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out of pocket fees with insurance

Hello everyone, I'm currently on my 5th month of my 6 month supervised medically supervised diet. I'm almost done and wondering if anyone had out of pocket fees even with insurance. I have BCBS in San Diego, CA. Thanks

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Hello everyone, I'm currently on my 5th month of my 6 month supervised medically supervised diet. I'm almost done and wondering if anyone had out of pocket fees even with insurance. I have BCBS in San Diego, CA. Thanks

I have a large amount of out of pocket even with insurance. The surgeon I am going to requires a program fee of $3500. The hospital is anticipating their costs to be about $3000. The labwork, xrays, and EKG that was required are still being processed. So, it almost feels like I don't even have insurance with how much they expected me to pay! Every plan is different. I thought we had decent insurance, but I am finding out through all of this that it is a horrible plan and I probably would have been better off as a self-pay patient!

I have Anthem Blue Cross California. My husband works for the state, so it is the Large Pers Group Plan. It is expensive and covers so little, so it seems!

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Thx for the info Melissa, that's pretty expensive. I've definitely have to sit down and chat with my surgeon's office. I don't think I can do it if it is going to be that much. :-(

Thx for the info Melissa, that's pretty expensive. I've definitely have to sit down and chat with my surgeon's office. I don't think I can do it if it is going to be that much. :-(

Be sure to also talk to the hospital about their anticipated fees. I am hoping that mine will be less than what they anticipate. The program fee was the biggest chunk! I had to apply for CareCredit in order to do it, even though I am anti-credit right now! However, the surgeon I am seeing is the closest one to where I live and is 130 miles away. I don't have a lot of options. Besides, my health is worth it and my family supports it.

Definetly do your research and talk to every facility and doctor that you will see. Your surgeon will be your best resource. I hope that you are able to find a way to do the procedure! Even though I am now in the poor house for awhile, I am still glad that I am able to find ways to get it taken care of. My surgery in Monday, Feb 28.

Good luck and keep me posted!

By the way, I am on the opposite side of the state. I am in far Northern California. I live about 45 mins from the Oregon border!

That is why my options are very limited. The next closet place for me is Sacramento, which is 4 hours away!

Edited by MelissaAnd

I have good insurance, but they do have a significant co-pay for bariatric procedures. My total will be about $4500 when all fees and copays are added together.

  • Author

Be sure to also talk to the hospital about their anticipated fees. I am hoping that mine will be less than what they anticipate. The program fee was the biggest chunk! I had to apply for CareCredit in order to do it, even though I am anti-credit right now! However, the surgeon I am seeing is the closest one to where I live and is 130 miles away. I don't have a lot of options. Besides, my health is worth it and my family supports it.

Definetly do your research and talk to every facility and doctor that you will see. Your surgeon will be your best resource. I hope that you are able to find a way to do the procedure! Even though I am now in the poor house for awhile, I am still glad that I am able to find ways to get it taken care of. My surgery in Monday, Feb 28.

Good luck and keep me posted!

Ill definitely let you know what happens. I'm planning on calling them immediately to find out. I'm just surprised how much out of pocke fees can add up but I do think you're right about being worth it. I'd rather put money towards the surgery then towards any more XXL shirts.

Your surgery date is right around the corner! That's awesome. Let me know how everything goes :-)

  • Author

I have good insurance, but they do have a significant co-pay for bariatric procedures. My total will be about $4500 when all fees and copays are added together.

hi caitlyn, thx for your reply, still cant believe it is so expensive :(

I have Cigna insurance here in Connecticut. I had to see the psych (3), the nutr(6) and other appointments to see if I may have sleep apnea and was anything wrong with my heart. I have co pays at all of those. Each time it was $24. The day of surgery my co-pay to be admitted for surgery was $350. I have Aflac insurance as well, so I am getting some money back for the hospital stay.

  • Author

I have Cigna insurance here in Connecticut. I had to see the psych (3), the nutr(6) and other appointments to see if I may have sleep apnea and was anything wrong with my heart. I have co pays at all of those. Each time it was $24. The day of surgery my co-pay to be admitted for surgery was $350. I have Aflac insurance as well, so I am getting some money back for the hospital stay.

That's wonderful! Hopefully my Co pay is that reasonable :-)

That's wonderful! Hopefully my Co pay is that reasonable :-)

I have a surgeon fee of $4500 that I need to pay the surgeon within the next few days (2 weeks before surgery) and a $1011 co-pay for the hospital but that covers my one night in the hospital also. It is expensive but will be so worth it in the end!

I work for sacramento county and have kaiser. I was very lucky and did not have to pay anything for the surgery. All I paid for was $20 for the 2 prescriptions they sent me home with. I did have to go to Richmond about 2hr drive from home, but that was nothing for what I got in return.

Good luck to you

I Blue Cross Blue Shield, last year we had a 90/10 plan

First consult with doc and blood tests Out of pocket 12.00

sleep study 89.00

ultrasound 16.00

pre opt testing 40.00

Lung doctor visit pre op 30.00

Surgeon fee for VSG 200.00

Doctor follow up in hospital 16.00

PCP hospital visit 9.40

Post op upper GI 30.00

Misc test, (who ran what?) 40.00

Pre op clearnence from PCP 8.00

EKG reading by cardiologist 9.40

Anesthiologist 140.00

and I am sure there was some other misc fees before hand in all about a hundred bucks here and there.

My EGD (stomach scan, where they put you under) was TWO THOUSAND DOLLARS. More than what I paid for surgery.

I got like 7 different bills for that crap, a lab, the ana, the doctor, the hospital, the NURSE even billed me. Ridiculous.

Thx for the info Melissa, that's pretty expensive. I've definitely have to sit down and chat with my surgeon's office. I don't think I can do it if it is going to be that much. :-(

Do not give up on the surgery...although it is quite expensive in the states, you have a great advantage...you are minutes from the border. I actually am a physician in Tijuana and would be happy to make some recommendations. Also, remember you have financing options and some insurances kick in south of the border. If you have any questions, I'd be glad to answer them.

Best,

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