My insurance will cover the procedure at 50% with a maxium coverage amount of $15000. I am curious if anyone has had a similar type of coverage and what your out of pocket actually turned out to be. My out of pocket maximum for the plan year is $2500, but curious to know what happens when the $15000 maximum coverage for WLS is filled. Also, I am curious to know what the difference has been in costs with those with insurance and those without and why.

Thank you in advance!

Amy

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I have Anthem as well but there's an exclusion on my policy, so they don't cover anything

Did you ask if they cover fills? (I forgot to ask that)

I didn't think to ask that, but should have! I was more concerned about understanding how the coverage actually works!

Where do you live? That will play a role in how much the surgery costs. (In most cases)

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Are you in CT?

Someone on this board was telling me about a doctor in Hartford who only charges around $11,000. I checked and he's on the Anthem physician list. (I don't know anything about his experience or reputation though)

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Seems like on average the surgery is any where from $18,000 - $25,000.00. Plus or minus about $5,000

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I would call Anthem [ :rolleyes aren't they just soooooo pleasant and helpful? :rolleyes ] and ask them to explain exactly what that mumbo-jumbo means. Sounds like you'll end up having to pay the full $2500

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Self pay can be as cheap as $7500 in <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:pMexico</ST1:p</st1:country-region> or $9950 in <st1:City><ST1:pDenver.</ST1:p</st1:City><O:p</O:p