So I had this nexplanon implant for years and it was time to get it out. Honestly didn’t even think about insurance coverage at first – just walked into my doctor’s office last Tuesday expecting a quick procedure.
The wake-up call at reception
When I handed over my insurance card, the nurse goes “You know this might cost you right?” She gave me this pamphlet about removal fees. Felt totally unprepared – guess I assumed since insurance covered the insertion they’d handle removal too. Bad move.
My insurance detective work
Pulled out my phone right there in waiting room and called my insurance provider. Went like this:
- Pressed 5 million menu options to reach human
- Told them I needed CPT code 11976 (weird they speak in number codes)
- Got transferred to prescription coverage department
- Then got bounced back to medical claims
The final verdict? My SilverBlueCross plan would cover it… after hitting my $200 deductible. And get this – doc’s office charged $375 just for removal!
The billing surprise
Got mailed two weeks later. Insurance paid $175 and I owed exactly $200. Perfectly matched my deductible amount. Doc’s office tried sneaking in $35 “facility fee” but insurance kicked that out. Called billing office and told them to remove it – worked!
Ended up paying $200 cash. Felt like robbery for ten minutes of work, but whatever. Lesson? Always triple-check that insurance crap beforehand.
