Uuugggghhhhh!

[PdxMan 4,292]

My local "Best Bariatric Surgeon in Portland" quoted me $35,000 for self pay for the sleeve as my insurance does not cover bariatric procedures. I ended up going to Dr Umbach in Vegas for $10,400.

There are a few screwy things with this ...

$35,000 is by far the highest I have heard for this surgery, so when you say your Dr charges $50,000, I would get a detailed breakdown of those costs. $15,000 max payout? For surgery? I have heard of max payouts for vision, but not for medical. If they are covering it, then it should fall into the same boat as other surgeries. Either it is covered or it isn't. Is this a rider which runs along side of your current policy? Perhaps involving your HR people might be best to understand this, but this seems unusual to me. Almost like your Dr's office is working you over a bit.

What is your insurance? Are there other bariatric surgeons covered?

[BigGirlPanties 957]

Holy Moly!!! That's insane!!!! My doc said if we were self-pay they would work out a better price, but I'm SURE it was under $20,000...more like $12,000...something is definately wrong there... good luck on your research!

[Seela 1,187]

Seela - is your doctor in Ventura? I also paid a $1,500 program fee, so I thought by chance we may have the same surgeon :-)

No, chico, CA

[Bandarella 223]

Call your insurance provider. They will tell you exactly how much your out of pocket costs will be. The doctor cannot charge you anything more than your copay and coinsurance total. If they insist, mention your state's ins commissioner and attorney general. My total billed to ins was $22k, I paid $150, GB removal was $18k, I paid $150. Band removal $19k, I paid $150.

You might need a different Dr, but be sure to get your records first.

[PrettyThick1 1,860]

I smell B.S. Something is wrong with that figure, if the US cost was actually $35k, there's no way you could get it in Mexico for less than $15 - $20k. It's not THAT much of a cost difference.

[vogue 310]

My Dr never gave me a self pay price because I never asked. I was told there was special pricing for self pay.

When I got my EOB , my insurance company did pay over. $25K.

I'm guessing there is one price for the insured and another for the uninsured or underinsured

I had a similar experience with PS. Dr quoted me a price and when my insurance approved me they inflated the price so my OOP would be the same as a cash paying patient. No thanks

[cheryl2586 3,053]

Something is wrong there because the whole surgery doesn't even cost 12,000 and that is with the hospital stay so someone is busting your chops I would call the insurance company not the office and ask them if it is true.

[Cherryhair 88]

I had my surgery in December. I just recently received the bill for $35,000. My insurance paid all except $185. I live in Chicago not sure if that matters or not.

Edited March 20, 2014 by Cherryhair

[Mrs.RRn 2,111]

Crazy. It would be much cheaper not to go through insurance ( sad but true). Robbery!

I paid $9600 in the US as a self-pay. So insane-- hope you get some better news than that!!!

[terri82much 80]

I paid 6500 US for my surgery and 1000 for my trip to Mexico to have it done from Canada. Google Dr. Jose Castaneda Cruz in Peurto Vallarta. He was excellent and my friend just went down and got it done two weeks ago. No issues great facility!

[Danni-doinit4me 140]

Fishy!! Just because they charge the insurance company 50,000. Don't they usually discount that to their contracted amount?? You know darn well the insurance company wouldn't pay that much!!

[knt4ever 137]

My surgery total bill was $51,000 but the insurance "discount" brought it down to $26,000 and I had to pay only $300.

Isn't it great the insurance company gets 50% discount but self pay gets no discount?!

[jamilyne 102668 1,207]

I paid $9000 for my surgery as self-pay. That was for everything. My ins didn't cover wls. Had my surgery in south Florida.

Edited March 20, 2014 by jamilyne 102668

[kyleebean 209]

wow can I empathize with you. The only thing I can say is at least you found out BEFORE you had surgery!. I was approved and had surgery (revision from lapband to sleeve) in November 13. I was hospitalized 4 days due to complications. A few weeks later I get a bill for ..... wait for it.... $132,000. So I have a major anxiety attack and call my insurance who tells me they indeed did approve the surgery but my policy only covers up to $25,000 per life time. They never told me that nor did they tell the program coordinator at the hospital I went to. Now, I have to tell you, the hospital did "reduce" my bill to $47,000. That was nice of them. When I called to make payment arrangements, the lowest they would accept per month was $800.00. That just isn't going to happen, I'm a social worker who works for a non profit agency. Scary stuff.

[kyleebean 209]

wow can I empathize with you. The only thing I can say is at least you found out BEFORE you had surgery!. I was approved and had surgery (revision from lapband to sleeve) in November 13. I was hospitalized 4 days due to complications. A few weeks later I get a bill for ..... wait for it.... $132,000. So I have a major anxiety attack and call my insurance who tells me they indeed did approve the surgery but my policy only covers up to $25,000 per life time. They never told me that nor did they tell the program coordinator at the hospital I went to. Now, I have to tell you, the hospital did "reduce" my bill to $47,000. That was nice of them. When I called to make payment arrangements, the lowest they would accept per month was $800.00. That just isn't going to happen, I'm a social worker who works for a non profit agency. Scary stuff.