Jump to content
×
Are you looking for the BariatricPal Store? Go now!

How much did it cost me? UHC high deductible plan.



Recommended Posts

Hi everyone, I have a UHC high deductible plan through my employer. My plan has a deductible of $1750 and a maximum out of pocket of $3250. This means I would never pay more than $3250 annually, even if I hadn't already met my deductible. I'm waiting on bills from the hospital so I can pay the remaining amount (out of $3250) I owe.

Just as fyi - this is what the hospital, surgeon,etc. billed insurance and what insurance paid them.

$4000 - Surgery; $2650 - insurance paid, remaining amount was labeled as "plan discount"

$27691 - Surgery, hospital stay (2 days) and misc. services such as medication; $27046 - insurance paid; I owe $644.

$270 - Pathology (hospital); $182 - insurance paid; remaining amount - plan discount

$1680 - Anesthesia; $1322 - insurance paid; remaining amount - plan discount

$114 - Xray of esophagus (1 week leak test - analysis); $86.00 - insurance paid; remaining amount - plan discount

$632 - Xray of esophagus (1 week leak test - images); $239 - insurance paid; remaining amount - plan discount

I was required to do the following before surgery approval -

1. Attend a seminar - surgeon requirement

2. Meet with a physical therapist - surgeon requirement (possibly insurance too)

3. Meeting with psychologist - insurance requirement

4. Meet with a nutritionist - surgeon requirement

5. 6 month supervised diet - insurance requirement. I met this requirement quickly since I had already participated in a Dr. supervised WLS program approx. 1.5 years ago (for exactly 6 months - who knew I would be that lucky!?).

6. Have my primary care Dr. sign off on this and include a 5 year history of weight. This was best guess since I have only been with this Dr. approx. 1 year.

7. Meet with the surgeon.

Share this post


Link to post
Share on other sites

Thanks for this information! I have UHC as well. What exactly did the doctor need to do in order to give you the 5 year history of weight? He was just able to fill out a form for you? I have no idea what doctor I went to five years ago.

Thanks for any help!

Share this post


Link to post
Share on other sites

@@SMOKEY2112

The Dr. and I sat in his office and I made my best guess for each year.

The form was provided by my surgeon, so I'm not sure if it was an insurance requirement or not.

There were a few other questions on the form and the Dr. signed it and faxed it to the surgeon's office.

Share this post


Link to post
Share on other sites

Thanks for that info. I'm going to see if the surgeon has a form like that I can give to the doctor. My insurance is requiring it.

Thanks again!

Edited by SMOKEY2112

Share this post


Link to post
Share on other sites

The cost is crazy! I have Federal BCBS and only had to pay 560 for everything but the bill to insurance was $38,000. Wow! I have a new luxury car for my stomach!!

Share this post


Link to post
Share on other sites

I am self pay and my estimate is $18,000. We'll see what it comes out to. And yes I have BCBS insurance but my employer specifically excludes it. Nice, right?

Share this post


Link to post
Share on other sites

I count myself extremely lucky. Mine will be a $250 co pay for the whole thing, and I have no deductible.

I'm Kaiser Fed.

Edited by The Candidate

Share this post


Link to post
Share on other sites

I have UHC West, and I paid nothing other than office copay of $30.

Share this post


Link to post
Share on other sites

Our deductible is $5,500 plus per person $12,000 per year for hubby and myself. He broke his foot a few years ago and I wrote $6-8,000 checks to hospital yippy skippy. Appreciated your info the self pay where I'm going is minimum $12,000

Does anyone have a cost on the liquid pain meds and shots you have to give yourself for the first week, it's a blood thinner I think- thanks?

Share this post


Link to post
Share on other sites

@ I didn't have to give myself any shots.

Share this post


Link to post
Share on other sites

@@FocusOnMeNow

My employer excluded it (bariatric surgery) from our regular PPO policy, but had the second High deductible policy available. Maybe there is an alternate plan? Just a thought.

I also used my HSA to pay for everything to date. I maxed out my contribution to cover my max. out of pocket and a little extra.

Edited by no onions

Share this post


Link to post
Share on other sites

Some of you paid a lot of money. I had a $40 copay to see the doctor, $40 copay to see the therapist, and $40 copay to see the surgeon. Surgery was free and the hospital stay was free. It cost me a total of $120 and I used my husbands HSA card for those charges. I have kaiser through my husband's job.

Share this post


Link to post
Share on other sites

@Imm I had the heparin (blood thinner) but those shots were given to me in the hospital, and I didn't continue them when I was discharged.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Recent Topics

  • Most popular:

  • Together, we have lost...
      lbs
    ×