hello everyone......i have private health insurance but my surgeon has told me i need to pay about $3000 out of my own pocket. Did u all have to pay this out of pocket expense too? Im just a bit confused as to why i have to pay this.I dont know if its the surgeon charging more or if this is what everyone has to pay. Thanks Fee

Hi Fee! I too have to pay about 3000 out of pocket. I had to pay for the nutritionist consultation which was $200 then the psychological evaluation test which was $160 my insurance picked up the rest of that($140). The weight loss workshop here where I live is called obesity to balance I attend that for 2 days in August which is $500. I will also have a bill from the physician for about $2000 after the surgery. .

hmmm...yeah it doesnt sound right does it??

anyone else have this problem?

Hi Fee,

Everyone's insurance is different and there are many reasons you might have some out-of-pocket expenses. For example, if the doctor, hospital, or even the anaesthesiologist is not in your network you may have some out of pocket charges. In addition, the nutrional and psychological evaluations are often not covered by insurance at all. Your plan may itself have co-insurance and copay features that amount to a significant charge.

If your doctor's office is, however, charging for additional services over and above the surgery and related services itself, they are very likely to be optional. Check the fine print and see what exactly you're being charged for and whether you have control over those expenses.

ok will do....thanks so much......fee

My insurance covered the Psych eval and tests, etc. I will have a copay of 20%. Not of what the Dr charges but what the insurance company has prenegotiated rates with them on, My dr is in the network too, I have Empire BCBS...

I had to pay either $2000.00 or $25000.00 before the surgery out of my pocket for my deductible...

like the others said. It all realy depends on your insurance coverage. I had $25 co pays, for my physicals, and psyc eval. I have to pay a $400 deposit prior to surgery, and of course i'm responsible for anything above and beyond wha the insurance will pay. Considering that this is a $18,000 surgery, i feel like i'm getting a pretty good deal out of it.

I know that the Wish center in Chicago told me that there was a $2,000 "lifetime support" fee. I explained to them that I was far away and would never use the support group and I had one locally and they said it was not optional. I called the insurance company and was told that was not payable. That would be on top of any co-pays deducts and such. I went with a closer and I think better surgeon.~Mandy

You should talk to the Doctor directly about it. That seems totally unreasonable.

I had to pay surgeon and hospital upfront for deductible and 20% and it was about $3000.00. I feel this is good and not have to pay all $20,000.00 myself. But all insurances are different.

Good luck!! I am 5 days paot op and back to work tomorrow.

fee you're in Australia arent you? Its just the gap between Medicare and what your surgeon charges, like any other operations. So, medicare will cover x% of the surgery as long as it's clinically necessary but beyond question your surgeon will charge way more than the scheduled fee, they all do, your private health insurance will cover the cost of your hospital stay according to your policy and then depending on the policy may cover some of the gap charged by the surgeon.

The "program fees" are the latest way to make up the difference between what the doctors get paid and what they think they should get paid. It's not just for LapBand. while researching the other surgeries, I have found $800 "program fees" and $3000 "program fees." They are charging that because, so far, it is not prohibited by their insurance contracts.

Once it is, they'll probably charge $3000 for pre-paid parking, even you you take a bus. It's about the money.

fee you're in Australia arent you? Its just the gap between Medicare and what your surgeon charges, like any other operations. So, medicare will cover x% of the surgery as long as it's clinically necessary but beyond question your surgeon will charge way more than the scheduled fee, they all do, your private health insurance will cover the cost of your hospital stay according to your policy and then depending on the policy may cover some of the gap charged by the surgeon.

yeah im in australia.....ok thanks everyone for your help

when i attend the seminar on the 17th august i will get the full rundown of the costs!!! Thanks Fee