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I have is craptastic, as they won't pay for the surgery unless I cough up $1,000 plus 20% of the surgery bill upfront.

if you have health insurance, even crappy one, $1,000 plus 20% would not be due upfront. You are likely not to even see the bill for 3-6 months. Generally the only time doctors/hospitals ask for the money upfront would be if you are paying the "not covered price" or "no-insurance/cash price". Even then the doctor should be willing to work with you to finance the procedure even if it is considered elective and not covered by insurance.

Not to mention, asking for 20% of an unknown and indeterminable amount upfront does not pass the sniff test. With so many unknowns (how many stitches, what level of anesthesia is needed, how many physical therapy visits, etc.), it is impossible to know what that 20% would be. Given that doctor's can't know the actual bill until you have the procedure (part of the 3-6 month delay mentioned above), the 20% of the total cannot be determined up front and therefore can't be documented prior to getting the surgery.

Your issue may be with the selected doctor/facility. Asking for that kind of money up front sounds shady.

FWIW: To me, it sounds like you may have a very good plan because a $1,000 deductible is not common any more and is consider low in today's market. That tells me your company pays a lot for that plan and that your portion seems high to you but in reality with most other employers would be much higher.

I went to my 401K to withdrawl enough to cover this, and was told "NO"!

Likely this was a case of an incorrect term being used when you asked. Had you asked for a loan (a type of loan where you pay your own 401k account back) and provided documentation (likely a doctor's note stating the need for the surgery and the specific total amount upfront payment) the check would likely already be in your hand, but it would not have been a next day type of process. Fidelity is top notch but even as automated as they are, you are looking at a 2 week process at a minimum to satisfy all the legal signatures and plan documentation requirements. You would only be penalized if you left your employer prior to paying yourself back.

Sounds odd to me that they did not offer a hardship withdrawal option. It has been nearly 15 years since I worked at a 401(k) provider, but I remember plans had to offer a hardship withdrawal option to be compliant with government regulations.

Hope this helps.
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