Dymeond

Ok here is an update. As is of 2017 all Kaiser Colorado plans now have a state requirement that bariatric surgery deemed as medically necessary must apply to the deductible and out of pocket max. Therefore you oop Max is the most you will pay. I called them yesterday and they confirmed this. So $1500 will be my max. Hopefully this helps you Avarine since the $14k is no longer an issue for us.

Wow 3 weeks already! Don't be too hard on yourself. I hear stalks are common. I had my consultation last week with Bolanowski. She scheduled me for Jan 23rd so I'll be joining you guys pretty soon.

Yes super congrats to you! Glad to hear everything went well. I have my last class this Thursday so surgery will likely be at the end of Jan. In the meantime I look forward to hearing how well things are going.

So happy for you! Yet nervous as well. Good luck on your surgery today. You will certainly be in my prayers. Please keep us updated on your progress!

Wow! You guys are having surgery the same day. Congrats to you both! Krystal did something change with your payment? I was told from Kaiser my deductible and out of pocket max in 2017 would now apply so if it holds true the most I will have to pay is $1500. Keeping my fingers crossed.

Do you have your surgery date yet?

Avarine--- Yes it really sucks. I am starting to come to terms with switching over to Aetna since paying the $338 for 18 mths is simply too much on top of all the other costs. I am still going through with the Kaiser process since it will meet the Aetna requirements. Potential setbacks are that the surgeon could require additional tests which Kaiser does not require any test. Definitely keep me posted!

Yes! And those who have a HSA can benefit as well!

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.

Has anyone been able to get approved for assistance from the hospital? I was told by both Kasier and the facility where my surgery will be that bariatric is considered elective so would not be eligible. Just curious.....

That is interesting . If your full total with St Joe is only 6850 and mine Is $14k it doesn't make sense why they only require $2k from me but full amount from you. Just weird. Aetna does treat as medically necessary. I wish I could purchase both insurances lol. If your husband adds you it likely will not be an issue for St. Joe. They really don't care who pays and will be more lenient. Another thing is if you don't have a FSA already you could do it for $2500 and the full amount is available to use at the beginning of the year . You can even schedule your surgery at the end of Jan and won't have to wait until tax time. I am using mine in the same way. Even the amount I have left this year I will be able to combine with next years amount towards my expenses if I am scheduled for Jan. That is just an idea to consider.

Oh man! Really sorry to hear that. Hard to image that is the before surgery amount. I called this morning and the Kaiser portion isn't that bad (less than $1500 total) but the total at St. Joseph's is $14k for the bypass and that is based on me having 50% co-insurance for the bariatric benefit and there is no out of pocket max or deductible applied to this benefit. St. Joe requires me to put $2k down and apparently pay for the remaining $12k over 18 months. This is still ridiculous . Now both Kaiser and the hospital have financial assistance plans but apparently consider bariatric surgery as cosmetic. I am in open enrollment right now and may switch to Aetna because I understand it is treated as any other surgery so my out of pocket max would be $2500 which is so much more affordable. I really like my treatment at Kaiser more than Aetna in the past but that's why this decision is so troubling for me. I am approved for classes finally beginning in 2 weeks. Hopefully you won't have to wait too long to get your surgery done and maybe your husband's insurance will help you keep your cost down.

Wow krystalb4rny! That was fast! I'm certainly rooting for you. Have my appt this afternoon so really hope I get the go ahead to start the next class. And yeah I couldn't imagine having 12 week and definitely not 6 months of classes required for some of the CA Kaiser locations. Colorado likely takes less time because it is statistically one of the leanest states which leads me to believe there are less ppl in the surgery line and much less population in comparison to CA overall. However I suspect if the population continues to grow as fast as it has over the last few years we could be in trouble too.

Yes the date is definitely what matters. I have mixed feelings about the drain. Some of the most reputable surgeons think it's necessary to eliminate infections. It just seems gross but I'll have to do more research about it either way. Please keep me posted on your consultation!

Great job on the weight loss! That's pretty awesome. I've been trying to do little things to prepare as well so it won't be as painful for me when the time comes. Too bad the classes are repetitive. It's likely they use fillers to slow the timeline down in case it ever becomes too busy. Since your last class is today it will be interesting to see how soon you hear back from the surgeon's office. Do you know when the next class starts? I go on Tuesday for follow up and really hope I can start the next one. I was stalled for an entire month then suddenly I dropped 7lbs this last week, though I will admit the inches I lost through the stall are insane! We are so close now. One of the ladies that works at the Kaiser Franklin information center had the surgery last year and told me she heard back about 3 weeks after her classes and surgery happened about 3 weeks after that. You have a really good chance of late Nov/ early Dec date. I'm hoping for the new year at best. I'm assigned to Dr. Bolanowski and have only heard great things about her.

Wow! I am getting so excited for you! How have the classes been? You are almost done. My weight has stalled for like a month since my last visit so I rescheduled to Oct 11. Hopefully the scale has started moving again but I'm not doing this weeks weigh until the weekend.

Yes I met Terry yesterday! He was nice but kind of awkward as well (not wanting to shake hands kind of way). But hey we all have our issues, plus he made some good points about my own personality that I've been struggling with. I had my wall up going in but then eventually broke down so thought I wouldn't pass. But he told me I've made good progress and because I am already receiving counseling he approved me for classes. Whew! Thank God I got threw that. Now if I can get the go ahead for the classes on the 20th I can get this thing really going. Though I'm surprised to hear it can take four months to get approved and have surgery after classes. I was initially told it could take 1 month to 1 1/2 months. Maybe it's just that time of the year where people have more motivation to get in line.

Kaiser Denver - I was required to do a sleep study which was fine but they won't perform surgery unless BMI is 60% or less. I started out in Feb at 447 with referral, in June began phentermine, now down to 400 as of last week. Need to lose 17 more lbs by next visit Oct 20 to begin classes. That means i would be almost 70 pounds down to even qualify for the surgery. Classes are 6 weeks and even though most people lose weight during the classes they won't even allow me to start classes and continue on with the 17lbs loss during that time. Especially since it could possible take a few mths to schedule the surgery after that. Psych evaluation next week so will see how that goes.