Will I eventually have to pay this?

I will make the call to insurance on Monday, but wanted to get any feedback since it is after hours.

Just picked up my mail.

Saw the Explanation of Benefits for my growth sono done on 12/22.

The cost of the sono was $285. It then says plan pays $80- patient pays $18 which is the co-pay I paid at time of sono.

There is also a line saying patient is not responsible for difference unless there is an annual benfit maximum for this service. I am not sure if this applies.

Insurance really annoys me because I feel like they are always trying to get over.

fyi.. My insurance is Empire Plan NYSHIP. The explanation of benefits came from the United Health Care portion of the plan.

So what do you think? if anyone has had this experience, please chime in.

Re: Will I eventually have to pay this?

I don't think you have to pay. Your co-pay is it.

Explanation of benefits don't explain anything!

Re: Will I eventually have to pay this?

I have the same insurance and didnt have to pay anything. HTH

Re: Will I eventually have to pay this?

I'm sure there's not going to be an annual benefit maximum for that service. You should be fine.

Re: Will I eventually have to pay this?

Since I've been doing IVF for years and have been getting this things since the beginning:
All it's for is to tell you how much they charged and what they get paid, including your co-pay. Anything above and beyond that is their loss basically.
I think the idea is that if you didn't pay a co-pay at the time of the visit, it's to inform you that you owe the office $18.

Re: Will I eventually have to pay this?

All you pay is the $18 co-pay. Whatever agreement insurance has with the doctor or what have you is that they accept the $80 and the rest is a wash. I get statements like that all the time---I have the same insurance. You are only responsible for the co-pay.

Re: Will I eventually have to pay this?

Thanks ladies.

The explanation of benefits can be very confusing sometimes.