Claire -
My insurance is paid for by my employer and is through Guardian. The network is PHCS - Private Health Care Systems.
My individual deductible for in-network services is $400 per calendar year. Last year, my $400 was applied to my MRI, so all the costs of my AN surgery were paid 100% by my insurance company - after they discounted it. The anesthesiologist wasn't in my network, but because I had no choice of providers, the insurance paid him as if he were, and thankfully he didn't charge me the difference.
This year my $400 deductible went towards my BAHA surgery. I'm waiting to see what happens with the cost of my BAHA processor - estimated by the doc & audiologist to be $2,500. If it's billed through the doctor's office, the insurance should pay for it 100%. If it's billed through Cochlear America - where it was manufactured - I'll probably get hit with a $800 out-of-network deductible plus 20% of the balance.
I sure hope it's billed by the doc's office
Jan