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ABC-7 Special Report: Understanding your insurance plan

By Stephanie Valle
Published On: Dec 24 2013 08:47:34 AM CST
Updated On: Jan 16 2014 02:28:52 PM CST

Reporter: Stephanie Valle

EL PASO, Texas -

It's a common occurrence.

You anticipate paying a certain amount for a medical procedure, only to receive bill after bill for services and from doctors you didn't account for -- and you end up taking a big hit in your bank account.

That's what happened to Bonny Schulenberg.

"I went to the hospital to do the pre-check-in. And that's when they told me I was going to owe $1,500," Schulenberg said, clutching a scrap of paper with handwritten estimates of what she's paid in medical bills since Nov. 2012, when she underwent an elective venous closure surgery.

She thought she had already met her $200 deductible. But she learned something new about her insurance that day.

"There's two deductibles. I didn't know that. And that was something I should've checked on," Schulenberg admitted, adding she wasn't able to get an exact cost of the procedure from her doctor.

"I didn't even know how much the surgery was going to run until I started getting the Explanation of Benefits from the insurance company."

ABC-7 tried pinning down how to avoid the confusion and financial impact, speaking with Dr. Michiel Noe, an OB/GYN. Noe also serves as city representative for East El Paso.

"You can get a lot more accurate estimate of what your bill's going to be if you take a little time and you're patient," Noe started off, ticking off a "to-do" list for patients preparing to undergo non-emergency or elective procedures.

The list includes examining the insurance plan, co-pay and deductibles, talking with the doctor overseeing the procedure, and speaking with someone at the hospital if it is an in-patient procedure.

"Find out all the different possible scenarios and all the things they can charge you for," Noe said, adding that hospitals will charge for each service provided, whether it be performing an X-ray or issuing medication.

After doing all that, Noe said you still may not even get an exact amount that you owe.

"You'll be prepared, but not 100-percent. There are always surprises possible."

Meanwhile, Schulenberg sat at her dining room table, thumbing through the bills she's received over the last nine months. She said she learned her lesson. It was a $1,500 lesson. And she'll be paying for it another year and a half.

"If I had known prior, I probably would've saved that money up and had it done at another time."


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