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

FMLA approved....one more hurdle to go.



Recommended Posts

My surgery is scheduled for April 18th. I've already bought all my Vitamins and such, and have started my 2 week pre-op liquid diet. Now that I know I have the time off work that I need, my last huge worry is the amount that my co-pay for the surgery itself will be. I have been told I'll have to pay it the day of surgery and I am terrified I won't have enough money for it. I'm trying to not stress too much and stay positive, but this could potentially put everything at a screeching halt and I can't imagine not having the surgery at this point. I guess just pray for me guys, and if you don't pray please keep me in your thoughts or send some good vibes my way!

Sent from my LGLS990 using the BariatricPal App

Share this post


Link to post
Share on other sites

You should be able to get an estimate of the amount you will owe now.....If I were you I'd give them a call and ask.

Share this post


Link to post
Share on other sites

You should be able to get an estimate of the amount you will owe now.....If I were you I'd give them a call and ask.

They told me since I have so many things pending to be applied to my deductible that I wouldn't be able to get an accurate amount until the day of, which is frustrating and stressful ????

Sent from my LGLS990 using the BariatricPal App

Share this post


Link to post
Share on other sites

@@tiffanymarie6997 If I were you I would ask them to estimate it based on if it had to be paid "today"......at least that way you will know the "most" you'll be expected to pay.....going in blind is not a good idea in my opinion. Another thing you can do is check what your out of pocket maximum is for your insurance plan....... For example for me....I have a $250 deductible and a $2500 max out of pocket......So I know worst case by the time I pay all the doctors and the hospital the most I will pay is my $250 deductible plus 20% but it will not exceed $2500 max out of pocket....so no more than $2750 (deductible + max out of pocket)...my surgeon's office it telling me it should be less than that, but as long as I plan for that I know I won't be surprised. Good luck!

Share this post


Link to post
Share on other sites

@@tiffanymarie6997 If I were you I would ask them to estimate it based on if it had to be paid "today"......at least that way you will know the "most" you'll be expected to pay.....going in blind is not a good idea in my opinion. Another thing you can do is check what your out of pocket maximum is for your insurance plan....... For example for me....I have a $250 deductible and a $2500 max out of pocket......So I know worst case by the time I pay all the doctors and the hospital the most I will pay is my $250 deductible plus 20% but it will not exceed $2500 max out of pocket....so no more than $2750 (deductible + max out of pocket)...my surgeon's office it telling me it should be less than that, but as long as I plan for that I know I won't be surprised. Good luck!

Thank you! I'll give them a call tomorrow and ask. This is my first big medical venture as an adult so I feel a little overwhelmed with the whole insurance aspect as I don't completely understand it all, I'm sure we all feel overwhelmed at some points though no matter how insurance savvy we are. Thank you for your input :)

Sent from my LGLS990 using the BariatricPal App

Share this post


Link to post
Share on other sites

@@tiffanymarie6997 I retired from BCBS of Florida after 29 years and you are right it can get confusing!!!

Share this post


Link to post
Share on other sites

I called again today to try and find out a money figure of some sort, spoke to 3 different people and still don't have an answer. One lady told me $8500 and I told her there was no way that was right due to my insurance covering some of the surgery and my out of pocket max. She was surprised that insurance covered it, she said most insurances don't. She still could not give me any kind of estimate though which is really stressing me out. I'm praying I have enough to cover the amount...I'll be devastated if I don't. ????

Sent from my LGLS990 using the BariatricPal App

Edited by tiffanymarie6997

Share this post


Link to post
Share on other sites

I called again today to try and find out a money figure of some sort, spoke to 3 different people and still don't have an answer. One lady told me $8500 and I told her there was no way that was right due to my insurance covering some of the surgery and my out of pocket max. She was surprised that insurance covered it, she said most insurances don't. She still could not give me any kind of estimate though which is really stressing me out. I'm praying I have enough to cover the amount...I'll be devastated if I don't. ????

Sent from my LGLS990 using the BariatricPal App

That woman is an idiot. Most insurances do cover it. It just depends on how much. You won't have to pay one cent more than your max out of pocket. So think of that as your worst case scenario maybe?

Sent from my SM-G900T using the BariatricPal App

Share this post


Link to post
Share on other sites

I'm hoping that's not the case because I'd have to postpone it a bit which is not ideal since I already have my date, FMLA approved, bought everything and doing the liquid diet. I hope it's less than that because I know other things have been applied to my out of pocket. I just wish someone could give me an answer instead of me just hoping for the best and facing disappointment :/

Sent from my LGLS990 using the BariatricPal App

Share this post


Link to post
Share on other sites

She told me to call back Monday (1 week before my surgery date) and try again. So I guess that's what I'll do...ugh.

Sent from my LGLS990 using the BariatricPal App

Share this post


Link to post
Share on other sites

She told me to call back Monday (1 week before my surgery date) and try again. So I guess that's what I'll do...ugh.

Sent from my LGLS990 using the BariatricPal App

That has to be terribly frustrating! I'm sorry you're having to go through this!

Sent from my SM-G900T using the BariatricPal App

Share this post


Link to post
Share on other sites

Have you tried calling your insurance to ask? They might have a better idea?

Sent from my SM-G900T using the BariatricPal App

Share this post


Link to post
Share on other sites

Are u calling the doctor or your insurance company? Usually your insurance will give you an estimate the dr office usually doesn't know what they get paid right before surgery... Also you can check your insurance coverage what's your yearly deductible example I have UHC and after I pay $300 deductible for whatever procedure my insurance will cover 100% of anything I get done for the rest of the year. So if you haven't yet call straight to your insurance company!

Share this post


Link to post
Share on other sites

I ended up looking on Anthem.com and it looks like I only have less than $500 before I meet my out of pocket limit so I'm hoping that means it won't be any more than $500. I'm still going to call and double check though.

Sent from my LGLS990 using the BariatricPal App

Keep your fingers crossed for me please!

Sent from my LGLS990 using the BariatricPal App

Share this post


Link to post
Share on other sites

See I'm glad you checked! And probably it will only be that!

Good luck!

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

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×