Really Upset..insurance Covering 85% Of Lap Band But I Have To Pay 15%

[MrsMyers10 2]

Found out today my insurance will cover 85% and 15% will have to come out of pocket..called today and got exact amount I will have to pay upfront and although it could be worse I still regardless do not have this much money just sitting around. I was hoping and praying I could have my surgery by January but I don't think I'll be saving that much money anytime soon..I was so ready, and idk if I can handle the wait now..

[SkinnyMiniMe 63]

My my co-insurance is suppose to be 20% but my Surgeon will take my insurances 80% as payment. I am glad because I wouldn't be able to do that. Especially because it would be for my husband and I. Good Luck!

[Shellyac 22]

You should look into Care Credit. I used them for my LASIK surgery and I was given 1 year to pay it off You may even be able to finance it for longer. Also if you have the opportunity to contribute to a flex spending account for next year put in the max, I believe that you will be able to use it all in January even though your payments will be still be coming out throughout the year. Finally, talk to your doctor's office, they be able to offer you more suggestion or be able to work with you and your situation.

Good Luck and don't be discouraged,

Michelle

[MrsMyers10 2]

I actually already applied for care credit and I was turned down.

I talked to my Doctor office/facility and neither will budge.

I guess I will end up pushing my surgery a couple months back and use all my tax money to pay b/c i reallyyyy want this!

[Cazzy 725]

I hope all the finance problems get sorted out for you and you get your surgery

March isnt that long away, and this journey is years long so a couple of months wait in the grand scheme of things isnt that long to be honest. Use the time wisely, get fitter and see if you can drop some weight that way the extra time u have to wait will have been worth it .

Good luck !

[SkinnyMiniMe 63]

I am sorry that so sucks. I had a choice to go with an in network doctor but mine is out of network but I was told whatever they pay he will accept as full payment. Could the surgeon at least let you make payments to him? 85% is a pretty generous amount. Would you consider looking for another surgeon or at least an out of network one. Maybe if you tell them that they will work something out. You are the customer if they want to keep you they should accommodate you. Just saying

I actually already applied for care credit and I was turned down.

I talked to my Doctor office/facility and neither will budge.

I guess I will end up pushing my surgery a couple months back and use all my tax money to pay b/c i reallyyyy want this!

[MrsMyers10 2]

I don't really want to have to change surgeons,

I really liked the one I'm with now and I'm pretty particular but I felt really comfortable with him,

so I was pretty happy about that.

I think I just had myself so hyped up and ready to go when I realized I might have to wait an extra couple months I overreacted, lol.

I had great plans for my tax returns this year though, lol! But I guess what better use to put it towards my health!

[SHC 6]

Hope it works out for you..at least yours is 85/15...mine is 80/20 and I don't know how much it will be out of pocket since it will be the start of the new year.

[kewlshort1 4]

Holy crow, that is awesome!! I've never heard of a surgeon doing that. Sweet!

My my co-insurance is suppose to be 20% but my Surgeon will take my insurances 80% as payment. I am glad because I wouldn't be able to do that. Especially because it would be for my husband and I. Good Luck!

[Jim1967 3,569]

Wow sorry to hear all the troubles your having. This thread makes me think though. I didn't think about the possibilty of having to pay the difference up front before the surgery. My insurance covers 90% and I thought I would just be able to make the 10% in payments over time. I guess I better do some more research.

- Jim

[Dawn200321 146]

I also have to pay 15% percent. I did not have to pay that up front. I was told I would get a bill. I did have a co-pay at the time of surgery for 104.55. I am awaiting my final bill. I then plan to make payment arrangements on it. No idea how much im looking at

[MrsMyers10 2]

Yeah I thought they would just bill me too! Oh well, I called again today, apparently I have a $400 copay, $400 deductible, have to pay doctor atleast $700 upfront and facility will be billing me about $2500 but will have to pay $1200 of that upfront.

[NWgirl 574]

Don't forget to look at out of pocket maximums for the year- I know my insurance charges deductible plus 20%, but if costs go over the out of pocket max for the year, I don't pay. Unless, of course, bariatric surgery is marked as "out of pocket maximums don't apply." Good luck!

[Violet953 46]

Hello,

I am having kind of the same issue with my insurance, except I have medicaid and it's a spend down. I don't know where you are from but I live in Connecticut and I called the hospital's billing department where the surgery will take place and asked if I could make payments for my share, and they said of course you can, then they looked into it further and told me one of the charity programs they have would actually cover it 100% for me...so you should call the hospital and find out if they have any programs that you qualify for, or make payment arrangements! I mean come on, they are getting 85% up front, you'd think they'd be fine with getting payments for the rest!

[SkinnyMiniMe 63]

He is not the only one here that does that. I called another surgeon and same thing.

Holy crow, that is awesome!! I've never heard of a surgeon doing that. Sweet!