Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

What's the max/min anyone has paid out of pocket with insurance?

Share this post


Link to post
Share on other sites

Of course, the answers are going to vary depending in the insurance carrier. My personal out of pocket that has to be met is $2,000 before insurance kicks in at 80/20. The maximum OOP is $4,000 with no limits. That's why, after I had my gallbladder removed in February, I'm working to get everything fixed this year. In fact, I'm sitting in bed recovering from surgery to fix my deviated septum. Once I meet all my insurance requirements, I should be sleeved at no additional cost to me.

Share this post


Link to post
Share on other sites

I have UHC and WLS monies do not apply towards the annual out of pocket max.

Share this post


Link to post
Share on other sites

I have Aetna (actually an employee) and I have a $1600 deductible to be met and then my surgery and all the other things like cardiac and pulmonary clearance and psych eval will all pay at 80/20. Unfortunately I am healthy other than overweight so all my pre-op doctor and psych eval, surgery consult all have to be paid by me .....am hopeful that all of these will have me meet that deductible befor surgery so then I will only have to pay that 20% as I understand I have to prepay that...or maybe I misunderstood....If I have to that's ok I have that money put away.

Share this post


Link to post
Share on other sites

I have Cigna OAP and my OOP is 2500 which my surgeon wants paid before surgery.

Share this post


Link to post
Share on other sites

Yup that's what I need to prepare for, well I have a few more months before my paperwork gets submitted, so I bet start saving ;)

Share this post


Link to post
Share on other sites

Have you checked with your insurance company yet? They can give you the exact total you'll have to come up with. Or you'll probably meet with the insurance coordinator on your first visit with the surgeon. They do a pre-authorization and will give you paperwork showing your portion. Good luck!

Share this post


Link to post
Share on other sites

I have Cigna OAP and my OOP is 2500 which my surgeon wants paid before surgery.

I have Cigna OAP also, and my out of pocket for just me is $1,000. The out of pocket for my family is $3000. I just think $2500 seems like an awful lot for individual.

Share this post


Link to post
Share on other sites

I'll take the 2500 my out of pocket max is 5000 just for me but with all the appoints and other visits so far I'm at 2000.

Share this post


Link to post
Share on other sites

I'll take the 2500 my out of pocket max is 5000 just for me but with all the appointments and other visits so far I'm at 2000.

Share this post


Link to post
Share on other sites

I wish I had that much taken off mine with all my appointments only 400 has gone toward my out of pocket. I was submitted June 5th so im done with appointments, waiting for approval now

Share this post


Link to post
Share on other sites

WOW all your visits and you have only $400 towards your deductible. My psych eval was almost that much alone. I had to pay that since I hadn't met my deductible yet.

Share this post


Link to post
Share on other sites

My deductible was 750 and its been met. I had a cat scan and an ultra sound and that's what really boosted my out of pocket.

Share this post


Link to post
Share on other sites

Yeah I'm hoping to reach my out of pocket before surgery.

Share this post


Link to post
Share on other sites

I have Cigna and will be covered at 100%. I will have to cover 20% of my psyc eval, and $15 for my nut. Also my surgeon requires an aftercare program that everyone is required to pay for. That will be $500- and is not at all billed to inc.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×