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



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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.

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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!

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@@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.

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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

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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!!

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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?

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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

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

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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?

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

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@@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

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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.

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@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.

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