amy4hr 0 Posted February 21, 2007 My insurance will cover the procedure at 50% with a maxium coverage amount of $15000. I am curious if anyone has had a similar type of coverage and what your out of pocket actually turned out to be. My out of pocket maximum for the plan year is $2500, but curious to know what happens when the $15000 maximum coverage for WLS is filled. Also, I am curious to know what the difference has been in costs with those with insurance and those without and why. Thank you in advance! Amy <!-- / message --> Share this post Link to post Share on other sites
Candle 11 Posted February 21, 2007 I have Anthem as well but there's an exclusion on my policy, so they don't cover anything Did you ask if they cover fills? (I forgot to ask that) Share this post Link to post Share on other sites
amy4hr 0 Posted February 21, 2007 I didn't think to ask that, but should have! I was more concerned about understanding how the coverage actually works! Share this post Link to post Share on other sites
Candle 11 Posted February 22, 2007 Where do you live? That will play a role in how much the surgery costs. (In most cases) <O:p</O:p <O:p Are you in CT? Someone on this board was telling me about a doctor in Hartford who only charges around $11,000. I checked and he's on the Anthem physician list. (I don't know anything about his experience or reputation though) <O:p</O:p <O:p</O:p Seems like on average the surgery is any where from $18,000 - $25,000.00. Plus or minus about $5,000 <O:p</O:p <O:p</O:p I would call Anthem [ :rolleyes aren't they just soooooo pleasant and helpful? :rolleyes ] and ask them to explain exactly what that mumbo-jumbo means. Sounds like you'll end up having to pay the full $2500 <O:p</O:p <O:p</O:p Self pay can be as cheap as $7500 in <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:pMexico</ST1:p</st1:country-region> or $9950 in <st1:City><ST1:pDenver.</ST1:p</st1:City><O:p</O:p Share this post Link to post Share on other sites