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Insurance copay question and link



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Hey everyone, I posted a question at the link below concerning fed bc/bs insurance copays. I wanted to mention it here as well so that folks who have already had their surgery and finished up the insurance process would see it, as they might not be as inclined as pre-op folks to look at the insurance forum. By basic question is has anyone ever heard of a facility billing the band itself as an implant? This has caused my copay to go from $40 to almost $2,000!!!! For more details, please see my post at the link below. Any input is appreciated.

http://www.lapbandtalk.com/f8/fed-birth-control-bs-co-pays-54536/#post747682

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Not sure, all I know is that Hospitals try to charge as much as they can to the patient as they don't get anywhere near what they want from insurance companies and insurance companies try to get out of paying anything they possibly can.

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It's an appliance, not an implant.

Get your doc to order it from Inamed...don't let the hospital do it.

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It's an appliance, not an implant.

Get your doc to order it from Inamed...don't let the hospital do it.

Too late for that, it's already either applied or implanted, whichever way you want to look at it lol.

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Don't feel too bad. My insurance wouldn't cover me and I payed $16,500.00!

I do feel very fortunate and blessed that I have insurance that covers this procedure in any amount, as many arent in the same boat. Even if I end up with the copay for the band itself, thats a small amount to pay for the benefits I will receive. However, this is a situation that I havent heard any others speak of, with my insurance or any other type. Therefore, I'm trying to gather as much info as possible in order to determine if there is anything I can do to avoid the extra cost.

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I don't have Fed BC/BS, but I do have Empire BC/BS. My copay went up from $250 to $1500 for the hospital stay for my surgery. Plus, that $1500 doesn't count toward my deductible or coinsurance out of pocket maximum. It sucks, but compared to the self-pay cost from my doctor of $16,000, it is a huge benefit.

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My insurance covered my surgery but we still ended up paying close to $5000. My doctor was in network but his partner did not take United and we ended up paying like $2500 for out of network doctor for his assistance with the surgery, plus their $900 program fee that was not covered, another $400 for the psych eval that was not covered, and another $500 to the hospital for our copay which wasn't told to us until the hospital called to register me. There were also little fees here and there like the hospital fee for the EGD, etc. The only upside to mine is that all of my fills are included. I would pay it all over again though!

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I had to pay 1,500 but they let me work out payments. I am thinking some doctors charge more than others. I don't know how it works but that is alot of money for me to come up with. hope it works out for u.

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