WLS costs?

[SamIAm3791 22]

hello all. so far our "out-of-pocket" costs look like this - PCP monthly weigh-in visits $25 copay per visit x 6, $100 unlimited nut consults for life, and $240 psych consult. multiply that by my wife and myself and thats $980! this doesnt even include the blood workup, EKG, and PFT (pulminary function test). so far i have no idea what those are going to cost and how much of them are covered by our BCBS PPO Blue Insurance. was told today by psych dr that the $240 fee will be out of pocket since we havent met deductible yet. i am scheduled for my psych visit june 24th. my question is isnt there a way to find out what our out of pocket costs for the procedure will be before we spend $1000+ of our own money? i mean if we have to dish out money on top of money on top of money for this i dont know if its the right decision for us. we'd hate to dish out $1200-$1400 out of pocket just for the insurance company to come out and say ok now you have to pay another $2,3,4K! ------ feeling a bit discouraged today

[SLF1027 136]

I have BCBS TRS and ours breaks down like this:

Pre-Op

$50/ea dr visit

$50/ea NUT visit

$150 per procedure (endoscopy, stress test, etc)

Procedure

$5000 Dr copay + 20% of procedure

$150/day hospital stay (max $750)

Annual deductible of $2500

At 3 days hospital stay, Terry with BCBS calculated my max out-of-pocket to be $8200.

For my husband and myself both: $13,900

(And this was after calling around to all the BC Blue distinction Centers of Houston to find the cheapest price.)

[serenity1959 67]

You should have a deductible and out-of-pocket max. Call your insurance company and ask them. Wish my insurance covered it, but I will be self pay.

[SLF1027 136]

I have BCBS TRS and ours breaks down like this:

Pre-Op

50/ea dr visit

50/ea NUT visit

150 per procedure (endoscopy' date=' stress test, etc)

Procedure

5000 Dr copay + 20% of procedure

150/day hospital stay (max 750)

Annual deductible of 2500

At 3 days hospital stay, Terry with BCBS calculated my max out-of-pocket to be 8200.

For my husband and myself both: 13,900

(And this was after calling around to all the BC Blue distinction Centers of Houston to find the cheapest price.)

[/quote']

***The $8200 does not cover any pre-op visits or charges. That number is for procedure only.

[angiemorda 39]

Mine is $1500 deductible for yr, after that's met surgery is 50:50! The psych was $265, pcp $30 each visit, chest X-ray $120, surgeon consult was $290, upper endoscopy was $800 with $350 being anesthesia. Problem was if my deductible was met insurance would've cover half of each thing but not my case since 0 was used if deductible so far. As of now my deductible covered up to $900 n surgery is on June 12th. The scariest part of whole thing is unknown of how much this will be in the end. Our insurance isn't the best either and $90 a wk comes out of hubby check a wk for premium n it only covers him n I. My kids are on state insurance thank god! We have blue care network of Michigan.

[jackj 6]

Its scary how insurances very so much. All I pay is $35 each office visit (Nut, Diatician, Psych Eval), EGD was a little over $100 after insurance and $435 after insurance for the Sleeve Procedure. Glad I signed up for the higher package.

[******** 397]

Its scary how insurances very so much. All I pay is 35 each office visit (Nut' date=' Diatician, Psych Eval), EGD was a little over 100 after insurance and 435 after insurance for the Sleeve Procedure. Glad I signed up for the higher package.[/quote']

I paid nothing for anything...really wish I could stay on my mom's insurance for life...she paid nothing

[SamIAm3791 22]

just talked with the insurance company. we have a $1000 family deductible to meet then a 90/10 coinsurance up to $500/person $1000/family. so if im correct it should cost us both around $2000 total to get this done together or $5/lb lol still cheaper than a porthouse steak and baked potato!

[town976 15]

just talked with the insurance company. we have a 1000 family deductible to meet then a 90/10 coinsurance up to 500/person 1000/family. so if im correct it should cost us both around 2000 total to get this done together or 5/lb lol still cheaper than a porthouse steak and baked potato!

Double heck with your insurance company and find out what your max out of pocket is. There is usually a per person out of pocket max and a family out of pocket max.

For example : my deductible is $1250 and my out of pocket max is $3750. I have to pay my deductible and then the out of pocket max kicks in. Therefore, my actual out of pocket max is $1250 + $3750 = $5000. My bariatric group tells me they don't think I will have to pay all that, but they have to wait to get the pre-approval back from y insurance company to confirm my actual out of pocket.

What a pain.

[jackj 6]

This insurance stuff gives me a headache. Only thing I understood was the bottom line price. The EOB's and whatnot are confusing :-(