Trying To Get An Idea Of How Much I Will Need To Pay For Gastric Sleeve Surgery

[augustkiwi 18]

I know i have a while before i get my approval and surgery date but I am the type of person who likes to have an idea of how much i may need to pay WAY ahead of time. I have cigna and its 90/10. So i know i will pay 10% until i reach my out of pocket maximum of 2000 (after my 300 deductible of course) so is it safe to say that all i really need to know is that im guaranteed to pay at most 2000? since thats what my insurance benefits are?

thanks for you help

[SC~Amanda 0]

I would say yes $2000 max out of pocket plus your $300 deductible.

My hospital bill alone (no surgeon or anesthesia) before insurance paid was $49,000

My max out of pocket was $3000 and $750 deductible so in total it will be $3750.00

[longer-life 139]

Some surgeons have fees for their programs and they usually need to be paid before surgery. I had to pay the hospital before surgery as well. Lastly, before my first appointment to see my NUT, she warned me some insurances don't pay for it and told me the cost. I haven't received a bill yet.

[augustkiwi 18]

got it! thanks so much for the replies!

[mommy794 119]

I'm going thru the same thing right now! I actually work for the hospital system where I will be getting sleeved at their center of excellence and normally my insurance is 70-30%. So my surgeons office calls and says your approved (which I already knew from calling insurance co. myself) and I can sch. right now ( instead of finishing my 10 week online program that I'm "required" to do by my insurance) and that my portion my co-pay is 8000!!!! I was like whooooaaa now!

how the heck am I going to come up with THAT!!!! in a month????? SO then I look at my insurance benefits online and it says it's 80-20 if you are at a Christus facility and that my max out of pocket it 2500... now that's more like it!!! So I let them know this and they said O ok well then we will go by that. So needless to say I'm going to re-verify all this with my insurance company and I'm going to the surgeons office to talk to them in person next week so I can BE SURE it's all correct and I don't get stuck with a HUGE bill.

[augustkiwi 18]

o wow yes that is WAAAAY better than 8k!! good for you!

[mommy794 119]

AHHAAA this ins malarkey is driving me NUTSSSS!!! I am going to the surg office Monday and try to get them to pin it down. I hope they will take the ins payment plus my 2500 out of pocket max...which apparently according to the rude lady I talked to at BCBS doesn't apply to bariatrics. She said it's 70-30 no matter what with a cap of 13k that BCBS will pay. Needless to say if the surg. and facilities are way too high I doubt I will be able to get this done jan. 30...possibly postpone or maybe not at all depending on fees.... which will REALLLLLY suck since I have been working on this since june 28. I actually have a secondarly ins. thru my husband and they are supposed to send a letter saying what criteria I have to meet for them to pay anything.... so maybe between the 2 I MITE be able to afford the rest...we will see I have BCBS blue edge as primary and BCBS anthem as secondary. Keeping my fingers and toes crossed!