How much did you pay out of pocket?

[Tina4heath4ever 27]

I have Anthem Blue cross insurance. They cover 80% of the costs, and I have a consult with a preferred provider. How much would you expect my costs to be? Is there in house financing for this?

Thank you!

[Anna Nim 196]

I have TRS Active Care with Aetna. They require a 5K co-pay, 20% of the surgery, the 'usual' doctor visits are paid at the regular rate (I think $50 a visit) AFTER the $2,500 deductible is paid and require a 3 month diet plan. That means about $10K out of pocket (mainly because my insurance re-sets on Sept 1st and it is not enough time for the 3 month diet and I have to meet my insurance deductible again).

To self pay with Southwest Baratrics is...about 10K... To go with Dr. Ganta (whom I really like) is about 13K..

Sigh.

[PixelToph 46]

It really depends on how much the hospital/surgeon you are going to charges. I have seen a huge variance of how much places charge. Everything from 5k (Mexico) all the way up to 50k+. At 80% coverage, if your surgery is 10k, your share would be 2k, but if they charge 50k, your share would be 10k.

My hospital charged my insurance $45,000 for my surgery (with an additional $2,300 for the anesthesiologist who billed separately). Thankfully my insurance paid for it and I didn't have to pay anything out of pocket.

[Tina4heath4ever 27]

Wow, yeah... this is going to be a challenge! Hopefully I will get more answers on the 1st. I have so many questions!

[Womanvsmirror 314]

A good rule of thumb is look at your oop, that's normally the max you would pay. Unless the facility bills something that's "not covered".

[KristenLe 5,980]

@@PixelToph @@Tina4heath4ever

Usually the 80% is the allowed amount by the insurance and it is irrelevant how much the hospital/surgeon charges. You can ask your BCBS plan what the allowed amount is for that procedure - but be aware that there will be additional charges on top of just the surgery (anesthesia, hospital days, medications, iv's, supplies, etc.) that you may have to pay a portion of as well. Your surgeon and hospital will go over all of this with you prior to surgery (no doubt) - and many will require payment upfront for a elective surgery. If you have a max out of pocket expense - look into that as well (it may cut down the amount you'd have to pay out of pocket).

[leliwhoaoh 27]

According to my doctor, the procedure costs $17,500 (including inpatient stay, etc). My insurance covers my procedure (vsg) at 100%, no copay, no coinsurance and no deductible/out of pocket applies. All I have to pay is the $40 specialist office visit copay and a $300 program fee for 10 visits with cardiac rehab (exercise visits) and 3 visits with a nutritionist. All in all, I will be paying $540 out of pocket. I was lucky in this respect since I happen to work at the hospital where I will eventually (fingers crossed) get the surgery

[Clarevoyant 347]

I have Anthem Blue cross insurance. They cover 80% of the costs, and I have a consult with a preferred provider. How much would you expect my costs to be? Is there in house financing for this?

Thank you!

My anthem covers 90%

Sent from my iPhone using the BariatricPal App

[Deletemyacct 39]

My bcbs cover 80% after I've met my $2k deductible. I will finance the rest if i have to, i need this.

Sent from my LGMS631 using the BariatricPal App

[trekker954 421]

There are many out of pocket costs pre surgery consults with potentially many doctors to get cleared for surgery. Between the requirements to send in to BCBS and my surgeon wanting me to get cleared I ended up having to see so many specialists. One would clear but then what a different specialist to clear me also, this went on and on with invasive testing with all results coming back just fine. This added up to over $650 out of pocket so far. I am approved for surgery by BCBS. But I had no idea I'd have these out of pocket costs before even going in under the knife. I would imagine this would be difficult for some.

[naynay35 10]

Do you have to pay your deductible before you can have the surgery?

[KristenLe 5,980]

Do you have to pay your deductible before you can have the surgery?

I don't think so but probably depends on your surgeon and the hospital.

[Read2016 658]

You generally get billed after the surgery for whatever the cost are, at least that's been my experience.

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

[BarrySue 602]

I paid 15k out of pocket. If I could do it all over again, I'd have run off to Mexico and saved a bundle!

[Ginger Belle 54]

I suppose to pay $622.00. I said that's not bad considering the amount surgery costs.