Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Your Out Of Pocket For Surgery.



Recommended Posts

If you don't mind me asking, what were your insurance terms. Basically, what was his charge for the whole procedure? My insurance pays 90%, I am left with 10% not bad, but I have vacay coming. What was your total cost of the surgery, what percentage did you have to pay through your insurance.

If that is too personal, just don't bother answering. Just trying to be prepared.

Share this post


Link to post
Share on other sites

I paid $17,000 plus all my travel costs.

Share this post


Link to post
Share on other sites

You should find out if your insurance has an out of pocket max for the year. All the testing I had to do to qualify for surgery plus the surgery itself pushed me over my $3000 out of pocket. My insurance wording was 80 % they pay / 20% I pay up to out of pocket max.

I know for the surgery itself, my insurance was billed approx 20k.

Share this post


Link to post
Share on other sites

I have 80/20 insurance.

Out of pocket, I had $3,000 to the hospital and about $1000 to the doctor and assistant.

I still have not got a bill from the anesthesiologist (2 months).

I also had copays for the lab work and psych visit.

Share this post


Link to post
Share on other sites

I paid for everything. My insurance didn't cover it. $10,000 which included all pre op appts (dietician, etc) and one year's worth of fills and visits.

Share this post


Link to post
Share on other sites

I have Aetna and normally they pay 80%, but for lapband they covered the "placement" at 100%. However i had other bills as well

6 months worth of visits , About $30.00 each 180.00

My mental health visit , 33.00

Dietitian , 50.00 ( Which was actually returned to me , not sure why... but i got the money back about 2 months later )

Pre op testing , Ekg. Bp... ( ect.) 35.00

Anesthesiologist ( Most expensive ) 500.00 ( But i got it lowered to 350.00)

Total $648.00 +/-

We have REALLY good insurance. I was lucky. Make sure you know your deductable, mine was 500.00 which i had already met. If i hadn't, then i would have had to pay 500.00.

Share this post


Link to post
Share on other sites

My insurance covers 80, I will pay 20%. my max out of pocket it $1500, so total it will cost me 1360.

Share this post


Link to post
Share on other sites

I have BCBS of Texas with the 80/20 plan. The medical center billed BCBS a total of $65,000 and the negotiated or actual cost ended up being approximately $25,000. My total out of pocket cost was $1,150.00. So far, everything that has been billed since the out of pocket was met, has been paid at 100% by BCBS. I keep hoping there will be no "surprises", but so far I have been very pleased!

Share this post


Link to post
Share on other sites

Isn't it amazing how everyone's insurance is so different.

Share this post


Link to post
Share on other sites

I have to pay 10,000 my insurance covers NOTHING!!!! Sucks!

Share this post


Link to post
Share on other sites

I know how you feel kwood! My past two employers carried insurance that would not cover gastric surgery at all. I had actually stopped thinking about it when I discovered my present insurance did cover all types of surgery! That's the downside of living in a society where our healthcare is employer-based! I'm not a big fan of other country's systems, but I do know this one is broken!

Share this post


Link to post
Share on other sites

I paid for everything. My insurance didn't cover it. $10,000 which included all pre op appts (dietician, etc) and one year's worth of fills and visits.

I did the same, 10K but it didn't include the fills... not bad considering everywhere else is at least 15K in my area... my fills are $150, hopefully I can get into "my sweet spot" before 6 fills...

Share this post


Link to post
Share on other sites

I have BCBS of Texas with the 80/20 plan. The medical center billed BCBS a total of $65,000 and the negotiated or actual cost ended up being approximately $25,000. My total out of pocket cost was $1,150.00. So far, everything that has been billed since the out of pocket was met, has been paid at 100% by BCBS. I keep hoping there will be no "surprises", but so far I have been very pleased!

That is disgusting how they over bill the insurance companies and they still end up paying way more than us self pay people had to pay. No wonder healthcare is where it's at... Greedy hospitals/Doctors.

Share this post


Link to post
Share on other sites

I know how you feel kwood! My past two employers carried insurance that would not cover gastric surgery at all. I had actually stopped thinking about it when I discovered my present insurance did cover all types of surgery! That's the downside of living in a society where our healthcare is employer-based! I'm not a big fan of other country's systems' date=' but I do know this one is broken![/quote']

You've got that right!!

Mine will cost me $10,999 with a few out of pockets so no more than $11,500.

Thankful for this opportunity though no matter the cost!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×