Chrysaia

Does anyone have United Healthcare's HDHP plan? Does it still cover bariatric surgery?

Thank God I found this post! I am in the exact same boat as you. I am also with Kaiser Colorado with a 50% benefit for bariatric. It is refreshing to hear you were quoted the same amount as me for Saint Joseph's, including the deposit amount. This issue also came up with another girl in Colorado but her plan pays less and they told her she has to pay almost $7k before the surgery which is absolutely ridiculous. Part of my issue is that I am starting the six week classes on October 27th and I have been on this journey for almost a year because I had to lower my bmi by 10%. Therefore I am completely invested with Kaiser and do like my services with them. My open enrollment is coming up in Nov and I may have to switch to Aetna which has an out of pocket max of $3k because they consider the surgery medically necessary when approved. The issue with Kaiser is bariatric pays completely different than other inpatient stays. I would normally have a 10% copayment up to $1500 OOP max. Bariatric coverage states the OOP max does not apply. I read somewhere on here that if you have to have another procedure such as a hernia repair that this benefit would kick in first for facility and anesthesia so you would only have to the additional cost for the surgery only which is only around $1500 for kaisers contracted price at 50%. I am tempted to see if I need a hernia repair just to test this theory. I asked both Kaiser and st Joe about financing and was told they consider the procedure elective so they likely would not offer this benefit for the surgery but I Still plan to try. I too was mislead by the online estimator and was told 1500 max OOP. I called into the regular benefits center before i even started and they confirmed this amount so imagine my surprise when I recently received this new figure from the counselor. I am looking into every option I can before open enrollment ends on Nov 15. I plan to call today to see is self pay would be cheaper and to ask if Kaiser if I can switch to the Colorado Springs area which is probably cheaper. Anyhow I will let you know if anything changes. I am so glad you replied. I am just at such a loss and the finance counselors at Kaiser just keep saying "Yes, we've heard this problem before and we're working on it." I just don't understand how Kaiser thinks. I'm at a BMI over 50, this isn't just so I can look pretty. This is to avoid serious health risks by continuing to carry around all this weight. Weight I gathered over time but continue to yo-yo on and off again. Even with watching what I eat and exercising as much as I can, I just keep bouncing between 320 and 255. This isn't elective, and I don't understand how they can continue on saying that it is. I may have to look outside my employer medical. They only offer Kaiser or United Healthcare. Unless United Healthcare offers better coverage, I may have to go back to the drawing board. I wish you the best of luck! No matter what you do, I'll be cheering you on =D

It's through St. Jospeh's

Yes, I have Kaiser of Colorado and their plan only covers 50%. What's really frustrating is that I used their estimator which states it uses my plan information to estimate, which I why I started the process. And then they turn around and say 50%. is all they cover and the entire bill is $28,000; so my share would be $14,000, and that's just for the surgery. I still have deductibles for speciality appointments with the doctor, mental health and the classes leading up to the surgery. It just seems crazy...and I just need to research and see if there is something I am missing.

Wow. can location seriously be that big a difference? That's crazy to think in one state it's 250 copay and in another state it's 14,000...

So I started the process today, met with intake. They had me call the Finance Counselors. I had already used the estimator on KP.org, so I was expecting 4 to 5k out of pocket. The counselor says no, it's 14k. They break it up into 36 payments of 338, which is after paying 2k just to schedule the surgery. Is that normal? I mean that's a car payment...I was okay with this when the estimator said the 4-5k. I'm not so sure I can put this financial burden on my family, even for the sake of my health. Is anyone aware of options I can look into? I'm in Colorado if that makes a difference.

Thank you all. I really appreciate you all taking the time to write and help ease my worries. There is just so much to think about, and so much to read. I am trying to even figure out what my options are. I was told last time that the doctors at the hospital I go to don't do LapBand anymore. I know they do Roux-en-Y. I am not sure what else they do, and I'm not which which option to even go with so I'm doing just as was suggested. I am researching. Haha though my husband is worried I will over research like I did when I was pregnant with our first child. At least I have his support in whatever I choose. I am very lucky in that regards.

Okay so I've been teetering on the fence about bariatric surgery for years. I've been overweight as long as I can remember, but it was never as bad as it is now. Seven years ago, I was 225lbs. Yes, it was overweight, but I wasn't stressed about it. I had enough on my plate with college, work, my husband being deployed for the first time and being in a new and unfamiliar place. It was a lot, and left no time for worrying about my weight. It wasn't affecting my health in obvious ways. So I'd brush it off to the side to deal with later. Then I became pregnant with my daughter, and the doctors worried because I was overweight. They told me not to gain weight. So I didn't. Heck, by the time I delivered I had lost 27 lbs. I had the smoothest of pregnancies, no complications at all. I joked I was one of the healthiest obese person my doctors would meet. So I brushed off worry about my weight again. I found excuse after excuse not to address the matter. In the last two years though, I've tried diets and programs and nothing lasted. Another thing I used as an excuse to not take the final step. If I can't bother to keep on with the diets, who am I to pursue surgery which is far more permanent. Now I am 340 lbs and I've stopped with the excuses and I've made the decision to look into my surgery option. I know I'm already approved by my insurance. It's just a matter of going through the consult and finding out if this is really the best route for me. But now I have my consult set up for December and I am left with questions and worries. Is this normal? Were most of you sure that this was the right choice for you? What helped you make the choice? Honestly, any help and advice is appreciated. I am just so new to all this and I feel like there are too many questions to ask...