My cardiologist can only see me in an outpatient hospital setting. Is there a way to avoid all the “hospital service” copays?

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Sep 28, 2010

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Insurance Question from East Freehold, NJ

Asked on 09/28/2010

My cardiologist can only see me in an outpatient hospital setting. Is there a way to avoid all the “hospital service” copays? I have Tetralogy of Fallot, a congenital heart defect. I am an adult now, and must see an adult congenital heart disease specialist, of which there are only about 50 of in this country. I see my doctor at a children's hospital out of state. I am being plauged with "outpatient hospital" copays, for a variety of services, including exams, EKGs, echo's, MRIs, etc. Many of these services have no copay in an office setting. I, however, have no choice as to where I can be seen. Is there anyway to avoid these copays?

Answer given on September 28, 2010

Outside of changing your insurance or having your employer pick up the charges for you…. which is an entirely different conversation, no.  Really, if you aren’t paying for the bulk of your premium and you have copays, you should be happy to have them.  You’re only paying a portion of the visit each time, and the insurance is picking up the rest.  

The only bad thing about this arrangement is that, even if you max out and hit your deductible and out of pocket, you will still have to pay the copays.  

As I mentioned earlier, there is a way that your employer ( I am assuming that you have group insurance through your employer ) could provide you with a benefit that would pay these copays for you, but that would involve some tax strategy and more discussion with your employer.  


Good luck!

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