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Did you have to pay your surgical copay upfront

Yes I know this is a question to ask directly of the office but they haven't mentioned anything so fat other than I have to pay 10% and I was wonder if your surgeon made you pay before surgery. I'm hoping not since my surgery will be right before bonus time so was planning to pay for it with that. I DID have surgery with one of the other surgeons in the office (gallbladder) and didn't pay anything until after the fact. My copay might will also probably max out after surgery with either the surgeons or hospital bill depending on which gets paid first.

So you experiences?

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3 days before my surgery I had to pay my deductible. Was NOT planning on that! However, The doctor bill was in before the hospital bill so I ended up getting most of my deductible back to pay the doc. CRAZY, I know, but wanted you to be prepared. Good luck!!!

The only out-of-pocket cost I had was a $500 co-pay. My surgeon's office set me up on monthly payments, which didn't even start until after the surgery. After reading these replies, I feel extremely lucky to have the monthly payment option I was given. :)

I would ask your surgeon's office if they would be willing to set you up on monthly payments. Good luck!

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I won't need monthly payment if I can pay when a normal bill would be due. It'll be interesting to see if they do handle copays differently for bariatric surgery than the rest of their payments. It's a huge practice so wls shouldn't be that different. As I mentioned prior to I had my gallbladder out with one of the other wls surgeons in the same practice and billing was afterwards. I hope they would say something because they gave advance notice about having to pay up front for the psych.

I dont even know how much the copay would be anyways only that its 10%

Just speaking medical insurance wise, anything referred to as a copay would need to be paid at time of service. Co - insurance and deductible is usually billed after the fact.

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What is the difference? Is copay when its say $20 or a fixed dollar amount and co insurance when it's a percentage?

I guess I'm wondering is how will they know what the amount will be without billing the insurance if its a %

  • Author

OK looked at my plan and its a 10% coinsurance of the total amount. I only have $x left for the year before my copay is maxed out and they start picking 100% so I'd prefer not to have to pay upfront and have to fight to get it back. Already though not their fault they have overcharged me for my office copay so I should have a small balance.

My cost was $250 (after secondary insurance picked up $1750 of my hospital copay of $2000). The $250 was paid w/my FSA. This was due the day I checked into the hospital for my surgery. My biggest expense was $500 for WLS education workshops (required by my team before surgery is scheduled). These were not eligible for FSA funds so they were my only out of pocket expense and had to be paid in full, up front.

I had to pay everything to the surgical group which was 730 + 300 + 153 before having the surgery and I got an invoice from the hospital telling me I have to pay 1,216 prior to the surgery or the day of. That was my 20 % of the surgery and know that whatever you have to pay the hospital is totally separate from the dr.

I was pretty bad off after the surgery and had extra drs and extra testing, so I don't know what will happen with those charges of if they will be grouped under what I already paid.

I didn't have to pay anything. My thousand dollar deductible and six thousand out of pocket max had already been met. I do know that most surgeons charge a fee which has to be paid upfront. I would of had to pay it if my OOP max would of not been met. I may have to pay the hospital 3500, but they are going to bill it since they didn't tell us about it until I was in the middle of surgery. My husband was so mad that they waited until then to discuss money with them. I hope everything works out for you.

  • Author

I'm lucky that the WLS preop education program for my surgeon is free of charge. That includes all the nutrition and preop classes, dietitian and support groups.

The only thing that they told me I'd have to pay upfront for which was for the psych clearance which I did. I should ask next time I'm there but I find sometimes I forget. Also they have a lot of HMO patients so the way payment is handled for them is different. I know when I went to the seminar I was the only one not referred by a particular IPA.

My cost was $250 (after secondary insurance picked up $1750 of my hospital copay of $2000). The $250 was paid w/my FSA. This was due the day I checked into the hospital for my surgery. My biggest expense was $500 for WLS education workshops (required by my team before surgery is scheduled). These were not eligible for FSA funds so they were my only out of pocket expense and had to be paid in full, up front.

Bonus: I planned my gallbladder removal for December of the same year because my deductible was already met so it was a freebie. :-)

A copay is the set amount due at time of service regardless of the service. A coinsurance is a percentage of the final charges that you are also responsible for. Those are in a bill after the charges are completed and insurance is billed and then you are as well. :)

A copay is the set amount due at time of service regardless of the service. A coinsurance is a percentage of the final charges that you are also responsible for. Those are in a bill after the charges are completed and insurance is billed and then you are as well. :)

That is not how mine went. I have a 20% copay and they did an estimation of the surgery/hospital costs and billed me the 20% previous to the surgery.

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