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Just curious what's the average cost of gastric bypass?

I called my insurance today and they said they will cover 80% so now i lay here unable to sleep trying to figure out what the other 20% will cost me.

I live in Michigan. I have Priority Health POS A

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Posted (edited)

Just went back and found more information for the area I am in. These are prices of the procedure if you pay without insurance.

Gastric Bypass Surgery Cost Comparison Kansas City

Bariatric Center of Kansas City Blue Valley Surgical Institute North Kansas City Hospital St. Luke’s University Of Nebraska Medical Center
Private Pay Gastric Bypass $18,000 Not Offered $20,000 $25,000 $23,000
Edited by dathvick

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15 hours ago, williamsk39 said:

Just curious what's the average cost of gastric bypass?

I called my insurance today and they said they will cover 80% so now i lay here unable to sleep trying to figure out what the other 20% will cost me.

I live in Michigan. I have Priority Health POS A

Sent from my LGMP450 using BariatricPal mobile app

you need to ask your hospital and or insurer. I've seen insurance inflated bills over 100k. the actual cost should not be more than 20k...but that is not the same thing as the cost that will be billed to your insurance company.

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Mine ended up costing me $3500 out of pocket and that’s 20%, and a couple small bills around 300-600, for small things like anesthesiologist and blood work

The hospital sets up a payment plan if it’s needed, they seem cool to talk to about it, don’t be afraid to look into it

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I had my surgery Feb. 15. I don't yet know what I'll have to pay for my hospital stay (the bill given to my insurance company is $49,473, but with my plan I shouldn't be responsible for even CLOSE to that) because it's still processing, but for the costs that have gone through (anesthesia and surgeon), so far I'm responsible for $1,251 out of $14,370 (about 8%), but my portion includes a $1,000 deductible.

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i know when i had a similar surgery called abutment put in the parts alone were like 18 grand so 20% was around like 3800 if that helps it should be similar

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The bill to my insurance was over $75k. That was just a normal RNY surgery, no complications or anything funky. The bulk of the costs were for the 3 days stay. I paid in the $2k range.

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The cost of the surgery doesn't matter as much as your out of pocket maximum.

Example: the hospital can charge 1 million for my surgery, I don't have to pay 20% of that. I am responsible for my deductible and co-pays ONLY up to the out of pocket maximum. Check what that is for you.

Also, I am familiar with Priority Health and they typically make you jump through a few hoops first. I would get started on the process right away.

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The cost of the surgery doesn't matter as much as your out of pocket maximum.
Example: the hospital can charge 1 million for my surgery, I don't have to pay 20% of that. I am responsible for my deductible and co-pays ONLY up to the out of pocket maximum. Check what that is for you.
Also, I am familiar with Priority Health and they typically make you jump through a few hoops first. I would get started on the process right away.

Thabk you! I did finally talk to the surgeon. They explained my insurance and i feel a lot better. They also have payment arrangements if need be.

I know i will have to do the 6 month supervised weight loss as well as egd and other pre op stuff. I go Meet with surgeon And nutritionist again March28th to get the entire process moving :D

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Retired Insurance agent here.

The Cost is what people without Ins Pay, each carrier has a negotiated rate with every Doctor, Hospital etc. Your Cost could be 75K but negotiated rate is like for example $10K.

From there it starts with your Hospital Deductible, the after deductible is met you have co-insurance which normally is a percentage like 20% . The Co-insurance is up to certain amount like $5,0000. So based on this you take the assigned deductible you have and deduct from the 10K. Then whatever is left over you Pay only 20% of that balance until it adds up to your out of pocket max of $5,000. Until you reach your out of pocket max, everything else is 100% coverage until next year when your deductible starts over. Now this is for this standard plan, there are many other plans out there like HSA, and some where you pay your full deductible which is normally high and everything else is 100%. And still many other plans out there. It’s always best to consult with your agent and get a better understanding how your plan works. You’d be surprise how many people I met thru my years in the Ins business and they had no clue how what they had worked. There are hundreds of plans out there and a good agent will consult with you and look into your health history and families health history to figure out what plan is best and if it would be wise to add a supplemental policy to help with out of pocket expenses.

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