Hey everyone,
I recently submitted a lab work bill to my health insurance so it would count toward my annual deductible. I got this bill back from them (see attached image), but I’m really confused.
The breakdown of the charges and adjustments is there, but at the very end it says I owe $0. I’m not sure if that means the insurance actually covered it, or if they just didn’t count it toward my deductible and I’m still on the hook for paying the lab directly.
Has anyone seen something like this before? Does “$0 owed” mean it’s been fully covered, or could it still mean I’m responsible for the bill in some other way?
Appreciate any insights!
by Deathlezer
1 comment
They counted it towards your yearly Franchise (“bereits bezahlte Franchise” = 69.30), but they are not reimbursing anything to you (“zu Ihren Gunsten” = 0.00). So you still need to pay the lab bill.
Also, in general it works like this: If you get a bill (with a payment slip / QR code) from a medical service provider (lab, hospital, pharmacy, doctor, etc.), you always need to pay that yourself. You then send a copy of the detailed service bill to the insurance (most often a list/copy of all the detailed line items – which you can send to the insurance – is already included with the bill), and then the insurance will reimburse you (for the amount they need to cover, after deducting the Franchise and Selbstbehalt, if applicable).
The insurance only will pay medical bills directly, if the service provider directly sends their bill to the insurance (often the case for expensive hospital stays, pharmacy bills and some – but not all – doctors). In that case (bill sent by service provider directly to insurance), the insurance will then charge you for the parts of the service providers bill they don’t cover (e.g. if your franchise is not used up, after that the 10% deductible up to 700 CHF per year – and also any non-insurance-covered services like e.g. missed appointments).
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