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

out of pocket fees with insurance



Recommended Posts

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

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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. :-(

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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 :-)

Share this post


Link to post
Share on other sites

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 :(

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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 :-)

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

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

    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 1 reply
      1. kezbeth

        I may have to have gall bladder surgery during my weight loss surgery. Not thrilled about it either but do not want 2 recovery times. Just want it over with.

        Thanks for your post. I may need to rethink my decision... :(

  • 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

    ×