Approved- ?s about cost and coverage

[steeler350 0]

Hello all, any help would be appreciated.

Have BCBS of Massachusetts

coverage is 50% coinsurance , $10,000 Lifetime benefit for bariatrics

deductable $200 , max out of pocket $3000

approved first try bmi of 43 , high blood pessure

pre-op fri 13th (ooooh scary)

surgery wed 25th

non-insurance; self-pay cost with my surgeons group is $17,000

anyhow after finding out my coverage i contacted surgeons office , they told me that the surgeons office would be billing my ins $5000 and said that the hospital would bill ins for everything else not related to surgeon but could not give me any approx figures.

I asked her how much the band itself cost and after chewing the fat she told me she "thought" it would be billed for around $8000

Have an appt with surgeon one week prior to surgery and was told i needed to bring $1042 at that time. I asked if i could expect anymore billing from surgeon and was told " I wouldn't think so"

Am I correct in assuming that the $1042 is my 50% coinsurance that I am responsible for in regards to the surgeons fee. ( I am assuming they have already contacted insurance and know that they will actually only allow payment of $2084 even though billed $5000 )

Also if the above is correct would the $1042 count towards my max out of pocket expense.

Just trying to get an idea of how much this is going to cost me (although it will not change decision).Seems between the surgeons office, hospital & insurance co nobody can seem to give any answers that aren't related to " I think "

If anybody has been in similar spot or happens to know how this may be billed, I would greatly appreciate your time and response.

Thanks

Karl

btw surgeon is

Dr Olsofka

Louisville Ky

Saint Marys Hospital

[lilith 6]

Did you ever get any answers?