Freaking out, ease my worries

[Adrianabelle 4]

Okay I just saw a post about a crazy hospital bill. Now I'm freaking out. I looked up the average cost of rny in my area and its $25,000. My insurance pays 70% after my deductible.

Basically, at this price, I calculated I'd be paying roughly $7000 out of pocket. Which is fine, my husband is borrowing against his retirement and we've saved.

But I just saw a post with multiple people saying their bill was 100-200k+. Does anyone have a similar insurance as mine? If so, what did you pay out of pocket? Please say I'm freaking out for no reason.

[Invictus 56]

Do you have an "out of pocket maximum". Because of that, my total cost was supposed to be about $8000, $5k co pay for bariatric surgery, and then about three thousand to hit the maximum. I paid the copay to the surgeon, then got a call that I had a refund coming from them. Confused at this point. Waiting on the insurance and hospital to finalize everything

[Mountaingal 322]

Can't imagine surgery costing anything like $100-200,000 unless there were major complications. At that price Mexico would be a very valid option. even if you have ins would be cheaper than the co-pay. Hope your only surprise is a nice one and this will cost less than you expect.

[James Marusek 5,244]

$100 - 200K seems excessive. I had a RNY and the total was $50K of which my insurance covered all but around $5K. The total cost of Bariatric Surgery has many components including the Medically Monitored Weight Loss and Exercise program, the Pre-Op Tests, the Surgeon, and the Hospital costs. These add up. In my case it took about a year from the time I started until I had the surgery. This meant that the costs were stretched out over two calendar years. And the deductibles had to be reached for each of these years before the insurance began to pay.

[Daisee68 2,493]

​That seems very excessive. And remember that the hospital bills an amount to insurance, but it isn't necessarily the amount insurance agrees per contract (assuming you are using in-network hospital). You will only have to pay your share 30% of the approved amount. I would also check in to out of pocket max too. After that is met, then insurance usually pays 100%.

[VDB 800]

Okay I just saw a post about a crazy hospital bill. Now I'm freaking out. I looked up the average cost of rny in my area and its $25,000. My insurance pays 70% after my deductible.

Basically, at this price, I calculated I'd be paying roughly $7000 out of pocket. Which is fine, my husband is borrowing against his retirement and we've saved.

But I just saw a post with multiple people saying their bill was 100-200k+. Does anyone have a similar insurance as mine? If so, what did you pay out of pocket? Please say I'm freaking out for no reason.

My RNY (98% covered by insurance) cost Aetna about 60 grand...this is in western Colorado.... my results have been so wonderful, I would have figured out a way to do this even if I had to leave retirement and work for a year, it saved my life, that is worth alot.

[OKCPirate 5,323]

Self pay costs are much lower. However you lose NUT, Pysc Consult and exercise support. BUT, IMHO, too many of these are crap and you will get most of the information on this site. Too much of the cost in this procedure is in lawsuit avoidance and insurance companies trying to get rid of those who are non-complaint.

So, it depends on you.

• How motivated to learn all you can on your own?
• Can you read, research, reason and integrate sometimes conflicting information and make your own decisions?
• How committed are you to using this as a tool vs. thinking it is a magic wand which will solve all your problems?
• Just how bad of shape are you in with other medical complications? (I was NOT diabetic. I did NOT have heart problems. I WAS active.) All these factors are important to the amount of support you need to make this work.
• And how much can afford out of pocket?

All of these should be considered in making a final call. You are an adult, make the best call for you.

[Sharon1964 2,530]

If you are using an in-network hospital, there is an agreed-upon rate between the hospital and your insurance company. It doesn't matter how much the hospital bills; they will write off anything over the "fee schedule" price.

Example:

Hospital bills $50,000

Fee schedule is $10,000

You have a 70/30 plan

Your insurance pays $7,000, you pay $3,000, the hospital writes off $40,000.