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Your Out Of Pocket For Surgery.



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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.

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

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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.

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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.

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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.

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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.

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

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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!

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

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

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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!

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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...

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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.

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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!

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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    • 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.
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      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!

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

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