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So frustrated! Not covered 100%

So I have been going through the process since January and just got a call from the surgery coordinator with a surgery date!! Was so excited and she then scheduled the pre-op for this Friday (2 days from now) !! Then she mentions that my insurance considers this elective surgery so there will be out of pocket expenses!! And the hospital fees are due at the pre-op appointment in 2 days!!! WHAT?!!!!! She said she will get back to me about how much money this will cost. I am freaking out!!!! Does anyone have any idea how much out of pocket will be? I am sick to my stomach right now! I just want to cry!!

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  • Yayyyyyy just talked to insurance and they said it is only $25.00 lol !!!!!!!!!

  • That's such great news! I actually had to hire an advocacy group to have my denial overturned! I I WON and and am having my Bypass on 03/11. I feel like the temporary freekout will only make me more o

  • Yes, they approved it. I guess I was naive !! I just need to calm down and get over my anxiety before I call them.. And maybe have a sip of wine lol.

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Oh no! That's got to be an awful feeling. Hopefully it isn't a whole heck of a lot. I'm surprises they didn't tell you your surgery was elective before hand!

  • Author

I know!! When I had my initial appointment, they asked what insurance I have and when I told them, they said my insurance always authorizes the surgery which led me to believe they would pay for it !! And no one has ever mentioned it before now. It's just so frustrating and making me feel so defeated. Well, if nothing else, maybe I will lose some weight since I have absolutely no appetite now!! Lol

Did your insurance approve your surgery? If so, do you know how much your out of pocket is... thats how much you'll probably have to pay. If your insurance doesn't cover/hasn't approved your surgery you'll have to pay for it all. Can you call your insurance and ask them? Have YOU talked to your insurance yet?

  • Author

Did your insurance approve your surgery? If so, do you know how much your out of pocket is... thats how much you'll probably have to pay. If your insurance doesn't cover/hasn't approved your surgery you'll have to pay for it all. Can you call your insurance and ask them? Have YOU talked to your insurance yet?

Yes, they approved it. I guess I was naive !! I just need to calm down and get over my anxiety before I call them.. And maybe have a sip of wine lol.
  • Author

Yayyyyyy just talked to insurance and they said it is only $25.00 lol !!!!!!!!!

Yayyyyyy just talked to insurance and they said it is only $25.00 lol !!!!!!!!!

What a relief!

I like the saying "if you expect the worst, you can only have nice surprises" ????

Best wishes with your surgery ☺️

  • Author

Thanks so much !!!!!!

Be sure that's for everything. Remember, there will be a bill from your surgeon, a bill from the hospital and another from the anesthesiologist, maybe one from radiology if there is a post-op radiograph, etc.Even though my insurance technically covers it, I will still have several hundred dollars of co-pay/deductible stuff for both the hospital and the surgeon. But that's what the patient coordinator at my surgeon's practice is there for - to get those figures ahead of time for me so there is no shock afterward!

  • Author

Hmmm I asked the insurance company if there were any other expenses and she said everything else is covered because my husband is active duty military. But I will definitely ask the coordinator when I meet with her on Friday !!! Thanks so much!!!

Well that's great! I wish I'd had this done when my husband was active duty LOL! He is still a federal employee but our BCBS has lots of copays and stuff. Still, I'm lucky to have it covered most of the way!

I freaked when I went to orientation and the woman next to talked about how much she had to pay. Same insurance company but different plans. I called and found it is covered on my plan, no deductible. I started February 2 but asked for surgery in June. I hope they can accommodate this.

That's such great news! I actually had to hire an advocacy group to have my denial overturned! I I WON and and am having my Bypass on 03/11. I feel like the temporary freekout will only make me more of a weight loss rock star and it will for you too! Just hold on to that feeling of how freeked you felt when you were on the edge of your seat and how amazing it was to know you were ALL SYSTEMS GO! lol Keep us all updated!

I started this whole thing last May started my 6 months of visits and of course I didn't know how strict it was and my first one was in June then the doctor called to change it back a week which made it July 2nd so now July was my month one not June. Then about Nov my husband found out his company is changing insurance Jan 1st we panicked trying to get it all done before the year ended since we had already met my deductible but of course test results took forever so we could even apply to insurance so of course it was after jan before my advocate could submit. Now our insurance is way more expensive for worse coverage. I got approved but talked to financial last week and my part is over $2000 due the day of surgery! Once again panic mode I wish I had been told that on the front end!!! Still having the surgery March 18th but having to use our whole tax return plus clean out our savings!! So angry!

  • Author

That's such great news! I actually had to hire an advocacy group to have my denial overturned! I I WON and and am having my Bypass on 03/11. I feel like the temporary freekout will only make me more of a weight loss rock star and it will for you too! Just hold on to that feeling of how freeked you felt when you were on the edge of your seat and how amazing it was to know you were ALL SYSTEMS GO! lol Keep us all updated!

So glad everything worked out for you!!! Good for you!!! Please keep us updated on your status as well !!! Are you doing a liquid diet before surgery?
  • Author

I started this whole thing last May started my 6 months of visits and of course I didn't know how strict it was and my first one was in June then the doctor called to change it back a week which made it July 2nd so now July was my month one not June. Then about Nov my husband found out his company is changing insurance Jan 1st we panicked trying to get it all done before the year ended since we had already met my deductible but of course test results took forever so we could even apply to insurance so of course it was after jan before my advocate could submit. Now our insurance is way more expensive for worse coverage. I got approved but talked to financial last week and my part is over $2000 due the day of surgery! Once again panic mode I wish I had been told that on the front end!!! Still having the surgery March 18th but having to use our whole tax return plus clean out our savings!! So angry!

Wow, so sorry about your insurance issues but glad you found a way to make it happen!!! When they told me I had out of pocket expenses, I was convinced I would have to come up with $10,000 lol. Good luck with your journey- you are 2 days after me!!! Keep us updated !!

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