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When did you have to pay?

Hey guys, I am posting this in Post Op since I have already had the surgery.

When I went to the original seminar they said that any co payments that you were responsible for would be due at the time of surgery.

My max out of pocket expence is 1500 (down from 3000 last year). So, I figured this would be my final cost since my insurance covers 80%.

Well, when my surgeon sent my prior bill it was only $400.00. So, I am wondering...Is this all I am going to pay, or is someone going to bill me. If there is more to come, when should I expect it, and who will it come from??? Insurance, Surgeon, hospital???

My insurance is BC in California...

Thanks guys!

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IWBS

I don't have an answer for you but I've been wondering th same kind of thing. I've got one thing left, waiting for recommendation ltr from my pcp, so I haven't wanted to call the insurance company till they get my packet from the surgeon. My surgeon's office sai I have a $350.00 deductable and $1,000 max out of pocket. I've been wondering if that means my surgery will cost $1,350 cheap compared to self pay but still a lot at one time.

I had to pay $300 for a program fee to the bariatric center for nutrition, phsyc and program support. That was not detailed as medical bills usually are the reciept just says $300 to Norton Health Care I've also been wondering about submitting that to insurance to see if it can be applied to my max out of pocket.

I'll be watching your thread to see responses....thank for asking

You will also probably owe the hospital where the surgery was performed. My supposed out of pocket was 2500, but my portion was actually 2700. I still dont know how that is possible, but it was worth it, so I just paid it. Oh, and yes, they asked for it upfront.

Hey guys, I am posting this in Post Op since I have already had the surgery.

When I went to the original seminar they said that any co payments that you were responsible for would be due at the time of surgery.

My max out of pocket expence is 1500 (down from 3000 last year). So, I figured this would be my final cost since my insurance covers 80%.

Well, when my surgeon sent my prior bill it was only $400.00. So, I am wondering...Is this all I am going to pay, or is someone going to bill me. If there is more to come, when should I expect it, and who will it come from??? Insurance, Surgeon, hospital???

My insurance is BC in California...

Thanks guys!

I had to pay $1500 total out of pocket costs and it was all due before I had the surgery because it was considered elective. I had to get a medical loan to pay for it. I would imagine that you will get bills from the hospital and anesthesiologist in addition to the doctor bill.

IWBS

I don't have an answer for you but I've been wondering th same kind of thing. I've got one thing left, waiting for recommendation ltr from my pcp, so I haven't wanted to call the insurance company till they get my packet from the surgeon. My surgeon's office sai I have a $350.00 deductable and $1,000 max out of pocket. I've been wondering if that means my surgery will cost $1,350 cheap compared to self pay but still a lot at one time.

I had to pay $300 for a program fee to the bariatric center for nutrition, phsyc and program support. That was not detailed as medical bills usually are the reciept just says $300 to Norton Health Care I've also been wondering about submitting that to insurance to see if it can be applied to my max out of pocket.

I'll be watching your thread to see responses....thank for asking

I had to pay a $500 program fee and was told by my doctor's office that it couldn't be applied to the out of pocket because it wasn't a medical fee. It was for online support, support groups, nutrition counseling, etc.

I had a hospital copay of $300 (standard charge for an operation with my ins.) since I paid when I did my pre-op blood tests they gave me a discount & I only paid $270. I have BC/BS with the Commonwealth of VA.

If you thought there were a bunch of different pre-op and post-op diets, just wait to see how many different insurance plans, copays and deductibles there are!

  • Author

If you thought there were a bunch of different pre-op and post-op diets, just wait to see how many different insurance plans, copays and deductibles there are!

Thats funny! I have noticed that already...I am just glad my max changed. I was trying so hard to get it done last year, but that 12 days probably saved me $1500.00. :thumbdown:

Since I have already had surgery, I will just wait for a bill I guess :lol:

If not, theres a nice bump in my savings account...

When I pre-registered at the hospital 4-days prior to surgery, they told me the same thing. All co-pays and such had to be paid on the day of surgery.

I called my case manager at my insurance company to find out if I had a co-pay and how much? I did not want any surprises. My insurance, Blue Shield said because my doctor coded my procedure as medically necessary that I did not have to make any co-pays for the hospital stay. I guess that is true, because I never received an invoice demanding payment.

I did receive an itemized statement from the hospital for services rendered and it was around $82K. I about died when I saw that. There is no way, I could ever afford a hospital bill like that.

As far as in your case, I would think someone would get their hospital bills within four-weeks of their procedure/hospital stay.

$82K!!!!! :w00t: And people wonder why we pay so much for health insurance. OMG what a rip off. I don't know of any lapband surgery that should cost much over 25K. Mine was around 17K.

$82K!!!!! :w00t: And people wonder why we pay so much for health insurance. OMG what a rip off. I don't know of any lapband surgery that should cost much over 25K. Mine was around 17K.

Well to be fair, I did have some complications, which required me to stay in the hospital for 2.5 days. It was ver expenses and thank-goodness the insurance company is covering those expenses.

so far all of mine are still in prosess with insurance but I do know right now for my lapband surgery with no over night stay and I am at 33K right now-- I had to pay 1100 up front for the psy eval, food supplements, and other doc cost that arent covered by insurance so I am sure after it is all said and done I will be paying 5000 or so for my 20%-- :-(

  • 2 months later...

Any updates on this? I'm wondering the same thing right now, my insurance is a PPO and says 80/20 with $300 co-pay for hospital - but it also says it's supposed to be "repriced" because it's an in network hospital... I wish they would just give you all the numbers before you get approved...

  • Author

I just recently got my bill. I got one from the hospital which was for $1500. I also got one from my nutrition appointment that was $150. I am getting another (I think) for $400 for lab work (I don't know why it didnt get covered, so I'm hoping I don't actually get it) and I had already paid $400 direct to the surgeon and $150 to the psychologist.

Out and out I am at $2500 ($2100 if they pay the lab like they should).

Last year the copay was going to be $3000 so I am still ahead since it was in January. I had put $2,000 into my account for the surgery, so I feel good about it.

I do want to find out why I paid the surgeon $400.00 when they said it was my "co-pay" but it never went through the insurance. Unless it is going to cover all of my follow-up, because if I ever change insurance (or lose it all together) that would be good.

I just recently got my bill. I got one from the hospital which was for $1500. I also got one from my nutrition appointment that was $150. I am getting another (I think) for $400 for lab work (I don't know why it didnt get covered, so I'm hoping I don't actually get it) and I had already paid $400 direct to the surgeon and $150 to the psychologist.

Out and out I am at $2500 ($2100 if they pay the lab like they should).

Last year the copay was going to be $3000 so I am still ahead since it was in January. I had put $2,000 into my account for the surgery, so I feel good about it.

I do want to find out why I paid the surgeon $400.00 when they said it was my "co-pay" but it never went through the insurance. Unless it is going to cover all of my follow-up, because if I ever change insurance (or lose it all together) that would be good.

Thanks for the info! At this point I don't think I care what I have to pay AFTER, lol - I just wish they would tell me what I have to pay before...... the 23rd is too close to stock pile money, I guess I should have been saving for it but I don't think I actually realized I had to payout upfront. :cool2:

I put a large portion of my tax refund away to pay max out of pocket if it's more then I'll have to go on payment plans.

The hospital where I had my surgery demanded my out of pocket up front the day of surgery ($1000). I got a call from the hospital a few days before my surgery was scheduled and they went over my portion at that time. Actually they wanted me to give them $1250 b/c I have a $250 deductable, but I had already paid medical bills outta pocket for the yr. I just took all the receipts for what I had already paid and they deducted that from my outta pocket. I ended up writting a ck to the hospital fot about $850. My biggest concern is that my insurance co has a cap of i think $25,000 that they will pay for bariatric services (lifetime if I remember right). The hospital told me the "negotiated rate" for my surgery was $14,000 (I think that is a load of crap) so I'm expecting the insurance co to cover all the rest of my costs, but I'm worried that it'll all be on me if i have any problems in the future.

Lilith, you could always call the hospital directly and as what they will be charging you.

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