I recently started working with True Results of Dallas to start the gastric sleeve process. They took all of my info and scheduled my first appointment. 2 days in, I find out that they are out of network with my insurance. True Results went out the window.
I then contacted my insurance company and asked for a bariatric surgeon/facility in my area that was in network. They referred me to the Baylor University Bariatric center, whom I contacted to begin the process. They had me complete a super long packet of information which I promptly turned in. By the end of the day, they called me and said "CONGRATULATIONS, you are pre-approved!" and proceeded to outline the requirements that I would have to comply with (6 months of classes, a psych eval, enrollment in a bariatric services program and provide 5 years of medical records).
I have a $3000 deductible. Once that is met, I pay 20% copay up to a max of $8000 out of pocket. Naturally, my first question was "What is it going to cost me?" Her answer was " If you had surgery today, it would be $2458 and that will probably go down as you continue doctor visits etc over the next 6 months. That didn't sound right, so I asked for a detailed explanation which she was unable to provide. I asked what amount will I have to pay 20% of? She didn't know but promised me it would be $2458 or less total out of pocket.
Today, I called my insurance to enroll in the bariatric services program (which Baylor said I must join) just to find out that I didn't need to do that. In fact, they told me I couldn't enroll if I wanted to because it wasn't a requirement for me to receive bariatric benefits.
At this point, I'm wondering if Baylor knows what the heck they are talking about, so I call them back and ask to speak to a billing supervisor to get a second opinion on the $2458 figure that I had been quoted. This lady tells me that the surgery will "probably cost $44,000 which doesn't include anesthesia, the classes, psych, or physician and physician assistant fees." I explain to the lady that I had been quoted $2458, but something didn't sound right because 20% of $44,000 is $8800. Her reply infuriated me. "Sir, there is no way for me to even estimate what this is going to cost you out of pocket. You just have to go through with the procedure and wait on a bill to find out. We can't even guarantee that the $44,000 number is accurate because it might only be like $34,000. You should plan on hitting your max out of pocket of $8,000, but we can't give you an estimate".
I can't afford that any way you slice it. Aside from that, how on earth can someone commit to something not knowing what it will cost?. That's like buying a car and the dealer saying just go ahead and take it with you-we'll tell you what you owe us in a few months. On top of all that, I find out today that if I don't use my insurance, the price is $10,500. I'm saving a whopping $2500 by having insurance. Sounds to me like they are raping the insurance companies.
Has anyone else run into this kind of BS? I can afford about $3000 to $4000, but $8K is out of the question. I'm not interested in financing or monthly payments. Should I just forget the whole thing and learn to be fat and happy?
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