Jump to content
×
Are you looking for the BariatricPal Store? Go now!

im a little confused



Recommended Posts

hello everyone......i have private health insurance but my surgeon has told me i need to pay about $3000 out of my own pocket. Did u all have to pay this out of pocket expense too? Im just a bit confused as to why i have to pay this.I dont know if its the surgeon charging more or if this is what everyone has to pay. Thanks Fee

Share this post


Link to post
Share on other sites

Hi Fee! I too have to pay about 3000 out of pocket. I had to pay for the nutritionist consultation which was $200 then the psychological evaluation test which was $160 my insurance picked up the rest of that($140). The weight loss workshop here where I live is called obesity to balance I attend that for 2 days in August which is $500. I will also have a bill from the physician for about $2000 after the surgery. .

Share this post


Link to post
Share on other sites

hmmm...yeah it doesnt sound right does it??

anyone else have this problem?

Share this post


Link to post
Share on other sites

Hi Fee,

Everyone's insurance is different and there are many reasons you might have some out-of-pocket expenses. For example, if the doctor, hospital, or even the anaesthesiologist is not in your network you may have some out of pocket charges. In addition, the nutrional and psychological evaluations are often not covered by insurance at all. Your plan may itself have co-insurance and copay features that amount to a significant charge.

If your doctor's office is, however, charging for additional services over and above the surgery and related services itself, they are very likely to be optional. Check the fine print and see what exactly you're being charged for and whether you have control over those expenses.

Share this post


Link to post
Share on other sites

My insurance covered the Psych eval and tests, etc. I will have a copay of 20%. Not of what the Dr charges but what the insurance company has prenegotiated rates with them on, My dr is in the network too, I have Empire BCBS...

Share this post


Link to post
Share on other sites

I had to pay either $2000.00 or $25000.00 before the surgery out of my pocket for my deductible...

Share this post


Link to post
Share on other sites

like the others said. It all realy depends on your insurance coverage. I had $25 co pays, for my physicals, and psyc eval. I have to pay a $400 deposit prior to surgery, and of course i'm responsible for anything above and beyond wha the insurance will pay. Considering that this is a $18,000 surgery, i feel like i'm getting a pretty good deal out of it.

Share this post


Link to post
Share on other sites

I know that the Wish center in Chicago told me that there was a $2,000 "lifetime support" fee. I explained to them that I was far away and would never use the support group and I had one locally and they said it was not optional. I called the insurance company and was told that was not payable. That would be on top of any co-pays deducts and such. I went with a closer and I think better surgeon.~Mandy

Share this post


Link to post
Share on other sites

I had to pay surgeon and hospital upfront for deductible and 20% and it was about $3000.00. I feel this is good and not have to pay all $20,000.00 myself. But all insurances are different.

Good luck!! I am 5 days paot op and back to work tomorrow.

Share this post


Link to post
Share on other sites

fee you're in Australia arent you? Its just the gap between Medicare and what your surgeon charges, like any other operations. So, medicare will cover x% of the surgery as long as it's clinically necessary but beyond question your surgeon will charge way more than the scheduled fee, they all do, your private health insurance will cover the cost of your hospital stay according to your policy and then depending on the policy may cover some of the gap charged by the surgeon.

Share this post


Link to post
Share on other sites

The "program fees" are the latest way to make up the difference between what the doctors get paid and what they think they should get paid. It's not just for LapBand. while researching the other surgeries, I have found $800 "program fees" and $3000 "program fees." They are charging that because, so far, it is not prohibited by their insurance contracts.

Once it is, they'll probably charge $3000 for pre-paid parking, even you you take a bus. It's about the money.

Share this post


Link to post
Share on other sites

fee you're in Australia arent you? Its just the gap between Medicare and what your surgeon charges, like any other operations. So, medicare will cover x% of the surgery as long as it's clinically necessary but beyond question your surgeon will charge way more than the scheduled fee, they all do, your private health insurance will cover the cost of your hospital stay according to your policy and then depending on the policy may cover some of the gap charged by the surgeon.

yeah im in australia.....ok thanks everyone for your help

when i attend the seminar on the 17th august i will get the full rundown of the costs!!! Thanks Fee

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×