$70k for Gastric Sleeve Surgery?

[FamilyGuyNJ 123]

I'm just 2 months past my SVG surgery and lost just over 50lbs. I've been watching the bills roll in from my Doctors and the Hospital and I'm shocked at the expenses. But I'm even more shocked that my insurance is actually paying these rates.

Based on what I've ready, SVG in the US costs $18k on average and I've seen higher charges up to $30k so my mouth dropped to the floor as to what I've seen come through my insurance. For example:

• Surgeon charged $22k, insurance paid $17.5k.
• Surgeons assistant $11k, Insurance paid $4k.
• Hospital $23k, Insurance paid $22k.
• Anesthesiologist $12k, Insurance paid $8k

There are many other smaller charges like the NUT, Psychiatrist, Xrays, Bloodwork, etc. All charges to my insurance exceed $70k in total. Overall, my insurance paid out more than $50k. Fortuneateately, I only paid a few hundred dollars in co-pays and used by FSA card. I guess I should be happy as there were no complications, the recovery has been a cake walk and weight continues to melt off at 5lbs a week but I feel incredibly guilty. I work for a small company of 150 employees. They offer great benefits. We are Self Insured and pay an insurance company to manage the policy... and it's one of the biggest health insurance companies out there. I thought the point of the Insurance company is to pay the least amount possible to Hospitals and Doctors. I feel in this case, everyone gouged my insurance and insurance rolled over on their backs to get their belly rubbed. In the end, my company will be the ones paying $50k. My blood pressure meds and sleep apnea machine is much less expensive than this surgery over the course of 20 years.

I escalated to the insurance company to say "I don't think you represented my company fairly", but responded by saying they paid out the customary fee and nothing was considered excessive.

So I'm asking the folks on Bariatricpal.com... what did your doctors/hospitals charge your insurance? What did they actually pay out? Am I the only one who feels this way? Or am I over reacting!

[kempermorris 144]

I'm just 2 months past my SVG surgery and lost just over 50lbs. I've been watching the bills roll in from my Doctors and the Hospital and I'm shocked at the expenses. But I'm even more shocked that my insurance is actually paying these rates.
Based on what I've ready, SVG in the US costs $18k on average and I've seen higher charges up to $30k so my mouth dropped to the floor as to what I've seen come through my insurance. For example:

• Surgeon charged $22k, insurance paid $17.5k.
• Surgeons assistant $11k, Insurance paid $4k.
• Hospital $23k, Insurance paid $22k.
• Anesthesiologist $12k, Insurance paid $8k

There are many other smaller charges like the NUT, Psychiatrist, Xrays, Bloodwork, etc. All charges to my insurance exceed $70k in total. Overall, my insurance paid out more than $50k. Fortuneateately, I only paid a few hundred dollars in co-pays and used by FSA card. I guess I should be happy as there were no complications, the recovery has been a cake walk and weight continues to melt off at 5lbs a week but I feel incredibly guilty. I work for a small company of 150 employees. They offer great benefits. We are Self Insured and pay an insurance company to manage the policy... and it's one of the biggest health insurance companies out there. I thought the point of the Insurance company is to pay the least amount possible to Hospitals and Doctors. I feel in this case, everyone gouged my insurance and insurance rolled over on their backs to get their belly rubbed. In the end, my company will be the ones paying $50k. My blood pressure meds and sleep apnea machine is much less expensive than this surgery over the course of 20 years.
I escalated to the insurance company to say "I don't think you represented my company fairly", but responded by saying they paid out the customary fee and nothing was considered excessive.
So I'm asking the folks on Bariatricpal.com... what did your doctors/hospitals charge your insurance? What did they actually pay out? Am I the only one who feels this way? Or am I over reacting!

I had gastric bypass at $50K. Medicare paid it all

[OutsideMatchInside 10,166]

Mine billed at 39K total, BCBS paid 11K at the negotiated rates.

[jrmoseley 101]

the other factor that we don't talk much about in the US is that almost all of our medical expenses carry an invisible surcharge that pays for the system to work. You know how so many politicians say that the uninsured can always get care at any ER? Well, guess what- there's no magic fairy that absorbs the cost, we all pay it with exorbitant fees. The pols can say we can't afford single payer healthcare all they want, but it seems to me we're already paying for it, we just don't have anything to show for the money we're spending.

[Clementine Sky 707]

Wow. $70K is steep, though it doesn't shock me considering the expenses of American healthcare. My insurance wouldn't cover any of my expenses because my BMI didn't meet the qualifications, so from the start I was planning on being self-pay. I was quoted $29,000 to $35,000 in Los Angeles. I ended up going to Mexico in August of 2015 where the VSG was $4200, and the experience very positive. I've been maintaining a size 2-4 for six months now. If insurance would have paid for my surgery, I would have had it locally, but I think the reputable surgeons and facilities in Mexico are a good option for those who will have to pay out of pocket.

[Deactivatedfatgal 377]

I was self pay and paid 13,995

[caddygirl 208]

Wow. $70K is steep, though it doesn't shock me considering the expenses of American healthcare. My insurance wouldn't cover any of my expenses because my BMI didn't meet the qualifications, so from the start I was planning on being self-pay. I was quoted $29,000 to $35,000 in Los Angeles. I ended up going to Mexico in August of 2015 where the VSG was $4200, and the experience very positive. I've been maintaining a size 2-4 for six months now. If insurance would have paid for my surgery, I would have had it locally, but I think the reputable surgeons and facilities in Mexico are a good option for those who will have to pay out of pocket.

Congratulations if I could get to a size 2-4 it would blow my mind [emoji3]

[Syaniya 319]

Well my bills seem to be still rolling in, but we are up to $33k and they have paid about $11k of these bills. Thankfully, my co pays all equaled under $500 for my whole surgery.

Sent from my SM-N920V using BariatricPal mobile app

[YeaMe 246]

I was a self pay and paid surgeon $5,500 and hospital $4,800. I did have a hiatal hernia fixed at the same time. The total hospital bill was $38,000, with the insurance paying the complete share of the "discounted" rate. Since the insurance paid the entire hospital bill, I get my $4,800 back! Nice surprise - now I can put new clothes on this new body. The surgeon does have a cash price of $15,500 that includes his fee and he hospital.

[caddygirl 208]

I was a self pay and paid surgeon $5,500 and hospital $4,800. I did have a hiatal hernia fixed at the same time. The total hospital bill was $38,000, with the insurance paying the complete share of the "discounted" rate. Since the insurance paid the entire hospital bill, I get my $4,800 back! Nice surprise - now I can put new clothes on this new body. The surgeon does have a cash price of $15,500 that includes his fee and he hospital.

I'm thankful my insurance paid 100%! I haven't even seen my bill! That was Feb 20/17

[mariernest 32]

$4,000 surgeon. Insurance paid hospital. I paid small amount for a class or two and a pellet shot, Vitamins etc but most other visits monthly and classes were free.