NewKristen 356 Posted February 8, 2013 I was so blessed! I have a $2000 deductible, but my employer reimbursed us for it. I had to pay the $2000 up front, but I get it back. I live in KS, but work from home for a software dev firm in Massachusetts. My insurance is BCBS of Mass. Ironically, BCBS of KS doesn't not cover WLS. I am not sure if this happened or not, but at a WLS seminar I attended as a prerequisite of my surgery they told us that Medicare/Medicaid would start covering WLS in 2013. It is sad to me that a private plan (that you have to pay for) wouldn't cover WLS, but Medicare and Medicaid possibly would. Share this post Link to post Share on other sites
NikkiV1986 121 Posted February 8, 2013 11,000 and that doesn't include dr visits and copays for testing and blood work. My insurance sucks, so the surgeon gave me the cash price of 16,000 and my ins only pays a lifetime max of 5,000 so the rest is up to me!! Share this post Link to post Share on other sites
MzRobin 59 Posted February 12, 2013 11' date='000 and that doesn't include dr visits and copays for testing and blood work. My insurance sucks, so the surgeon gave me the cash price of 16,000 and my ins only pays a lifetime max of 5,000 so the rest is up to me!![/quote'] **** for half that u can fly to mx and get it done!, Share this post Link to post Share on other sites
kshepa 77 Posted February 12, 2013 Hi everyone!! I paid 1500.00 to surgeon for membership fee, 3400.00 to hospital because it was out of network. Then 1300.00 to surgeon for all the little extras he took care of that my insurance didn't take care!!! This surgery sure wasn't cheap. But worth every penny!! Share this post Link to post Share on other sites
sr910 55 Posted February 12, 2013 I was stressing about this today and called my insurance company. Although I have a $2,000 deductible, that only counts toward copays. My in-patient surgery copay is only $200, and that's all I have to pay. I reworded and asked over and over to make sure $200 was correct as my total out-of-pocket cost, and it is! But of course I'm preparing myself in case they surprise me with a bigger bill. =) and I have anthem blue cross in California -- the select ***. Share this post Link to post Share on other sites
mark! 449 Posted February 12, 2013 My deductible is $4750, my out of pocket will be around $4200 when it's all said and done, pending no extra days in hospital, and no hernia. But, it doesn't matter to me, my max amount is $4750, I say just use that up suckers so I can go scott free for the rest of 2013. Share this post Link to post Share on other sites
SeriouslyChange 319 Posted February 12, 2013 My out of pocket total including all preop appointments was: around 300-400 I have an ***. Share this post Link to post Share on other sites
futuresleever 44 Posted February 12, 2013 I don't think that my hospital will take a partial payment, they want it all upfront. Not sure if I will have it. Share this post Link to post Share on other sites
flmama 105 Posted February 12, 2013 My deductible is $500...I have to pay that up front. My OOP Max is $1500 and that is applied to the 20% coinsurance I owe. But all of this other pre-op testing will eat up a chunk of that, so they will all submit bills and we will see who I end up owing it to (whoever submits first) vs who will be paid 100% by insurance. But my total OOP will be $2000 to somebody at some point. Share this post Link to post Share on other sites
Ready4aNewLife 1 Posted March 7, 2013 My out of pocket max is $2,000. I'm pre-op but my MD says to expect to be in the hospital for two days. If that is the case, then I will only pay $1,000 as I have a $500/day hospital stay copayment. Trying to find the silverlining: Having heard from most self-payers that the cost of surgery starts at about $5,000 and up. I figure I'm lucky. What insurance do u have ? Share this post Link to post Share on other sites
HalloweenBaby24 447 Posted May 20, 2014 I'm getting paranoid reading all of this. I have my surgery set up for September 8th, At the moment I'm getting my thing's together to send it into the insurance company. There is no way I can pay $2,000 up front, I just don't have that sort of money and I'm hoping that's not the case but I guess I won't know until I get approved and everything. I have BCBS of Mass it's a PPO and my surgery is being preformed in NJ. Is there anyone can give me an idea of how much I'll be spending out of pocket for the hospital stay/Surgery? Share this post Link to post Share on other sites
HumanMerelyBeing 287 Posted May 23, 2014 Just the surgery itself, I paid about $4800 out of pocket and insurance covered about $18,000 or so. This includes surgeon, room (2 nights), supplies, anesthesia. I have a CIGNA HMO high-deductible health plan and went to a Center of Excellence Hospital in New England. Share this post Link to post Share on other sites
Jersrose43 837 Posted May 24, 2014 I'm getting paranoid reading all of this. I have my surgery set up for September 8th, At the moment I'm getting my thing's together to send it into the insurance company. There is no way I can pay $2,000 up front, I just don't have that sort of money and I'm hoping that's not the case but I guess I won't know until I get approved and everything. I have BCBS of Mass it's a PPO and my surgery is being preformed in NJ. Is there anyone can give me an idea of how much I'll be spending out of pocket for the hospital stay/Surgery? I wouldn't panic I'd ask lots of questions of your insurance. Ie how much deductible you've met, maximum out of pocket etc. Get educated on the financials and you'll be fine Share this post Link to post Share on other sites
Kindle 8,667 Posted May 25, 2014 Ask and then ask again about OOP costs and then be prepared to pay a lot more. A friend of mine has BS of Idaho and her deductible is $3500. She had a hysterectomy this winter that was "approved" by insurance. But after all was said and done, she had to fork out almost $9000 for all the expenses insurance wouldn't cover, despite approving the surgery. As for me, I am self employed and have BS of ID HSA with a $5000 deductible/$6250 max OOP. (The only policy I can afford thanks to the "affordable" health care act...my old policy was MUCH better) Individual policies do not cover WLS, so I was totally self pay and went to an International Center of Excellence in Mexico and spent $250 more than my max OOP would have been even if insurance did pay. So instead of a down payment on a new truck, I have a teeny tiny tummy and I'll take it!! Share this post Link to post Share on other sites