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Kaiser Questions

Chrysaia

By Chrysaia, in Insurance & Financing

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Chrysaia    6

Chrysaia
Posted

So I started the process today, met with intake. They had me call the Finance Counselors. I had already used the estimator on KP.org, so I was expecting 4 to 5k out of pocket. The counselor says no, it's 14k. They break it up into 36 payments of 338, which is after paying 2k just to schedule the surgery. Is that normal?

I mean that's a car payment...I was okay with this when the estimator said the 4-5k. I'm not so sure I can put this financial burden on my family, even for the sake of my health.

Is anyone aware of options I can look into? I'm in Colorado if that makes a difference.

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Alfred Day    90

Alfred Day
Posted

I'm with Kaiser in Northern California and the cost is covered with a $250.00 co-pay.

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Chrysaia    6

Chrysaia
Posted

Wow. can location seriously be that big a difference? That's crazy to think in one state it's 250 copay and in another state it's 14,000...

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Jdserra    78

Jdserra
Posted

Southern California here and I'm also $250

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FunkyMunkyBrat    205

FunkyMunkyBrat
Posted

Oooh silly me LoL Kaiser question means your insurance.. Excuse me.. Sorry.. And Holy sh!t that's crazy for a "co-pay" ????

Munky

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Chrysaia    6

Chrysaia
Posted

Yes, I have Kaiser of Colorado and their plan only covers 50%. What's really frustrating is that I used their estimator which states it uses my plan information to estimate, which I why I started the process. And then they turn around and say 50%. is all they cover and the entire bill is $28,000; so my share would be $14,000, and that's just for the surgery. I still have deductibles for speciality appointments with the doctor, mental health and the classes leading up to the surgery.

It just seems crazy...and I just need to research and see if there is something I am missing.

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shedo82773    1,236

shedo82773
Posted

Well, you can look into going to Mexico. It is a lot cheaper. But I wouldn't suggest BELITE, they send their patients to JUAREZ. The surgeon is amazing but the Hospital really isn't anywhere close to the USA. But I have heard that in Tijuana it is much better. My hubby had his SLEEVE done in Juarez and like I said our experience wasn't too good with the practice of their hospital. It was called STAR MEDICAL or just MED I don't totally remember.

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stormid    7

stormid
Posted

What hospital are you using? Can you use Denver health, Rose, St Joe?

Sent from my SM-G920T using the BariatricPal App

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lizmo8175    56

lizmo8175
Posted

WOW, I know everyone's insurance is different however if my insurance didn't cover my surgery it would be 12500 out of pocket and that would cover everything all appointments also they require half down and then we'll set up the remaining 6000 divid it into payments.. 4 years ago when I had the Lap-Band it came back that my insurance didnt covering the surgery that I wanted which was the sleeve they Said it would be 17000 cash so I ended up paying $9,000 and went with the Lap-Band I wish that I would have done more research and looked at other facilities however I was vulnerable and was desperate for anything now I have to deal with this thing until I can get it out and have the sleeve done...in which I hope is soon!!!!!!

Sent from my SM-N910V using the BariatricPal App

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Chrysaia    6

Chrysaia
Posted

What hospital are you using? Can you use Denver health, Rose, St Joe?

Sent from my SM-G920T using the BariatricPal App

It's through St. Jospeh's

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stormid    7

stormid
Posted

Might check the other hospitals to see if it is cheaper.

Sent from my SM-G920T using the BariatricPal App

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Moogle    116

Moogle
Posted

I am on a platinum plan I purchased through the state exchange (Maryland). My premium (which I take no assistance for) is about $320 a month. I got the higher-end plan because of my health issues. My copay for the surgery was $350 (would have been $250 last year).

It is really late in the year, which means health insurance enrollments will be opening up soon. Do you have the option of changing plans? Maybe see what else is open? Just something to look into. I told my doctor that I wanted a referral for bariatric surgery on my first visit two weeks after I got on the insurance and there was absolutely no problem.

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necarv    4

necarv
Posted

I think it depends on your plan. Maybe you can change your plan during open enrollment? Some plans have $0 co-pays, $25+, and some have deductibles. I'm also in CA, so not sure how the plans work in your state.

Wow. can location seriously be that big a difference? That's crazy to think in one state it's 250 copay and in another state it's 14,000...

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krissyfattofab    68

krissyfattofab
Posted

I have Kaiser NorCal and I work for a big

Bank that only offers co insurance plans. I enrolled in the best one they offer and I have to pay $2000 which is my individual out of pocket max. We used to have the $250 copay with my hubs

Company but they no longer offer Kaiser.

Sent from my iPhone using the BariatricPal App

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

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      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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