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What's the average out of pocket expenses. Got HBF health cover

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Generally depends on the after support program, plus how much extra above the medicare scheduled fee the surgeon charges.

Have you confirmed that your particularly insurance covers WLS, been a lot of changes as to what is being covered in the various levels of cover lately.

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I don't know if there is an "average" out of pocket as the % coverage varies with each policy. I would first make sure you can qualify with your insurance and that your provider is covered by your insurance.

Additionally, you could end up with multiple bills not only for for pre and post appts but different things directly associated with the surgery including but not limited to the hospital, the surgeon, the anesthesiologist, the lab,etc.

If you need it, I would encourage you to also enquire with your hospital/clinic regarding financial assistance (I was able to find information online). I qualified for assistance- between insurance and assistance, all care directly associated with the clinic and hospital was covered- i had to pay a copay for the anesthesiologist and biopsy of the stomach that was removed (less than $300)- my nutrition and surgeon appts pre and post op as well as labs were also covered.

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I would think it would vary widely depending on high high your deductible is, what is your maximum out of pocket expense limit under your plan, etc. For me, last month, the surgeon and hospital bills totaled around $56,000 billed, of which the insurance paid at their negotiated rate $23,000 and my portion out of pocket was only $600

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My procedure totaled about $24,500 as billed to insurance. My portion was $2,975. I spent another $2,200 on the diet appointments, nutritionist, all the labs, psych eval, etc. So total just over 5k out of pocket, but that was over an almost two year period.

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My total bill for the surgery was $92,437.19 and my out of pocket was $750.00

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      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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