BCBS of OK (same as Illinois, Texas) can someone help me understand cost?

[RedDirtRoads 64]

My husband and I have our first appointment at the bariatric clinic tomorrow. I have talked to the staff over the phone and I cannot get even approximate cost . . . I am hoping I can get better answers tomorrow in person. My dilemma is that I am enrolling in my employer's cafeteria plan to help cover out of pocket cost and I want to know how much I should set aside in the plan to cover both of us. The personnel at the office told me "your cost will be 10% of whatever he charges you for the visit tomorrow" but they cannot tell me what the cost of an initial visit is. "Your insurance pays 90% of the surgery cost after your deductible is met". What is the normal cost of the sleeve so I can figure out what will be left for me? They don't know! Is this normal? Sounds unorganized to me . . . I know they are a fairly new clinic but I haven't even been there and I already think I want to go some where else. Am I over reacting or not asking the questions correctly?

[mentalistfan 189]

Well, they should know the price of the initial visit and cost of surgery...I have read $16,000 to $30,000 in the US, so I can't help you there. Talk to someone at your insurance provider, mine knew more than the insurance coordinator at the surgeons office.

[RedDirtRoads 64]

Thanks for that suggestion. I have to email my insurance company anyway, I am reading on here that BCBS of Illinois requires you to have their insurance for a year before they will approve you. When my supervised weight loss is over, I will have only had coverage through them for 9 months. *pout.

[NotGoingThere 19]

When I went to my first doctor appt they gave me a sheet with all expected out of pocket costs.

[sunnkistme 76]

My insurance is not great but I knew that going in. At least this year there is a limit on out of pocket expenses. I have a 2500 deductible and 5500 max in co pays. With all of the tests my surgeon has ordered and a few visits to my GP I have met the 8000 out of pocket max for the year and am still three months away from the possibility of surgery. I am making it clear to my surgeon, GP and anyone else who will listen that I have to get the surgery this year! I can not afford to do this again in 2015.

[Forsythia 882]

What you get charged depends on where you are and what hospital you go to. So a hospital in a rural area might not be as expensive as one in a metro area. A more affluent suburb might charge more than one that is more middle class. You need to contact the billing department for your surgeon's hospital. Ask them what they charge for a typical sleeve gastrectomy out of pocket before any discounts. If you have more than one competent surgeon in your area, you might be able to shop around for the best price/one to hit your wallet the least post insurance.

I live in Chicago and have BCBS IL. I do all of my medical stuff at Northwestern Memorial. The hospital fees were $47,000, plus another $7,000 for the actual sleeve procedure. My total out of pocket costs ended up being around $1800. I had met my deductible and part of my out of pocket max ($3500). The resulting $1800 is what was left of my out of pocket calendar year maximum.

[4EverChang'nSpy 44]

Bcbstx n I've met my $750 deductible and I only have $770 left from meeting my $3750 out of pocket expense max, after that insurance covers at 100% instead of 80%....tentative surgery date is 9/26 but I hope that changes since my insurance approval is now in the works....

[tnl1031 52]

My hospital told me that the cost for a VSG with no complications would be $63,500. I have a $750 deductible and have to pay 10%. They told me if the insurance company has a deal in place with the hospital, the price may be lower. They also said they have significant savings for people who are self-pay.