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    #16
    I imagine what happened is that your deductible increased. this happened to us.

    Our deductible has always been relatively low, this year it jumped way up. Same insurance company, same employer, same premium deducted from each paycheck, but insurance and the company claim that to cover the extras under the ACA they had to either raise the price of the plan (which they didn't) or raise deductibles.

    Another weird twist is this, when we go to the walk in or ER, we have to pay the deductible, then the copay, and at that point the insurance kicks in. Before we just had a copay for each, so now instead of the walk in costing a 75 buck copay, it could run up into the hundreds, depending what is done. And instead of the hospital ER costing $250...I'd probably end up meeting my whole deductible in that visit seeing most ER visits run into the thousands of dollars.

    Not crazy about the changes, but it is what it is, and it's better than no insurance.

    In their defense the company set up a nopay clinic for it's employees. Not open after hours but during the week you can go to the company clinic, get paid for the time away from work, be seen by a GP, not a NP, and in many cases leave with your prescription. Spouses and children are also covered in the same way...but there again, it's no help after hours or on weekends, but if you can hold out through the weekend if you have to see a doc, there's a huge advantage. (has anybody else come to the conclusion that UTIs love to crop up on a weekend)

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      #17
      Threads like this make me sad. I get free medical because I'm retired military, but dang...one would think that living in the US, everyone could get decent medical care for a respectable rate.

      $1200 copayment for an MRI would mean I don't get anymore MRIs. I have to have them twice a year.
      Katie
      "Yep, I have MS, and it does have Me!"
      "My MS is a Journey for One."
      Dx: 1999 DMDS: Avonex, Copaxone, Rebif, currently on Tysabri

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        #18
        Gracious that's a large amount! I had an MRI last week my first in 2 years. I had reached my deductible nor my out of pocket so I fully expected to pay a larger sum. Much to my surprise BCBS was paying 100% !! I asked no questions. I signed the papers and climbed in the tube. I have no idea how that happened.
        Dx'd 4/1/11. First symptoms in 2001. Avonex 4/11, Copaxone 5/12, Tecfidera 4/13 Gilenya 4/14-10/14 Currently on no DMT's, Started Aubagio 9/21/15. Back on Avonex 10/15

        It's hard to beat a person that never gives up.
        Babe Ruth

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          #19
          I haven't had an MRI for a couple of years. I may get one later this summer, just because I've had a bit more trouble walking.

          I don't really see the need to have them yearly unless a change in symptoms (dramatic) or med is giving you fits. My first neuro did them yearly to see if I was tolerating meds, and all this did was cause him to change meds based on the MRI rather than on me!

          Now I can't do Avonex, Rebif, or Tysabri. I'll stay on Copaxone for now.
          Brenda
          Adversity gives you two choices in life: either let it make you bitter, or let it make you better! I choose the latter.

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            #20
            ASK AHEAD.

            MRI's can be costly; they were even more than now, as much as $4,000 or $5,000. I would suggest calling your insurance company, ask them what they pay (in your case specifically). Ask if you have reached your maximum out of pocket, or deductible? It's better to know prior the MRI, not after. Good luck.
            You cannot dream yourself into a character; you must hammer and forge yourself one.

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              #21
              I know exactly what you're feeling! I have an MRI due in August, and I know it will be around $1200 - $1500. At least it will be $1500 because that's what my deductible is. So, I'm basically paying for the MRI.

              The insurance I had through my employer covered everything. This one, through my husband's work,covers nothing til that deductible is met.

              I got my neuro to keep pushing an MRI back, for nearly two years, but he can't/won't do this one. I take copaxone and he has to order.

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                #22
                What does your bill/EOB

                indicate the cost of the MRI was? The insurance company usually, if not always, pay much less than the charge. My MRI bill/EOB indicates a charge of $30,000 every time I have my annual MRI. The MRI's are of the brain, cervical spine and thoracic spine.

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                  #23
                  wow.

                  I'd call my insurance company and ask them why this is so much. You could have a high out of pocket deductible you have to meet before they will pay. It should be on the explanation of benefits from the insurance company.

                  Changing insurances can be a challenge. You get a lot of unexpected surprises. I changed insurances and it was NOT fun. I used to have a great plan with a small deductible. I wish I still did.

                  If you're having issues with the unexpected cost, you can try negotiating a payment plan or reduction of the bill as well. The worst they can say is no.

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                    #24
                    This bill says the total MRI was $2,200 with a reduction of the Lockbox payment OP, no clue what that is, of $1,000. I just saw that I will get a 1% discount if paid by 7/26.

                    I'm getting other small bills for the OP exam etc.
                    He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
                    Anonymous

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                      #25
                      Jules, there are some numbers you need to get from your insurance company or you will not be able to fight any scam someone tries to pull on you.

                      You need to know, what is your deductible, what is your out of pocket maximum per year (oop) and what percent they are asking you to pay on different kinds of bills.

                      My deductible is high enough that my first refill of DMD, or my first mri per year is extremely painful, but everything after that is much more reasonable.

                      Some plans cover a percentage rather than charging a deductible. That can add up to much more money, depending. You really want to know... or get a friendly person to find out for you.

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                        #26
                        I used to work full-time in health insurance, and I do not know what "Lockbox payment OP" means, so don't feel bad!

                        We did use the term "lockbox" and it meant the bank account into which premiums were deposited. The premium checks were sent to an address that might look like "Insurance company XYZ" but it was really the the mechanism through which the payments were deposited into the company's bank account.

                        As I understood it, our bank ("lockbox account") then did the tracking and accounting for those payments, resulting in faster processing of accounts receivable, and thus faster access to the insurer's funds.

                        I would guess "OP" = out-patient. So maybe a deposit of $1,200 ($2,200 less $1,000) was made to the lockbox account of the service provider (hospital or out-patient radiology or the corner MRI facility)? The "charge" may have been $2,200, but there was a negotiated discount rate of $1,200.

                        That still doesn't explain why you get a bill for $1,200, unless it wasn't truly a bill, but rather an EOB (explanation of bill) or EOP (explanation of payment) to inform you of what was going on behind the scenes. Maybe later you will get a "Balance due" bill for $1,000, reflecting a negotiated rate of $2,200 and possibly a $1,000 deductible you are expected to pay.

                        You still need to know the numbers Pipes123 mentions, to be sure that you are being billed correctly, and your provider is being paid correctly for the service rendered.

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                          #27
                          NMSS freenMRI

                          I qualified for one free MRI A year from the NMSS.

                          Could be worth looking into. I cant remember where i put the paperwork (imagine that) or I would share more. My neuro told me about this when she recommended I get another.

                          Was easy just had to fill out a sheet and fax it National MS Society.

                          GOOD LUCK
                          Leave the Heat and Stress for the birds!

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                            #28
                            All of my mris have cost me between $700-$1100 out of pocket. I wish I could get one for a hundred.

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                              #29
                              I just got charged

                              $1850 for an echocardiogram after my insurance company told me it would cost $50!

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                                #30
                                Definitely ask for a payment plan for your MRIs. Until I meet my deductible, I usually end up paying around 3,000 for mine. My deductible is 2,500. But my out of pocket is 5,000. So I do not hit that yet even with the MRI. I just ask for a payment plan. They cannot charge you interest on medical bills, so I pay the lowest amount I feel like I can pay, and pay it off monthly. It might be forever before they get their money, but that's too bad, they shouldn't inflate the charge so much.
                                Like others have said, you can also ask for money off up front. They will consider your income and bills. Then...get a payment plan.

                                Good luck
                                Lisa
                                Disabled RN with MS for 14 years
                                SPMS EDSS 7.5 Wheelchair (but a racing one)
                                Tysabri

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