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

Just Decided To Have The Sleeve Done...where The Heck Do I Go From Here? Help!



Recommended Posts

I'm good at math (better than spelling if you found my typos above lol). MilkD got it 100% right. Using her example of 2000 deductable and 4000 out of pocket max with 80% coverage after deductable is met; would mean that any approved expense over 12,000 would be 100% covered by insurance. You will want to check to see how much the out of pocket max is as this can vary a lot. Mine is 7,500 for example. Also see if your insurer has online access you can log into. It will tell you things like how much of the deductable has already been satisfied and details on coverages. Good luck. Also the deductable on many plans starts over Jan 1st, so if you think you can't get it done by endof year might hold off til jan 2013. Psy exam for example can be over 400 and billed separate so you might want to have all exp in same calandar year.

Share this post


Link to post
Share on other sites

I was self pay. My doc & the hospital take Care Credit. The doc was $3900 & the hospital which included OR, anasthesiologist was $7000. Luckily I was approved for $11k on care credit and that covered everything for my surgery. If my insurance would cover VGS, I would much rather have paid like a $3000 or so co-pay. But ultimately to me it was worth every penny.

Share this post


Link to post
Share on other sites

My deductible counts towards my out-of-pocket maximum. My deductible is $1650.00 and out-of-pocket max is $2500.00. Once I reached my deductible, about 2 months ago, I now only have about $800 left on my out-of-pocket max...which is payed 85/15%.

Share this post


Link to post
Share on other sites

I went the self pay route and it was 11' date='200 which included the hospital stay and my surgeon's fee, plus a years worth of follow ups with him. If you go with your insurance, you will likely have a lot of requirements to meet like diet documentation for so many months, and a BMI of a certain range for so many years. When you find a surgeon, their insurance specialist can do the insurance research for you, or you can just call the insurance company and ask them yourself. My surgeon is in Michigan, as am I and he does a lot of out of town patients because of his pricing. Good luck to you.[/quote']

Erin, where in Michigan?

Share this post


Link to post
Share on other sites

Also, keep in mind that if you have healthcare flexible spending accounts, it can be used for all of these charges, even if you decide to go to Mexico.

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

    • 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! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
  • 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

    ×