Amber's finances - assumptions galore

Situation Type Deal Gorl

Fuck your feelings, nancypants
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I am not sure if Amber had the insight of getting insurance last year. She said that she got supplementary insurance before her surgery. I think she would have flex her insurance. Having said that, if she did, she would have enrolled in the cheapest plan with a massive co-pay and deductible. There is always a possibility that she will skip enrollment this year but why, I don’t know.

If she has insurance, why does she want to pay for bariatric surgery? Her insurance would pay I assume. If she enrolls now, she would have to wait till January, less than 2 months, for the surgery.

She didn't get insurance. She got a supplemental payor plan, where the provider agrees to charge x dollars for a given procedure, and that's what the member pays. The prices are lower than what a provider bills to a fully-fledges insurance company (who then adjust it, but that's a topic for elsewhere). So let's say the removal of the ladybits is 5K if you have insurance. The medical supplemental may have negotiated the pricing to 3K, and that's what the member pays. Office visits that bill at $145 (for instance, at my primary doc's office) might be $90 for the member, and might be $75 for self pay patients (which I as at one point, same doc).

Insurance plans - real insurance, not her bullshit supp thing - does not fully pay for cosmetic, elective, or procedures that are deemed medically unnecessary. Since she does not, amazingly, have any comorbidities with her obesity (according to her), an insurance company could conceivably decline to pay when a bariatric office went to get preapproval.

Her smart move would be to get actual health insurance instead of throwing money away on diet schemes she knows she will never complete, but our gurl isn't much of a thinker, as we know, and is not very smart, as we also know.
 
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