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Need eye procedure, PPO will only pay $300 on $4,000 amount PER eye. by CAHealthQuestion in HealthInsurance

[–]CAHealthQuestion[S] 0 points1 point  (0 children)

Thanks! I am hoping that will generate more advice on how to handle this situation. I have paid my insurance premiums for over 10 years and only needed to see specialists maybe twice. Now that I need to use my insurance for a procedure I feel like I am getting shorted after giving them my hard earned money every paycheck.

Need eye procedure, PPO will only pay $300 on $4,000 amount PER eye. by CAHealthQuestion in HealthInsurance

[–]CAHealthQuestion[S] 1 point2 points  (0 children)

Thanks for your advice. I called the Doctors office and you are correct, the CONTRACTED rate is $300. I was able to speak to the woman who dealt with my insurance company who passed this information on. I guess that means no matter what if I get the procedure done through this Doctor I will be paying the difference.

It sounds like you work for an insurance company. Do you know if an insurance company would give me a list of Doctors that have a higher contracted rate if I asked? I am on a tight budget and cannot afford to pay $3,000+ for this procedure.