My husband and I have been getting prepared for the 6 months of qualifying for insurance to pay for our gastric sleeve operations since June. I had a feeling that my company would be changing their insurance and would be no longer covering weight loss surgery so I knew we had to both get it done this year if we were going to do it.

He just had his on the 5th and I have mine on the 11th. Our deductibles are paid but I had $1000 left Out of Pocket and he has $3000. We already had to pre pay $1100 last week for the doctor. We had to prepay $1,200 for our endoscopies 2 weeks before that among all of the other money that we had to pay up front for the psych exams, blood work, nutrition classes, drs appt, etc over the last months. I never imagined that it would be this expensive even with insurance. We are a paycheck to paycheck family, so I have had to put everything on credit cards. We have cut out a lot of stuff so I have been able to pay off the cards each month so we aren’t drowning in debt over this.

The surgeries cost $23k a piece and I ASSumed that the hospital would bill us the remaining out of pocket costs AFTER the procedures, but the morning of my husbands operation the hospital demanded the full amount left of our Out of Pocket amount before the surgeries or it they would be cancelled?!?!?

Our Drs office and even the concierge at the hospital stated we should be able to made a down payment and then set up payments with the hospital but they wouldn’t budge. They said with this type of surgery no payment plan could be arranged. Again, this is 2 hours before my husbands surgery. I was crying uncontrollably, my husband was arguing with the financial manager and even said that he would cancel his surgery since his was more and that I should just have mine. We called our drs office to see if there was anything they could do. They called the hospital and they finally agreed that since my husbands surgery was hours away he could pay $800 down and then make payments but I would have to pay in full since I still had a week. Needless to say, I will have to get a new credit card with deferred payments cause we don’t that kind of money and no way we have gone through everything just to walk away now. It made a stressful day even more stressful and draining.

I understand that these operations aren’t cheap, but I had no idea before we started this that everything would be prepay or we probably wouldn’t have even started. Anyone else experience this, or am I just naive and no idea how all of this worked?

Yes sorry for your confusion - They never let anyone know all the facts till the day before - I also paid cash for my surgery and it all had to be paid prior to the surgery. Hospitals are big business and they really do not care as long as the money is paid.

Still worth it and good luck with the funds

I paid my gap 2 weeks before surgery but insurance covered most of the costs..

I paid enough to get to my OOP max the week before surgery. Sounds similar to what they asked you to do and it seems fair.

My insurance has never been cooperative. Even with pre-approval they denied my $130k claim so now I get to play messenger between my hospital, my surgeon and some 3rd party because my insurance is out of state.

Edited December 9, 20196 yr by lvidacovich

On 12/7/2019 at 6:19 AM, Tammygirl79 said:

My husband and I have been getting prepared for the 6 months of qualifying for insurance to pay for our gastric sleeve operations since June. I had a feeling that my company would be changing their insurance and would be no longer covering weight loss surgery so I knew we had to both get it done this year if we were going to do it.

He just had his on the 5th and I have mine on the 11th. Our deductibles are paid but I had $1000 left Out of Pocket and he has $3000. We already had to pre pay $1100 last week for the doctor. We had to prepay $1,200 for our endoscopies 2 weeks before that among all of the other money that we had to pay up front for the psych exams, blood work, nutrition classes, drs appt, etc over the last months. I never imagined that it would be this expensive even with insurance. We are a paycheck to paycheck family, so I have had to put everything on credit cards. We have cut out a lot of stuff so I have been able to pay off the cards each month so we aren’t drowning in debt over this.

The surgeries cost $23k a piece and I ASSumed that the hospital would bill us the remaining out of pocket costs AFTER the procedures, but the morning of my husbands operation the hospital demanded the full amount left of our Out of Pocket amount before the surgeries or it they would be cancelled?!?!?

Our Drs office and even the concierge at the hospital stated we should be able to made a down payment and then set up payments with the hospital but they wouldn’t budge. They said with this type of surgery no payment plan could be arranged. Again, this is 2 hours before my husbands surgery. I was crying uncontrollably, my husband was arguing with the financial manager and even said that he would cancel his surgery since his was more and that I should just have mine. We called our drs office to see if there was anything they could do. They called the hospital and they finally agreed that since my husbands surgery was hours away he could pay $800 down and then make payments but I would have to pay in full since I still had a week. Needless to say, I will have to get a new credit card with deferred payments cause we don’t that kind of money and no way we have gone through everything just to walk away now. It made a stressful day even more stressful and draining.

I understand that these operations aren’t cheap, but I had no idea before we started this that everything would be prepay or we probably wouldn’t have even started. Anyone else experience this, or am I just naive and no idea how all of this worked?

The sleeve does eventually pay for itself .

I didnt have to prepay for anything. total OP after insurance was 3k. Could be based on hospital/state

I had to prepay to get to my max out of pocket the morning of my surgery. I think that is the norm. Your out of pocket max is in a calendar year. So if you have a payment plan, I can imagine you’d not be out of your max by the end of the year

I had sleeve in 2018 and bypass two weeks ago. I did not have to prepay any of it.

So sorry that you went through this. Just like everything else out there, medical systems are all about the almighty dollar.

Also, I had both surgeries in the same state but hospitals that are 300 miles apart from each other.