Did your insurace tell you that they only cover 50% of the surgery?

[munkee'smommy 0]

I was wondering if your ins. told anyone that they had to pay 50% of the cost of surgery and if so how much did it wind up being. I have BC/BS of AL and I have 3 comorbidities: pseudotumor cerebri, high cholesterol, and diabetes type 2, (and may have sleep apnea). I hope they see that i NEED this surgery and don't make me pay like $10,000.

[ParrotheadCathy 0]

The best (and really, only) way to know exactly what your insurance covers and at what percent is to call the customer service number on your insurance card and ASK. Even though your doctor's office will do all that, it's really in your best interests to call yourself and know absolutely! I know of one person who had called, was told her coverage etc. but someone in her doctor's office made a mistake and told her she wasn't covered at all. She knew otherwise, had a person's name that she'd talked to and was able to straighten it out the same day the doc's staff error came to light.

[munkee'smommy 0]

I have spoke to the insurance co. and that is what they tell me, that i will owe 50%. I am hoping after everything is sent for approval that i will wind up not owing as much.

[ParrotheadCathy 0]

Well, I hate to say it but .... if the insurance company says you will owe 50%, then you should be prepared to pay that amount!

[munkee'smommy 0]

UGH, i am afraid of that. i called yesterday to the insurace workers at the hospital. she saw a co payment of 20%, which is better. they are going to find out and call me back. I do know one thing, I don't care what I have to do, i will get this done. I need this for myself, my daughter, and my husband. Whatever i have to pay, debt, whatever tests, i'll do it.

[cindyj33 1]

UGH, i am afraid of that. i called yesterday to the insurace workers at the hospital. she saw a co payment of 20%, which is better. they are going to find out and call me back. I do know one thing, I don't care what I have to do, i will get this done. I need this for myself, my daughter, and my husband. Whatever i have to pay, debt, whatever tests, i'll do it.

Hey, I have BC/BS of Alabama too, I am finished with everything that I have to do, and I should be having surgery in November. I'm having the surgery in Decatur by Dr. Suggs. The payment I was told was $1,100.:bored:

Edited July 21, 2009 by cindyj33
Left out a word

[cindyj33 1]

Did you already have your labwork done?

[cindyj33 1]

I had several out of pocket expenses... 125.00 for the psych eval, 225.00 for my 6 month supervised diet program, 25.00 co-pay for my surgeon visit, 1,100 for the surgery and hospital co-pay. So far that is the only out of pocket expense...

[munkee'smommy 0]

Oh, thank you, thank you, thank you!!! I can handel that much better. I know my situation will probably be different from yours, but it gives me HOPE that I won't have to be in debt. I am using Dr. Scott Robbins in Dothan. Funny, we have a Dr. Suggs in Dothan for optometry. Why will it take until November? Am i not realistic in hoping for Sept.? Just wondering. :bored:

[munkee'smommy 0]

I had several out of pocket expenses... 125.00 for the psych eval, 225.00 for my 6 month supervised diet program, 25.00 co-pay for my surgeon visit, 1,100 for the surgery and hospital co-pay. So far that is the only out of pocket expense...

You know the only expense i have had so far was my psych eval $335. No lab work yet. I don't have to do the 6 mo. diet due to my BC/BS group number being 13000. I work with the state of AL. I am so happy about that. I haven't had a surgeon consult yet. So far i've done: the seminar, support group, psych eval, physical therapy, and sleep study. I need to: take the EMI computer course (i will on the 28th), meet the dietian, then the surgeon. (plus my doc is now writing the letter to my surgeon-got to get that in). After the surgeon meeting it is about one month till surgery. We have to go on a super low carb diet for a month. If you have a big liver, he'll sow u up and send ya home. I'm pretty new to everything, but i can't wait. :bored: I WISH YOU GOOD LUCK TOO!

[munkee'smommy 0]

i also remember some coworkers saying that they had to pay like $1000 out of pocket. I didn't know if BC/BS changed or not. I sure hope that is all i have to pay, but we'll see. My doc charges $17000 something cash pay, not sure what will be billed/accepted by insurance.

[cindyj33 1]

You know the only expense i have had so far was my psych eval $335. No lab work yet. I don't have to do the 6 mo. diet due to my BC/BS group number being 13000. I work with the state of AL. I am so happy about that. I haven't had a surgeon consult yet. So far i've done: the seminar, support group, psych eval, physical therapy, and sleep study. I need to: take the EMI computer course (i will on the 28th), meet the dietian, then the surgeon. (plus my doc is now writing the letter to my surgeon-got to get that in). After the surgeon meeting it is about one month till surgery. We have to go on a super low carb diet for a month. If you have a big liver, he'll sow u up and send ya home. I'm pretty new to everything, but i can't wait. :bored: I WISH YOU GOOD LUCK TOO!

:sneaky: I work with the state too!!!I'm with the Health Department in Winston County. The reason I am having surgery in November is I chose to because I didn't have the 1,100 at that time. Then I went through a HUGE bout of depression because I was convinced that I would never be able to save up enough to have it done, but slowly but surely I've almost got it, so have chosen to go for November because we have all those holidays and I won't have to burn as much annual.:thumbup:

[cindyj33 1]

i also remember some coworkers saying that they had to pay like $1000 out of pocket. I didn't know if BC/BS changed or not. I sure hope that is all i have to pay, but we'll see. My doc charges $17000 something cash pay, not sure what will be billed/accepted by insurance.

Dr Suggs told me when I went to see for the first time that if I had 12,000 he could do the surgery when ever I was ready...Even though I was ready my bills weren't ready to through that kind of money down and God knows, Gov. Riley doesn't want to pay us what were worth!!LOL I decided to hold off when all of the lay-offs and pay freezes started because I wasn't sure if I was going to have a job!!:bored:

[munkee'smommy 0]

I work with the state too!!!I'm with the Health Department in Winston County. The reason I am having surgery in November is I chose to because I didn't have the 1,100 at that time. Then I went through a HUGE bout of depression because I was convinced that I would never be able to save up enough to have it done, but slowly but surely I've almost got it, so have chosen to go for November because we have all those holidays and I won't have to burn as much annual.

mouth open OMG, LOL!!! :eek: I WORK AT THE HEALT DEPT IN PIKE CO!!!!!!!!! I'm a social worker for the -soon to be canned-asthma pilot program through medicaid. I don't know if i will have a job either!!! Too funny!!! What do you do at Winston? and why did they make u do the 6 month??? i understand about the money, if i loose my job, then i will have to ask for help from dad in law, or give 'em 5 bucks a month. yeah, riley freakin hates us. no state worker should have voted him back in. what is a raise and job security anymore, I forgot? i'm going to send you an email. LOL THIS IS TOO FUNNY!!!!

[cindyj33 1]

mouth open OMG, LOL!!! :thumbup: I WORK AT THE HEALT DEPT IN PIKE CO!!!!!!!!! I'm a social worker for the -soon to be canned-asthma pilot program through medicaid. I don't know if i will have a job either!!! Too funny!!! What do you do at Winston? and why did they make u do the 6 month??? i understand about the money, if i loose my job, then i will have to ask for help from dad in law, or give 'em 5 bucks a month. yeah, riley freakin hates us. no state worker should have voted him back in. what is a raise and job security anymore, I forgot? i'm going to send you an email. LOL THIS IS TOO FUNNY!!!!

Hey Girl, I just got in from work and saw that you too work for the Health Department!!LOL!! I am a nurse for Lifecare, actually I am the ONLY LPN working in Winston Co in the Lifecare Program.. I just wished that meant job security!! Hell I forgot what a raise looked like on my pay stub!!! As for the 6 Month diet, I think BC/BS has changed that recently.. I do know that BC/BS will approve you for a year from the original date they approved you. I thought that I wasn't going to be able to have it done:mad2: until I called the lady at Care Wise, they are the people who actually approve you and send it to BC/BS.When I found tha tout I decided to just save part of my travel checks from now until November.:eek: