Okay so if I understand what the woman told me is that my insurance, if they approve me for lap band surgery, will pay 80% of the surgery and then I'll be left having to pay $11,000. Now I'm waiting on a settlement from the lawyer so that should be about $12,000 but I really don't want to have to pay that much. What are other options? I'm also not sure if $11,000 is what I'd be left paying or if she meant that they will pay 80% of $11,000. I'm waiting for the woman to call me back to tell me exactly because if all I'm left owing is $2,200 then okay that's a little easier to deal with. What are other options for me though? I know a lot of people say Care Credit but I already have a credit card through them and I still haven't been able to pay off $1,000 in the last year and now I'm up to owing them $2,250 because of how high the APR% is GRRR. I'm getting so frustrated because I finally am in the process of doing everything. I could have told my husband not to insure our daughter and I under his insurance and kept my state insurance where they would have paid 100% of the surgery but I don't feel right to do that to the state. Someone else in the state of Vermont needs state insurance more then I do. I guess I'm just going to have to start saving up and if I have to wait until next year to get surgery then that's what I'm going to have to do. GRRR why does it have to be sooo frustrating. But seriously is there any other choices? I know that my surgery has to be paid IN FULL by the day that I have surgery.

Most insurance has an agreed amt that the doc and hospital can contractually charge and on top of that ins will pay a portion and you pay the rest. Cash payets at my docs office pay 12k out of pocket. His price agreed with my insurace is around 16-18k. Ill pay 250 deductible and then 15%.

Well my $250 program fee covers 100% complete access to remedyehr.com or something like that for a website plus being able to contact their nutritionists through their personal phone lines. I'm not 100% positive with everything. I live in Vermont and my insurance is Wellmark BCBS of Iowa but its a PPO insurance and I'm going to Dartmouth Hitchcock Medical Center in Hanover NH. They've never worked with this insurance before but they take BCBS and they cover 80% of it but dont hospitals do the surgery then bill the insurance? Because the woman I talked to said that she would bill the insurance then I'd get the remaining balance on my bill. I always thought that they can't bill the insurance company until after surgery just incase they have to do something extra or am I wrong? Do they bill before or after surgery?

Do it, borrow it- it's totally worth it- I paid for 10% so your 20% sounds pretty good!

-Cordelia, banded 1/08

That's 100%

-Cordelia, banded 1/08

Well I'd be saving to pay my part but my question is due they bill they insurance before or after? She said she would bill my insurance and after they pay their 80% that I'd have to pay the rest of the bill unless I have another insurance also. I'm praying they bill afterwards because then I'd set up a payment plan.

Yes they bill you after....even though the insurance pays 80-85% there are other factors like deductoble you might have already met and max out of pocket

Oh well my deductible is $100 and I dont have a maximum out of pocket

Okay so the woman did call me back today and she said that the $11,000 IS AFTER my insurance pays their 80% but what I don't understand is one of my friend's sister is going for gastric bypass and her surgery is $26,000 TOTAL WTF it doesn't make sense to me at all

That makes no sense to me. Is this person from the insurance company or the doctor's office?

that can't be right. That means the doctor giving you the band is charging almost $100,000 for the surgery. Something is not correct. Most surgeries are $11,000 - $18,000.

That makes no sense to me. Is this person from the insurance company or the doctor's office?

She's with the surgeon's office and it doesn't make sense to me either...it's sooo messed up so guess what...it looks like I'll be doing a payment arrangement. Gastric Bypass is only $26,000 total and my parents joked that I should just go for that lol I want lap band tho

that can't be right. That means the doctor giving you the band is charging almost $100,000 for the surgery. Something is not correct. Most surgeries are $11,000 - $18,000.

yeah see that's what I thought...it doesn't make sense at all but that's what she said. I just don't understand it.

Is this surgeon within your insurance company's network? I would call your insurance company and ask them about options. Maybe a different surgeon if this one is so expensive?

I would say that they are screwing you over. Insurance has an allowed amount that they contractually pay- My surgeon and the hospital billed total about $20k and my insurance only paid about $15k. Of that allowed amount (15k), I owed $800. I also did not have to pay a "program" fee. I went with a center of excellence location, and would suggest that you look for another surgeon who will not screw you over. You could SELF PAY for $11k in many places.

Well where I'm going I heard that everything has to be paid upfront but I thought that was just if u self paid but idk lol I guess I'll figure this whole process out sooner or later

Where I go wanted me to meet my 300 deductible and pay my out-of-pocket of 3000 up front,they stated that if I meet the both my insurance will pay 100 percent.My question is why dont they file my secondary insurance.They said they would file my secondary insurance and the insurance would reimburse me.I thought about it and went back to the doctors office requesting them to file the secondary first,they did grant my request.