Bill After Surgery

[Back~To~Amy 307]

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

[Lisa's Hope 421]

I can't beleive that some hospitals are charging 55K for this to insurance?? The reason I say this is because I'm self pay and I'm paying 16,620.00 for everything. Would have been 18,000 but I got them to come down since on the surgeons website they advertised this price. Anyway, this includes surgery, hospital, anesthia, pre op, and all post op for 1 year. I'm having my surgery at Des Peres Hospital which is a bariatric hospita of excellence in St. Louis. So, I guess if insurance is paying for this surgery, they bill more than they do self pay? Very confusing.

[Back~To~Amy 307]

Yup. They bill more when insurance is involved. Doesn't seem right, does it?

~Amy

[cookies 56]

I can't beleive that some hospitals are charging 55K for this to insurance?? The reason I say this is because I'm self pay and I'm paying 16' date='620.00 for everything. Would have been 18,000 but I got them to come down since on the surgeons website they advertised this price. Anyway, this includes surgery, hospital, anesthia, pre op, and all post op for 1 year. I'm having my surgery at Des Peres Hospital which is a bariatric hospita of excellence in St. Louis. So, I guess if insurance is paying for this surgery, they bill more than they do self pay? Very confusing.[/quote']

I'm self pay and it'll cost me $25,000 which includes the surgery, a two-day hospital stay, three months of post op care. It does not include my pre op testing, which will probably run me another 3,000 nor will it include the removal of my IVC filter. My surgeon usually leaves them in, but my hematologist wants it out after 6 weeks. So, that's another 5,000.

And not everyone can go to Mexico. Most of of the surgeons I talked to wouldn't touch me.

[Lisa's Hope 421]

I'm self pay and it'll cost me $25,000 which includes the surgery, a two-day hospital stay, three months of post op care. It does not include my pre op testing, which will probably run me another 3,000 nor will it include the removal of my IVC filter. My surgeon usually leaves them in, but my hematologist wants it out after 6 weeks. So, that's another 5,000. And not everyone can go to Mexico. Most of of the surgeons I talked to wouldn't touch me.

WOW! That's a lot! I don't really understand. I wonder why some hospitals charge so much more. This is a great hospital with a great reputation. Specializes in bariatric surgeries. This price also includes a 2 day stay in the hospital. Any extra days will be 950.00 per day.

I'm not sure if you are high risk or not but if so, do you think that could have something to do with your price being so high. I didn't think SC would be much different than Missouri.

I couldn't go to Mexico either. Just mostly because I'm scared to not have the same doctor close that is going to do my surgery.

[Lisa's Hope 421]

Yup. They bill more when insurance is involved. Doesn't seem right, does it? ~Amy

No it sure doesn't. Not that much of a difference anyway.

[Kat Crowder 34]

Yup. They bill more when insurance is involved. Doesn't seem right, does it?

~Amy

I actually think it makes more sense than the other way around, which is often the case. This way, they're providing discounted care to people who have to self-pay, and charging more like the actual cost to the insurance companies. What I hate seeing is when something "costs" X dollars, but the insurance discount is huge because the insurance company has agreed on a price that's so low that self payers need to make up the difference. That happens a lot in laboratory testing, for example. $700 tests can cost the insurance company only $25, but if you aren't on insurance you need to pay the full price or try to negotiate it down.

[gramaof4 58]

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.

Why are you not taking the $$ you saved and making a trip south....? Save yourself a bundle of money and have excellent care. Dr. Aceves in Mexicalli is a fabulous surgeon and he and his staff have taken exceptional care of me and more so than the US docs would of. Dr. Aceves emails me to find out how I am doing and asks if I have any questions and is genuinely concerned with my health well being.

I would say do some research you can get a plane ticket for cheap and have quality royaly care, for much less. I paid $8750 and was all inclusive...

Jan

[Kat Crowder 34]

Why are you not taking the $$ you saved and making a trip south....? Save yourself a bundle of money and have excellent care. Dr. Aceves in Mexicalli is a fabulous surgeon and he and his staff have taken exceptional care of me and more so than the US docs would of. Dr. Aceves emails me to find out how I am doing and asks if I have any questions and is genuinely concerned with my health well being.

I would say do some research you can get a plane ticket for cheap and have quality royaly care, for much less. I paid $8750 and was all inclusive...

Jan

I am considering it as an option if I don't get approved for my surgery, but with a max $1500 out of pocket on my insurance, I'd rather have it done here and stay local. I don't see any information about there being an exception for the OOP maximum for bariatric surgery for BCBS IL, but I'll be sure to call them on Monday.

[sarahcc 184]

So my bill will also probably be somewhere in the 50K range, but I had heart complications during recovery and had many many tests run. I fear visiting the nuclear medicine department just itself sounds expensive! I also worked with a cardiologist through my stay. My out of pocket maximum is $1800 with no deductible, and they bill all my charges so I'll be setting up a payment plan.

[kczar 166]

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...

Your surgery may cover all of your OOP, which means that you wouldn't owe anything on your husband's stay. Make sure to double check on that since his stay was before your surgery. If nothing else, they will refund anything you pay over your maximum.

Good luck!

[Mews 37]

Wow. Some of these surgeons and hospitals charge and arm and a leg. I just received my EOB from my surgery. In total, the charges were around $22K and I had to stay in the hospital for three days as I had problems keeping in my fluids. As I have to pay 10% of the approved amont, I'm basically only paying around $600 out of pocket. What is really funny is that my surgeon billed for $15,000 and the insurance company only paid him around $1,200. The anesthesiologist got more money out of my insurance company! As it is the contracted amount I don't have to worry about making up the difference.

To be honest, I think this is all part of the BS of our healthcare system. If the doctors only know they are getting a few thousand for a surgery why do they have the gall to charge tens of thousands to people who pay out of pocket? To be honest, $15,000 is a hell of a lot to charge for just an hour and a half of work.

[gramaof4 58]

I hear the reasons behind the huge charges is the political HIPA, and Mapractice Insr., this is rediculous but our society is so sue happy that the docs must be covered. The hospital must be covered so they charge the docs more to use the facility...Just wait til we get that rediculous OBAHMA CARE going we think its bad now...everyone will be in jail who don't have insr. and those of us who have insr. will be to broke to have anything done we cant afford the co-pays....catch 22

[deltadawn817 106]

Do you have a out of pocket max? if you do I would count on paying that. If not you can ask the hospital they can give you an est of the cost.

[beautifulnewme2012 164]

Each of us has an OOP max of 3000 is the deal...I have mine saved up for my surgery. But if my husbands bill is 3000 too, and they force me to pay his in order to get my surgery, his will get paid and I will have to spend another 6 mths saving up for mine...we have 4 kids so most of our extra funds goes to raising them! Not much left over for saving lumps fast!