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Bill After Surgery

Hi guys there's something that has been bugging me. INSURANSE after the surgery. I know I got approved and all that and that we all have a copy for the hospital some higher some lower mine was $300. I know they told me I have to cover 10% of that but if the hospital itself was 54K or so do the math it's crazy. Can I ask you after you got approve and sleeved how much did you ended up paying? I really need to be able to sleep hehe thanks in advance

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  • Ms skinniness
    Ms skinniness

    This is a lot of money. I was very fortunate and Kaiser referred and my copay was $5.00. I am so thankful.

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My insurance is great. I lucked out and for the whole thing I paid $1000 out of pocket. $700 to the doctor, and $300 to the hospital. But that is the max out of pocket expence that I would have with ANY situation.

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My insurance is great. I lucked out and for the whole thing I paid 1000 out of pocket. 700 to the doctor' date=' and 300 to the hospital. But that is the max out of pocket expence that I would have with ANY situation.[/quote']

That isn't terrible. I'm still scare cuz you never know with these INSURANSE companies. Thanks!!!

mine ins has a 13,000 limit on bariatric surgery, and they pay 70/30. so according to hospital and dr I will owe dr. $3000 and hospital $3900 I have bc/bs christus ins

Wow that is alot. My total came to about $55,000, I had a few problems, but my insurance took care of it all. I hope they do the same for the tummy tuck.

This is a lot of money. I was very fortunate and Kaiser referred and my copay was $5.00. I am so thankful.

I know they told me I have to cover 10% of that but if the hospital itself was 54K or so do the math it's crazy. Can I ask you after you got approve and sleeved how much did you ended up paying? I really need to be able to sleep hehe thanks in advance

My insurance doesn't cover it, but as for the 10% thing, most policies have what is called an "out of pocket maximum", which means once you've paid such-and-such dollars out of your pocket for the year, they will cover 100%. You might check your policy to see what your max is so you can relax a wee bit.

My insurance is 90/10. My deductible is $500 with an out of pocket maximum of $3000. I paid right around $2000 out of pocket for VSG and a hernia repair to the doctors and hospital. The $3000 out of pocket max doesn't include my deductible so the most I could have paid was $3500.

I am self-pay and will paying 16,620 for everything. Surgery, hospital (2 day stay), pre op, and post op appointments for a year. I'm having surgery in St. Louis, MO at a bariatric hospital. I'm praying I have no complications! My insurance has an exclusion on my policy so I will be screwed if something happens. :blink:

I am self-pay and will paying 16,620 for everything. Surgery, hospital (2 day stay), pre op, and post op appointments for a year. I'm having surgery in St. Louis, MO at a bariatric hospital. I'm praying I have no complications! My insurance has an exclusion on my policy so I will be screwed if something happens. :blink:

If you are self pay and it is costing that much, why not save a bundle and head down south of the border....My my what I could do with the extra money....a new wardrobe, tummy tuck, a little plastics later on....

I am scheduled for surgery May 15th. I have saved my OOP and what's left of my deductible. That's what the hosp will want me to pay to do the surgery. Here is a question though. My husband recently got sick and ended up in the hospital for 5 days. We should be getting a bill for that any day now. Any idea whether the hosp will want me to pay that bill before I can have surgery? I know we can't afford both totals at the same time.

Hospitals are usually great at setting up payment plans, so for your husbands OOP expenses they should be more than willing to help you. Same goes for your procedure. Also know that your OOP expenses are not calculated by the charges billed(higher rate) but they are Actually calculated by the negotiated rate between the hospital and insurance company. So even if your procedure is billed @ 55k your insurance company may actually only about $20k. Also be aware that your policy most likely have a OOP max for family, so check if you have a family OOP max and you will know that is the max you can billed.

They wanted my entire OOP and deductible up front so I saved that much and have that to pay so as long as they will let us make payments on my husbands amount due we will be fine...

I have BCBS and I only know the approved amount for the hospital. It is in the $42,000 range. Because my bariatric benefits are only 50%, I would have to pay half of that amount, $21,000. Also, my plan has out of pocket maximums, but not on bariatric surgery. There is no out of pocket maximum. So, based on just that, you can see why I am choosing the $12,000 cash pay option.

I totally understand! I hope some day all insurance covers most of the costs of WLS surgery...

I totally understand! I hope some day all insurance covers most of the costs of WLS surgery...

I know my benefits were chosen by my company. I think it is really crappy of them to basically say yeah we cover bariatric surgery only to find out they chose benefits so bad anyone would be stupid to use it when they could cash pay for cheaper. I have a huge issue with this and plan on nicely letting them know. My company is really good to us so maybe they don't know the bariatric benefits are so bad it saves us money to pay cash.

~Amy

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