newbeginings85 28 Posted January 15, 2015 (edited) My insurance pays 80 percent with my max out of pocket being 4500 so I'm thinking I will be paying 4500 Edited January 15, 2015 by newbeginings85 Share this post Link to post Share on other sites
Jersrose43 837 Posted January 15, 2015 My yearly deductible $4500 Max out of pocket $9000 per year 2014 was expensive. And I work at the insurance company. Smh Share this post Link to post Share on other sites
Kindle 8,667 Posted January 15, 2015 (edited) I would LOVE that kind of insurance. Prior to 2014 I had a pretty decent policy. But after being forced to switch to a crappy Obamacare policy, my insurance sucks.....$331 monthly premium, $5000 deductible, NO office visit copays and $6500 max OOP. So basically I shell out $8972 every year before insurance kicks in a penny. Affordable my ass! Makes me wish I lived much farther south, so I could take advantage of the REAL affordable health care in Mexico more often. Edited January 15, 2015 by Kindle Share this post Link to post Share on other sites
BLERDgirl 6,417 Posted January 15, 2015 @@Kindle - You live in a state that refused to accept the medicaid exemptions, huh? I have friends just one state over in the same predicament. Share this post Link to post Share on other sites
AhnaLucille 57 Posted January 15, 2015 @@Aranks, I did ask the insurance person at the surgeon's office a couple times.. she was no help at all Share this post Link to post Share on other sites
Ladiec2 74 Posted January 15, 2015 My out of pocket will be approximately $1400. Share this post Link to post Share on other sites
Nikkidoodlebug 120 Posted January 15, 2015 Be happy that's all you're paying, you could be paying all of it like me 12,500 cash and in other places up to 26,000 in cash. Wheww wee! Just be HAPPY Share this post Link to post Share on other sites
livvsmum 2,369 Posted January 15, 2015 I just had my insurance out-of-pocket co-insurance to pay and then my $20/co-pay for office visits. The co-insurance was 10% up to a max of $1000. In the end I ended up paying somewhere around $875 for the co-insurance. Share this post Link to post Share on other sites
karimeecham 4 Posted January 15, 2015 I am paying 18,000 for my sleeve procedure. I'm getting it done in Toronto at the smart shape clinic. Share this post Link to post Share on other sites
Garifab_VSG 122 Posted January 15, 2015 (edited) My hospital's bariatric surgery group tells you up front that there is a non-refundable (even if your insurance ends up denying you) fee of $600 that covers the psychiatric part, the nutritionist, and all other things insurance won't. But it also covers LIFETIME nutritionist appts. and support groups for their bariatric patients, so that's pretty awesome. I have an H M O, so aside from my per diem in-hospital fee of $150 p/day, I do not have any other out of pocket expenses. Oh, plus the specialist copays for my insurance, which for me is $40 per. (Cardiologist, Pulmonary doc., etc.) Edited January 15, 2015 by Garifab_VSG Share this post Link to post Share on other sites
alwaysvegas 702 Posted January 15, 2015 (edited) I had to pay whatever was left from my max out-of-pocket for the year, which came to around $1,000 in out-of-pocket. Insurance covered surgery, nutritionist, pysch eval, Protein drinks, and Vitamins. I'm not an insurance expert, but I think you should expect that whatever your max out-of-pocket is left on your insurance the year of your surgery, you'll end up paying. Having this surgery will save me so much in food and medical costs down the road that I was prepared to pay for the surgery myself if necessary. Edited January 15, 2015 by AlwaysVegas Share this post Link to post Share on other sites
Aranks 94 Posted January 15, 2015 @@AhnaLucille I would call your insurance and make sure you have no deductibles you have to meet prior, there are so many different insurance companies and branches that she may not be that familiar with yours. Some require a percent that you have to pay out of pocket for surgeries, some just have set copays for hospitalization, doctor's, etc. there are so many variations. Somebody from your insurance company should be able to assist you with that and also you can request a breakdown of their coverage, so you have a copy. Somebody in the surgeon's office should be able to tell you what the surgeon's specific fee is (separate from insurance). I didn't have to meet any deductibles the $300 was for my surgeon, for his program. Normally was $500 but I got a discount because my dad had bypass by the same surgeon. Share this post Link to post Share on other sites
joshwah 23 Posted January 16, 2015 13k out of pocket. Share this post Link to post Share on other sites
BeautifullyCreated1982 168 Posted January 16, 2015 (edited) My cost is going to be $400 for my co-pay and $725 for my deductible. i've already paid $250 in full for the 3-month perpatory program and I may have another bill for the Anethisiologist. :-\ I'm praying that insurance covers that. I have Aetna, so who knows! I'm just happy to get this done! yeah!!! It's the only thing keeping me going right now. My surgery date is 2/18/15. I'm extremely excited!!!! Edited January 16, 2015 by BeautifullyCreated1982 Share this post Link to post Share on other sites
AhnaLucille 57 Posted January 16, 2015 @@Aranks now I'm finding really weird that no cost were brought up at the consult. Maybe I don't have any??? haha I'm dreaming! I wish I were that lucky When I was leaving I went to pay my copay.. but they said I didn't need to. that my dual coverage paid for it. You'd think money would be mentioned .Seeing how he said this is his job, he gets paid to do this. My coworker went to a different surgeon's office and their program has a non refundable $250 for consult. I had nothing like that. I've already done all the research with my insurance. My hospital is a blue distinction center so that cuts the cost. I have an idea but an actually out of pocket has not been motioned. I'm guessing around $350. two nights and surgeon. I'm just going to wait and see. I can handle a few hundred in fees, but if its more than that. I'll have to wait until I saved up enough money or see if I can get on their payment plan. Share this post Link to post Share on other sites