Help: 2 weeks from surgery, still don't know my cost

[Thucydides 250]

My surgery date for gastric sleeve is September 14th and I am still having problems finding out how much my portion of the surgery cost will be. My insurance has approved me, but its coverage for bariatric surgery is pretty limited. Even after I pay my $5000 bariatric deductible and then my co-payment maximum, my insurance will only pay up to $13,000 for my surgery. I will be responsible for paying anything that exceeds that. The problem that I am running into is that I cannot get my insurer to tell me the contracted amount for my surgery and neither my surgeon nor the hospital have been able to tell me that either. Between the hospital financial counselor, surgeon, and hospital business office, I have received 3 different estimates of my portion of the bill that have each varied by several thousands of dollars.

Has anyone had this problem and figured out how to resolve it? My surgeon's office has not been very helpful, telling me that they cannot give me any information about the hospital costs for my surgery and have just left me to call around trying to find this information. This has made me start to wonder if I need to look for a different surgeon that has a better relationship with the hospital where my surgery will be. Is this an unreasonable expectation? I'm genuinely at a loss on how to proceed and am grateful for any advice.

[OutsideMatchInside 10,166]

I think to some extent they don't know what it will cost.

My surgery was paid for 100% by insurance but I looked at the bill. Each item was listed as the billed amount and then the amount insurance paid. So depending on what they use on you exactly in the hospital the costs are going to vary.

I don't have any good advice but I personally would not agree to surgery unless someone could tell me the cost and hold themselves to that amount give or take 1000.

If you have to pay a 5000 deductible, why not just go to Mexico? Or Blossom Bariatrics in Vegas?

[Lexigurl82 160]

Can you give us an update on this? My surgery is scheduled for December 2nd and I too do not know any costs. I've met my deductible for the year already. Did you have to pay anything up front before surgery?

[Thucydides 250]

It wound up being a pretty major ordeal for me. With less than 2 weeks before my surgery, I was still getting prices that were all over the map, some of which were unbelievable because I knew that i had both a $5000 bariatric co-pay and then a $2000 additional out of pocket max. This meant that I knew that I would owe at least $7000, plus any amount above the $13000 maximum that my insurance would pay. Finally, I just went to the hospital and asked to speak directly to the patient account director. Once I had there information, I knew that my out of pocket would actually be $18,000. As a result, I had to switch surgeons and hospitals and do some shopping around. I'm now scheduled for November 10th.

[Lexigurl82 160]

It wound up being a pretty major ordeal for me. With less than 2 weeks before my surgery, I was still getting prices that were all over the map, some of which were unbelievable because I knew that i had both a $5000 bariatric co-pay and then a $2000 additional out of pocket max. This meant that I knew that I would owe at least $7000, plus any amount above the $13000 maximum that my insurance would pay. Finally, I just went to the hospital and asked to speak directly to the patient account director. Once I had there information, I knew that my out of pocket would actually be $18,000. As a result, I had to switch surgeons and hospitals and do some shopping around. I'm now scheduled for November 10th.

OMG...you could have the surgery in Mexico for way less...no way should your out of pocket be $18,000, especially when you have insurance. Please keep us posted!