Before You Get These Medical Procedures, Understand How Much Your Insurance Will Pay
In many cities, you can find 10 or more locations where you can get common medical procedures. That may sound like a healthcare consumer’s dream, especially since the quality of service varies little from one place to another, but there’s a big catch: you may pay much more at one facility than at another for the same procedure.
For instance, getting your cataracts removed at one facility could run as much as $3,500, but up to $5,000 for the same procedure at another eye doctor’s office just up the street in the next ZIP code.
That’s why learning about something called the “maximum allowable amount” is so important before you go to get one of several common medical procedures.
Your health insurance will pay covered expenses only up to a “maximum allowable amount.” You’ll pay anything over that.
To keep your out-of-pocket expenses as low as possible, call Aetna Member Services, (800) 367-6276 before you pick a facility in which to have:
- Carpal tunnel release
- Cataract removal
- Colonoscopy
- CT scan with or without contrast
- Surgery to repair a hernia, called a “inguinal herniorrhaphy”
- MRI with or without contrast
- Removal of your tonsils or appendix
- Upper endoscopy, where doctors examine the lining of your esophagus, stomach and some of your small intestine.
One thing to remember is that maximum allowable amounts vary by ZIP codes.
