Lifetime Maximum
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Quick question for anyone out there who might have encountered something similar.
My wife and I have been looking into getting banded, but until now our insurance has excluded the surgery. My wife switched jobs and her new insurance does cover rny and the band, so we are both excited and get to work on setting things in motion.
While going over my policy I find that it has a Lifetime Maximum of $5000 on bariatric surgery per person. I know self-pay can be 2-3x this amount and I know the Dr/hospital bill way more than self-pay due to the discount rate the contract with the ins requires. I have a hard time believing that a 30k-40k bill gets reduced to anything close to this amount, so what should I expect my out of pocket to be? I know each Dr/Ins relationship is different so just a general idea would be most appreciated.
I know I have a 1500 deductible to meet then a 10% copay, if that helps any.
Thanks
Josh
edit: added additional information