Any Out of Pocket cost for your surgery?

[GMen88 70]

Hey all,

I received a fun phone call from the hospital where I'll be having my surgery. Finance department told me that my insurance covers 90% of my surgery, leaving me responsible for 10% or $2100. Cool. I knew that.

What I didn't know was that I would have to make a deposit of half of the $2100 to the hospital that day I arrive, prior to my surgery. I was under the impression that I'd pay for it once I received my hospital bill AFTER surgery.

It caught me off guard a bit but I have the money and can pay day of. Just curious as to the process for some of you in terms of when you were required to pay, etc thanks!

[PatientEleventyBillion 851]

For me Universal Healthcare is covering 100% of everything. Surgery here is the end result of the weight management program. To get to this point in Alberta you need to satisfy the gatekeepers (dietitian, psychologist, case manager, etc.) you've made adequate lifestyle changes to justify covering you for this surgery. It's also why I've seen so many successful post-op patients here. They set you up and ensure you're in the right mindset to be successful and that this isn't a meaningless surgery.

Since September 2015 when I've started the WM program as far as appointments, I'm estimating I've seen:

- Case Manager: 8 times

- Dietitian: 3 times (seeing her again this month)

- Psychologist: 3 times

- Generalist: 4 times (seeing him again this month)

- Hepatologist: 3 times (seeing her again Monday)

- Surgeon: 4 times (seeing him again early April)

- Spine doctor (dunno what they're called): 6 times (2 appts this month for facet injections)

- GP: 15-20 times

- sleep doctor: 3 times plus 2 more times for a nurse regarding apnea and CPAP trials

Edited March 10, 2017 by PatientEleventyBillion

[Newme17 3,444]

I'm required to pay in full before. I'm sure I could work something out if I wanted to, but I'd rather just get the $2000 paid and be done with it. I suspect there might be one or two bills to follow???? Usually is after surgeries, but I hope I'm wrong for this one.

[kins117 104]

I will reach my out of pocket max of $4100. I spent about half on pre-surgery testing and will pay the rest post-surgery.

[ThickGirl5683 318]

My out of pocket portion is $2400 which is due to the hospital the day of surgery. They are letting pay 60% and the rest after surgery

[kkami12 52]

They called me the day BEFORE my surgery saying i owed 1500$ talk about being super nervous and then they hit you with that.. i said id pay 200 and they can bill me, technically how do they know if the surgery is going to be performed?? Most places you are not obligated to pay in full you can say bill me.

[allinforachange 25]

My co-pay is $1,009. I was told up front that I need to pay it at my final pre-surgery appointment with my doctor when I sign my consent forms.

[CrowMilk 96]

I had to pay $2,000 beforehand and I have received several bills summing to around $750 more. I saved up in an HSA so the 2K wasn't bad, but that wiped the savings and I have nothing left for the remaining bills now.

[travelergirl 142]

I've been surprised by the costs of all the preop steps. Started at end of 2016 so deductible was covered. Psych consult $250 out of network got reimbursed $180. Surgeon was less than $10. Upper GI radiology test was $75. In 2017, had to meet deductible so $200 for another surgeon visit. $150 for gallbladder ultrasound. And now I'm getting bills for endoscopy...so far about $400. Just met deductible. Surgeon's office did say that I would be asked to pay my co insurance before surgery. So more costs to come. I will likely use up my HSA before this is over.

[travelergirl 142]

I've been surprised by the costs of all the preop steps. Started at end of 2016 so deductible was covered. Psych consult $250 out of network got reimbursed $180. Surgeon was less than $10. Upper GI radiology test was $75. In 2017, had to meet deductible so $200 for another surgeon visit. $150 for gallbladder ultrasound. And now I'm getting bills for endoscopy...so far about $400. Just met deductible. Surgeon's office did say that I would be asked to pay my co insurance before surgery. So more costs to come. I will likely use up my HSA before this is over.

Oh...and I forgot the nutritionist...that was 2016 and was less than $10.

[MeltsIntoWonder 125]

I've been lucky and so far only have had to pay my standard copays for office visits ($20). For the surgery, I'll just have to pay my deductible, but I don't know when. My pre-op appointment is on Monday, so I'm guessing I'll find out then.

[kaysc 14]

I had to meet my $2000 deductible before surgery. So after going through the process, whatever it took to meet that deductible is what I paid the day I had my pre-surgery appointment (they told me the amount ahead of time, it was like $700).

After that I got a $400 bill that they hadn't submitted until after I met my deductible. My max out of pocket is $4000.

[courtneyd 59]

I have Athem BCBS through Pepsi Co. $500 ind ded, 80/20 coins. My cost is $260, which is what I have left on my ded then I'll be billed 20% towards my $4,000 out of pocket max.

[TracyBar 132]

On 3/10/2017 at 3:47 PM, PatientEleventyBillion said:

For me Universal Healthcare is covering 100% of everything. Surgery here is the end result of the weight management program. To get to this point in Alberta you need to satisfy the gatekeepers (dietitian, psychologist, case manager, etc.) you've made adequate lifestyle changes to justify covering you for this surgery. It's also why I've seen so many successful post-op patients here. They set you up and ensure you're in the right mindset to be successful and that this isn't a meaningless surgery.

Since September 2015 when I've started the WM program as far as appointments, I'm estimating I've seen:

- Case Manager: 8 times

- Dietitian: 3 times (seeing her again this month)

- Psychologist: 3 times

- Generalist: 4 times (seeing him again this month)

- Hepatologist: 3 times (seeing her again Monday)

- Surgeon: 4 times (seeing him again early April)

- Spine doctor (dunno what they're called): 6 times (2 appts this month for facet injections)

- GP: 15-20 times

- sleep doctor: 3 times plus 2 more times for a nurse regarding apnea and CPAP trials

I'm in Alberta too - was at the bariatric clinic today for Dietician appt. I started the program in Aug/Sept. 2016, saw the surgeon a month ago. I'm not sure if I'll see the surgeon again or not. My surgeon is Dr. Mitchell and it takes the longest to get surgery with him, but he apparently has the most experience. Everyone passed me through pretty quickly (Nut, Psychologist, Nurse), and I'm a good candidate for the surgery. Just have an endoscopy I'll have to do in High River in a couple of months. I may see the surgeon for those results. Plus can see anyone I like at least every 3 months. I was down 10 lbs. so going in the right direction!

And you gotta love the healthcare system for sure! No cost at all - and I'll also be able to get a Tummy Tuck if I lose 80-100 lbs. which is also fully paid for. Hospital stay is free as well. We're lucky to not have to worry about medical bills. If I have the surgery in one year from when I saw the surgeon that'll take me to February or so 2018. Bit of a wait, but as I said Dr. Mitchell does other surgeries and is pretty booked up....

[PatientEleventyBillion 851]

1 hour ago, TracyBar said:

I'm in Alberta too - was at the bariatric clinic today for Dietician appt. I started the program in Aug/Sept. 2016, saw the surgeon a month ago. I'm not sure if I'll see the surgeon again or not. My surgeon is Dr. Mitchell and it takes the longest to get surgery with him, but he apparently has the most experience. Everyone passed me through pretty quickly (Nut, Psychologist, Nurse), and I'm a good candidate for the surgery. Just have an endoscopy I'll have to do in High River in a couple of months. I may see the surgeon for those results. Plus can see anyone I like at least every 3 months. I was down 10 lbs. so going in the right direction!

And you gotta love the healthcare system for sure! No cost at all - and I'll also be able to get a Tummy Tuck if I lose 80-100 lbs. which is also fully paid for. Hospital stay is free as well. We're lucky to not have to worry about medical bills. If I have the surgery in one year from when I saw the surgeon that'll take me to February or so 2018. Bit of a wait, but as I said Dr. Mitchell does other surgeries and is pretty booked up....

Say hi to Dr. Gill for me if he does your endoscopy in High River.