital Care	Inpatient (Precertification is required): $175 per day; up to $875 per admission Outpatient: $100 per day per facility¹
Surgery	$150 in an office setting¹ $200 in a non-office setting¹
ER (accidental injury)	$175 per day per facility
ER (medical emergency)	$175 per day per facility
Lab work (such as blood tests)	$0 copay¹
Diagnostic services (such as sleep studies, CT scans)	Up to $100 in an office¹ Up to $150 in a hospital¹
Chiropractic Care	$30 per treatment; up to 20 visits per year
Dental Care	$30 copay per evaluation; up to 2 per year
Rewards Program	Earn $50 for completing the Blue Health Assessment³ Earn up to $120 for completing three eligible Online Health Coach goals³

,15 tweets,3 min read

My Authors

Them: Your copay for the CT scan will be $500
Me: Whaaaat? No way. Who'd you talk to at my insurance?
Them: ...
Me: What's the cash self-pay rate, if I don't use insurance?
Them: Uh, $300
Me: ...

Me: So the CT scan is $300 if I self-pay, but $500 if I use my $500-a-month insurance?
Them: ...yep
Me: Okay I guess I'll pay cash then
Them: Fine. But the radiology charge will be separate, and I don't know what their self-pay fee is
Me: Can you find out for me?
Them: ...

Them: Okay here's the number for radiology to find out their self-pay fee
Me: Wait, while you had me on hold I checked my plan info...
Them: ...
Me: It says my CT scan copay should be $300, not $500
Them: ...
Me: So... can you call my insurance
Them: ... [sighs] Fine, sure

Mind you, this is all about an hour after my ENT's office called my insurance to get the CT scan approved, then called me back and said it would cost me $100. But maybe that's just the radiology fee? WTF?

When I asked why my insurance copay on this CT scan was more than a cash self-pay rate, I was told that the self-pay matches the best negotiated rate, i.e. the Medicare rate. So... why don't we all just have Medicare, again?

Them: So, two separate reps from your insurance told me it's *actually* gonna be $500 for this CT scan, *plus* a 50% coinsurance
Me: So... you're actually not in my insurance plan, is what you're saying?
Them: ...Yes?
Me: Kthxbai

Me: Dear insurer, can you please help me find a CT scan imaging co that's in my network?
Them: Sure. So you know that's a $400 copay, right?
Me: My plan info here says $300.
Them: Is that 2020 plan info?
Me: I mean, your website gave it to me! So it's [looks] ... from 2015

Me: Dear insurer, why is your copay on my plan $100 more than the self-pay rate for a CT scan?
Them: We can only vouch for our negotiated rate. That's why I tell people, if self-pay is cheaper, don't use the insurance.
Me: ...
Them: ...
Me: That's...
Them: ... I know, right?

Me: So I guess the place I'm scheduled for -- Broward Health Imaging on Andrews -- isn't in plan, since they say it'll cost $500 plus 50% coinsurance, so can you please send me a list of in-network providers for this CT scan?
Them: Sure thing, we'll email it
Me [opens email]:

At this point I'd just pay 300 bucks for a thickly accented Austrian to tell me 'Eet's naht a tumor'

Me: Dear insurer rep No. 2, can I get an in-plan CT scan at Broward Health?
Them: Well, they're in your plan
Me: Great!
Them: Buuuut they'll bill you as a hospital outpatient, so you're on the hook for coinsurance, let's find you an independent in-plan imaging office
Me: ...

Them: Whoa did someone tell you a CT scan would be $100?
Me: Yes! My ENT, when they got approval from you guys for the imaging
Them: Yeah no, $100 is for *X-rays*. Which *also* means your *CT scan* is not approved. Whew, good thing you didn't go to that appointment!
Me: ...

Me: So why should I do this for a $400 insurance copay and not just self-pay $300 around the corner?
Them: The copay covers everything at an approved imaging center. Does the $300 self-pay, or is radiology and disk space extra?
Me: I... dunno?
Them: Me neither, I'm just asking

Ct Scan Copay Kaiser

Upshot: Scheduled a CT on Monday with someone in plan that I have been told is insurer-approved for $400. And I got this far *only* because I'm an insistent asshole with time on his hands who's been professionally trained to listen carefully, take notes and ask pointed questions!

Ct Scan Copay

Update to this thread: A journalist contacted me for additional thoughts on my (pretty standard, really!) situation, and on US health care in general. Sharing the latter here for max visibility.