Insurance Vs Self Pay

[Tx809 5]

Greetings: All

I need someone to explain how this insurance works.

Already been preapproved for VSG

Dr. charges $12k cash for turnkey job, all costs covered.

My insurance co pays 15k max for surgery and all related expenses.

Found out hospital estimate to me after surgery and insurance payout will be around 14k.

??? This puts total payout to hospital around 25k after paying my Dr.

Somehow the math doesn't add up.

Help !!!

[LillianneMcBeth 1]

Greetings: All

I need someone to explain how this insurance works.

Already been preapproved for VSG

Dr. charges 12k cash for turnkey job' date=' all costs covered.

My insurance co pays 15k max for surgery and all related expenses.

Found out hospital estimate to me after surgery and insurance payout will be around 14k.

??? This puts total payout to hospital around 25k after paying my Dr.

Somehow the math doesn't add up.

Help !!!

[/quote']

Hi, I am a self pay sleeve patient and I am paying 22k, insurance denied me. Good luck!

[Lee71 0]

Does anyone have total health care? I have heard that they are really strict and denies most of their clients.

[AmandaRaeLeo 2,145]

Greetings: All

I need someone to explain how this insurance works.

Already been preapproved for VSG

Dr. charges 12k cash for turnkey job' date=' all costs covered.

My insurance co pays 15k max for surgery and all related expenses.

Found out hospital estimate to me after surgery and insurance payout will be around 14k.

??? This puts total payout to hospital around 25k after paying my Dr.

Somehow the math doesn't add up.

Help !!!

[/quote']

I was a self pay. $8750 for everything except airfare.

[Dr. B 0]

Hey Newbie!

the average cost for self pay sleeve totals is usually around 25K. That includes surgeon and hospital and may or may not cover pre-op and post-op care. Or you can get a passport and go to Mexico for 5-8.5K. You won't have any f/u in the States generally and if things go bad then...

Check out East Coast Sleeve Center in raleigh NC. Center of excellence surgeon and total operative price is 12,500! That includes surgeons fee, hospital fee, anesthesia fee, and BliS insurance. Check out the website www.eastcoastsleevecenter.com for more info and best of luck on your journey!

Dr. B

[AmandaRaeLeo 2,145]

Hey Newbie!

the average cost for self pay sleeve totals is usually around 25K. That includes surgeon and hospital and may or may not cover pre-op and post-op care. Or you can get a passport and go to Mexico for 5-8.5K. You won't have any f/u in the States generally and if things go bad then...

Check out East Coast Sleeve Center in raleigh NC. Center of excellence surgeon and total operative price is 12' date='500! That includes surgeons fee, hospital fee, anesthesia fee, and BliS insurance. Check out the website www.eastcoastsleevecenter.com for more info and best of luck on your journey!

Dr. B[/quote']

That's just not true. I went to Mx. My care exceeded expectations. All of my follow up is here. Period.

[Ms.AntiBand 2,984]

Hey Newbie!

the average cost for self pay sleeve totals is usually around 25K. That includes surgeon and hospital and may or may not cover pre-op and post-op care. Or you can get a passport and go to Mexico for 5-8.5K. You won't have any f/u in the States generally and if things go bad then...

Check out East Coast Sleeve Center in raleigh NC. Center of excellence surgeon and total operative price is 12,500! That includes surgeons fee, hospital fee, anesthesia fee, and BliS insurance. Check out the website www.eastcoastsleevecenter.com for more info and best of luck on your journey!

Dr. B

You're so full of S H I T ... I can smell you all the way over here in the PNW

[Dr. B 0]

Ms. AntiBand,

Nice language. And where is PNW?

Amanda Rae Leo,

I am not saying you can't have a positive experience in Mexico. If you are home, in the US, and have a problem, who handles it? Do both of you have a surgeon that has accepted your care? If you have you are fortunate. I have personally accepted pts into my practice who were refused by other surgeons because they do not feel responsible for another surgeons care. And that is the simple truth. Didn't mean to offend either of you.

Dr. B

[Museum-Mama 196]

I could be totally wrong, but what I am reading and hearing, etc...is that when insurance is involved, they are charged a higher amount from the hospitals. When you are self-pay, most are willing to work with you and not have such a heavy burden of cost. My doc is charging about $8000 for self pay, for all things covered...even follow up appts.

[Ms.AntiBand 2,984]

Ms. AntiBand,

Nice language. And where is PNW?

Amanda Rae Leo,

I am not saying you can't have a positive experience in Mexico. If you are home, in the US, and have a problem, who handles it? Do both of you have a surgeon that has accepted your care? If you have you are fortunate. I have personally accepted pts into my practice who were refused by other surgeons because they do not feel responsible for another surgeons care. And that is the simple truth. Didn't mean to offend either of you.

Dr. B

My language.. Who said f/u? Not me

Yes, I do have US docs who care for me. Anytime I need care in the US I am cared for... Regardless of where my surgery was. Problem with many US docs is they think they belong on a pedestal. Shame on them.

I've had several surgeries in MX and the care I received is far beyond care I've had in the states. I have two bariatric surgeons here in the US and although they are excellent and I'd recommend them, but because of experience, professionalism, and patient care, I prefer my MX surgeon by far

[Dr. B 0]

Hey MM,

8000 is a great price. I don't know how much insurance companies are charged by hospitals. Does that 8000 cost include the hospital and anesthesia charges too? Does he include BLiS insurance as well?

Dr. B

[Dr. B 0]

Ms. AntiBand,

By f/u I meant follow-up; not what you are thinking. My bad.

As I said, you are fortunate to have good docs willing to accept your care. That is not always the case.

I have met with and trained with many doctors from all over the globe; some do feel like they need to be on a pedestal, and some are simply humble; irregardless of where they are from or where they practice. The US does not have a monopoly on either, in my experience.

[Museum-Mama 196]

Hey MM' date='

8000 is a great price. I don't know how much insurance companies are charged by hospitals. Does that 8000 cost include the hospital and anesthesia charges too? Does he include BLiS insurance as well?

Dr. B[/quote']

I dont know what BLiS insurance is, but that is the all inclusive self pay price. This includes consult, psych eval, all pre op, 1 night hotel stay, all surgery costs, and all follow up appts plus labs for the year.

[Dr. B 0]

BliS insurance covers you for complications that may arise from surgery. If you have a complication (leak, stricture, bleed, clot in leg, pulmonary embolism, etc...) who pays for the care for that complication? If you have no coverage you may be surprised to find out that you are on the hook, even if you have general medical coverage through insurance. That can be financially disastrous. Thankfully complications are pretty uncommon. You can check out if your surgeon carries BliS by contacting the company via the internet. I provide a complimentary 90 day coverage policy for my patients and thankfully have not had to use it but its better to be covered in my opinion. 8000 for the hospital, surgeon, anesthesia and pre-op and post-op care is a great price! Best of luck to you on your journey!

[*susan* 1,709]

"Dr. B", welcome to our forums. When did you have your sleeve done, who did it, and how are you progressing? Were you self pay?

Actually, Mexico is a wonderful alternative for those who cannot afford to have their surgery in the U.S. Many of the surgeons there actually trained U.S. doctors. What is important is doing your research to make sure you make a good choice in surgeons. Like others, the care I received in Mexico far exceeded any care I have ever received here in the U.S. Additionally, while several years ago there was a problem with surgeons being willing to provide aftercare to Mexico surgery patients, that is not mainstream anymore, partly due to the popularity of people going to Mexico for their surgery. Most primary care physicians are willing to provide their patients any aftercare that is needed. And, many bariatric surgeons are now also willing to provide fills, follow-up care etc. Once again, it all boils down to doing your research and having all your ducks in a row prior to having your surgery.