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Just Decided To Have The Sleeve Done...where The Heck Do I Go From Here? Help!



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I'm good at math (better than spelling if you found my typos above lol). MilkD got it 100% right. Using her example of 2000 deductable and 4000 out of pocket max with 80% coverage after deductable is met; would mean that any approved expense over 12,000 would be 100% covered by insurance. You will want to check to see how much the out of pocket max is as this can vary a lot. Mine is 7,500 for example. Also see if your insurer has online access you can log into. It will tell you things like how much of the deductable has already been satisfied and details on coverages. Good luck. Also the deductable on many plans starts over Jan 1st, so if you think you can't get it done by endof year might hold off til jan 2013. Psy exam for example can be over 400 and billed separate so you might want to have all exp in same calandar year.

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I was self pay. My doc & the hospital take Care Credit. The doc was $3900 & the hospital which included OR, anasthesiologist was $7000. Luckily I was approved for $11k on care credit and that covered everything for my surgery. If my insurance would cover VGS, I would much rather have paid like a $3000 or so co-pay. But ultimately to me it was worth every penny.

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My deductible counts towards my out-of-pocket maximum. My deductible is $1650.00 and out-of-pocket max is $2500.00. Once I reached my deductible, about 2 months ago, I now only have about $800 left on my out-of-pocket max...which is payed 85/15%.

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I went the self pay route and it was 11' date='200 which included the hospital stay and my surgeon's fee, plus a years worth of follow ups with him. If you go with your insurance, you will likely have a lot of requirements to meet like diet documentation for so many months, and a BMI of a certain range for so many years. When you find a surgeon, their insurance specialist can do the insurance research for you, or you can just call the insurance company and ask them yourself. My surgeon is in Michigan, as am I and he does a lot of out of town patients because of his pricing. Good luck to you.[/quote']

Erin, where in Michigan?

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Also, keep in mind that if you have healthcare flexible spending accounts, it can be used for all of these charges, even if you decide to go to Mexico.

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