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Does anyone have to pay a large copay and deductible



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I'm looking at $500 per night for the hospital as a co-pay, along with $45 to each doc for visits, $275 for psych eval., $200 for nutrition consult -- plus radiology and lab copays of about $40 each. All in all, with 2 nights in the hospital, I'm probably looking at $2,000. My psych eval is Friday. I've had two visits with the surgeon, one with the cardiologist. Don't know what the endoscopy co-pay will be (probably $150). I'm already about $1000 into a max of $3500 per person per year, so I'm likely to tap out with this surgery in August and be free and clear the rest of the year.

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IF my insurance covered WLS, my max out of pocket would have been $6000. That's a $3500 deductible plus 20% of the rest until it hit $6000. But instead, I had to self pay because my insurance (which costs me $350/month) doesn't cover WLS. So I saved every penny I Could, including forgoing vacations for 2 1/2 years, went to Mexico and paid $6500.

Obamacare sucks @ss.

I know someone personally that is getting surgery through the Affordable care act! Her surgery is this month. She asked which plan covers weight loss surgery before she purchased insurance. It does pay, you just have to pick the right coverage.

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No, it doesn't always pay. There are absolutely NO individual ACA policies that cover WLS in Idaho. And before ACA I had $30 dr visit copays, my deductible was $1500 and my monthly premium was $220. So I stand by my original sentiment.
Sorry to hear that. We are in Georgia. Different state, different policy. Good luck with your journey!

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Sorry to hear that. We are in Georgia. Different state, different policy. Good luck with your journey!

Sent from my SM-G920V using the BariatricPal App

Thanks. But I guess spending every penny I had is part of what motivates me to keep all my weight off (2 years and counting). I'm just bitter about how crappy my insurance has become since ACA took effect.

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If I had to pay all these co-pays and jump through all these hoops I would just go to Mexico, this is ridiculous. I'm sorry people have to go through this.

I met my out of pocket and deductible in preoperative testing. Surgery cost me nothing. My max out of pocket last year was 1500. Needless to say, BCBS doesn't offer that plan anymore, lol.

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Sorry to hear that. We are in Georgia. Different state, different policy. Good luck with your journey!

Sent from my SM-G920V using the BariatricPal App

Thanks. But I guess spending every penny I had is part of what motivates me to keep all my weight off (2 years and counting). I'm just bitter about how crappy my insurance has become since ACA took effect.

You can thank your state for that.

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IF my insurance covered WLS, my max out of pocket would have been $6000. That's a $3500 deductible plus 20% of the rest until it hit $6000. But instead, I had to self pay because my insurance (which costs me $350/month) doesn't cover WLS. So I saved every penny I Could, including forgoing vacations for 2 1/2 years, went to Mexico and paid $6500.

Obamacare sucks @ss.

I know someone personally that is getting surgery through the Affordable care act! Her surgery is this month. She asked which plan covers weight loss surgery before she purchased insurance. It does pay, you just have to pick the right coverage.

Sent from my SM-G920V using the BariatricPal App

No, it doesn't always pay. There are absolutely NO individual ACA policies that cover WLS in Idaho. And before ACA I had $30 dr visit copays, my deductible was $1500 and my monthly premium was $220. So I stand by my original sentiment.
It's your state's fault. If the law in your state says bariatric surgery is considered an essential health benefit than it must be covered under your obamacare health insurance. Idaho doesn't consider it an essential health benefit. Talk to your lawmakers.

http://www.bariatric-surgery-source.com/obamacare-weight-loss-surgery.html

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You can thank your state for that.

Sent from my iPad using the BariatricPal App

Actually, no. The WLS coverage is a state thing but the drastic increase in premiums and higher deductible (because that's what I can afford) is a direct result of the implementation of the ACA and is the same in every state. Who do you think is paying for all those people that are getting free health insurance now? That would be those of us that own a small business or are self employed and work 60+ hrs/week with no PTO.

I make just barely enough to not qualify for assistance and 20% of my gross income goes towards my medical expenses at this point. I have to fight and appeal for every single thing and now one of my meds is no longer covered. I have had the same insurance (Blue Shield) for the last 12 years and never had any problems with my coverage or ever got denied for any procedure prior to the ACA. And yes, I looked at other companies and their premiums are even higher. I was much better off before health insurance became so "affordable".

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I have had the same insurance (Blue Shield) for the last 12 years and never had any problems with my coverage or ever got denied for any procedure prior to the ACA. And yes, I looked at other companies and their premiums are even higher. I was much better off before health insurance became so "affordable".

For this, you can thank your congressperson.

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I have had the same insurance (Blue Shield) for the last 12 years and never had any problems with my coverage or ever got denied for any procedure prior to the ACA. And yes, I looked at other companies and their premiums are even higher. I was much better off before health insurance became so "affordable".

For this, you can thank your congressperson.

Actually, all 4 of my my congressmen voted against the ACA and voted Yes to repeal it.

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I have had the same insurance (Blue Shield) for the last 12 years and never had any problems with my coverage or ever got denied for any procedure prior to the ACA. And yes, I looked at other companies and their premiums are even higher. I was much better off before health insurance became so "affordable".

For this, you can thank your congressperson.

Actually, all 4 of my my congressmen voted against the ACA and voted Yes to repeal it.
You're still proving my point. :-)

"When all is said and done, usually more has been said than done. "

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I have had the same insurance (Blue Shield) for the last 12 years and never had any problems with my coverage or ever got denied for any procedure prior to the ACA. And yes, I looked at other companies and their premiums are even higher. I was much better off before health insurance became so "affordable".

For this, you can thank your congressperson.

Actually, all 4 of my my congressmen voted against the ACA and voted Yes to repeal it.
You're still proving my point. :-)

"When all is said and done, usually more has been said than done. "

Not really. My congressmen did the best they could to not let this happen. It's the congressmen that voted FOR the ACA that I have to thank for my shitty insurance.

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I have had the same insurance (Blue Shield) for the last 12 years and never had any problems with my coverage or ever got denied for any procedure prior to the ACA. And yes, I looked at other companies and their premiums are even higher. I was much better off before health insurance became so "affordable".

For this, you can thank your congressperson.

Actually, all 4 of my my congressmen voted against the ACA and voted Yes to repeal it.
You're still proving my point. :-)

"When all is said and done, usually more has been said than done. "

Not really. My congressmen did the best they could to not let this happen. It's the congressmen that voted FOR the ACA that I have to thank for my shitty insurance.
K. No point in discussing further, the blind refuse to see.

"When all is said and done, usually more has been said than done. "

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