GEHA insurance ( united health care)

[cricketcree 10]

Has anyone used GEHA (united health care) insurance to get their sleeve? I ask because that's the insurance I carry. They made me go through 6 months of going to my primary care physician, psych apptmt, 2 nutrition classes. I pay the Surgeon $325 up front. Here's the kicker, Cabrini hospital told me 3 months ago that the hospital use/ and 1 night stay would be $400 (estimated), 15% of the total cost.

Well I'm at the end of my journey and sooo excited! I've saved $750 for the surgery. (a lot for me being I'm a single mom and school just started so that was a big chunk) My scheduled date is sept. 10th.

Today I called the hospital to get the exact amout of my deductible, which is 15% of the stay. They inform me today that the fee is now $1790.00. , which was negotiated and now is their flat rate cost to Cabrini for the sleeve to be done using their surgery room and 1night stay.. REALLY??????? After all that I have been through and the hospital is just now telling me this??

So now I don't know what to do? Do I switch insurance companies at the end of the year to federal blue cross blue shield?? My cost would be only $700 for everything. Or do I try a different doctor and hospital to see if I can get a better price???

[Heyher 581]

I would call your insurance and ask them what their contracted rate is. Also ask the hospital if you could put down the money you have and make monthly payments. A lot of hospitals don't advertise making payments, but their financial advisors typically work something out.

Going to a new insurance might start the six month diet over. So just be aware if that.

[Miss Mac 6,261]

My experience with United Health Care in the past is that they stink. As a retired federal employee now, I still have the Federal Plan with BCBS. For an $80,000 knee replacement, I paid just a few hundred dollars out of pocket. For my sleeve, I am in a 12 week program with all the usual visits with the nutritionist, doctor, psychologist, etc. I am not suggesting you change at this point, but maybe after this is over, go ahead and change for the future. Just sayin'.

[cricketcree 10]

Which bcbs do you have? Basic or standard?? And yes I am switching during open season

[Miss Mac 6,261]

Just Basic, but it has served me well for many maladies. I was in the hospital with a stroke for 6 days in 2010, and again only out of pocket for a pittance of the cost. FYI, I had excellent treatment and recovery, and my daughter is an occupational therapist. So, I recovered well except for balance and perception issues. I can see, but things are not where I think they are. It took me off the road and makes for an interesting day around the house!

[PhalconR 4]

Hi Cricketcree,

I have GEHA, I don't know if it is connected with United Healthcare. GEHA for me only required that I have a BMI of 40 or above or if my BMI is below 40 that I have a comorbidity, have documented 6 months of attempted dieting (the months leading up to surgery count towards that) and that I use a surgeon or practice listed with the "centers for excellence". My DR/practice had just lost their accreditation, but after I appealed and received my approval I was told that the "centers for excellence" only means they've done more than a certain amount of surgeries a year (I think the number is 285?). My appeal only took a week to sort out.

Be sure to check and see if your GEHA plan has a yearly limit on the amount out of pocket you pay for medical. I spent $500 prior to my surgery and my GEHA's policy is that after I reach $7000.00 (yearly) I can't be charged any more out of pocket for medical, so my remaining amount was only $6500.00 (altogether w/out insurance would have been aprox. $45,000).

[cricketcree 10]

You were out of pocket $6500? I'm only going to be out approx $2000. But my surgeon told me today that I can wait to opening season to change insurance to bcbs and have it in january and only be out $750. I'm still debating... Don't know is I just wanna get it over with, my scheduled date is sept 10th, or wait and save $1300. Decisions!!!!!

[PhalconR 4]

You were out of pocket 6500? I'm only going to be out approx 2000. But my surgeon told me today that I can wait to opening season to change insurance to bcbs and have it in january and only be out 750. I'm still debating... Don't know is I just wanna get it over with' date=' my scheduled date is sept 10th, or wait and save 1300. Decisions!!!!![/quote']

2000 is excellent. I didn't have a lot of choices in my area. I am driving 2 hours and crossing the Canadian border to get service. I found places on the west coast that offered cheaper service but not knowing anything about them made me too nervous to fly out and try them. Good luck!