If a patient had surgery in 2014 and then complications from that surgery arise in 2015 should the new surgeries or procedures in 2015 be applied to the deductible? Since the preauth was for 2014 and i already hit my deductible and the surgery in 2015 was due to a complication from the 2014 surgery. This is a pre -existing condition from the same problem why should i have to pay a deductible twice? Is there any rules that could help me avoid a double deductible?


Answer

If your medical treatment extends over two policy periods you'll have to meet the deductible twice, even if it's for the same condition. With health insurance everything is based on policy periods, as long as you have a plan while you are getting treatment then covered benefits will always be covered under the plans cost sharing. However, if treatment extends over two policy periods cost sharing amounts will be applied toward the deductible in the policy period in which the claim was made.

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