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Paying for Surgery

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Old 03-24-2013, 05:47 PM   #1
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Has anyone paid for part of their surgery or do most people only do it if insurance covers it? I will possibly have to pay 20%. I think this might be an issue for my dh. Advice needed.
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Old 03-24-2013, 06:05 PM   #2
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hmmm. you wrote only a few sentences, but wow, they're really loaded!

first of all , check your policy. many policies have a cap on the amount of money you have to pay out of pocket for the year. It can be anywhere between 2000 and 5000. So, if your surgery costs 50 000, and you have a 5000 cap on your out of pocket with a 20% copay, you'll 'only' pay the 5000, not the 10 000 [which would be 20%]. But please remember that it'll be a cap on what the insurance company actually pays. So, if the surgeon tells you it'll cost 50 000, by the time the insurance disallows this and that and pays the contracted rate, the total could be, say, 35 000. [and I'm just pulling these numbers out as examples - you'll have to have a heart-to-heart with the insurance company to understand exactly what they'll pay]

But check your policy.

some folks take their cash down to Mexico - much lower cost. You'll need to be sure to find a surgeon at home to do your post-surgery followup, though, and not all surgeons are willing to.

And I do know a couple of wealthy people who were self-pay. I'm sure not one of them. Some folks took out second mortgages. And some surgeons offer payment plans or financing.

So, there are quite a few options out there ... I hope that there's one that'll work for your situation.
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Old 03-24-2013, 06:15 PM   #3
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Thanks for the info. I'm going to check with ins again. I talked to one ins person and I didn't quite understand everything. We've had this policy for about a year and I'm just now getting used to how it works. Had BCBS forever and it was much easier to understand. I have Cigna now.
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Old 03-24-2013, 11:13 PM   #4
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My insurance paid for 80% of usual & customary (what they say the going rate should be basically). Then I had a $2,500.00 out of pocket maximum & a $250.00 deductible. So, I ended up paying close the $3,000.00 out of pocket but I don't remember how much my total surgery cost was. My hospital required a down payment & then had an option for a payment plan to pay off the balance. I should have it paid off in another year. It was soooo very worth it.
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Old 03-25-2013, 01:10 AM   #5
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My insurance doesnt pay. So I automatically have to be a selfpay, so Im not sure how the insurance works.
However, all surgeons have different prices. I think it has to do with the surgeon themselves, and the hospital its performed at.
For instance, I want the sleeve. Ofcourse the surgeon I chose does it at a large hospital who has a designated Bariatric floor. He charges just over $17500. That also includes some sort of BLIS plan which will cover me for 3 months, in the event of a leak, etc..
Theres another local Dr who charges $10500, who does his surgeries at a medical center. Im actually going to call him tmrw for more info!
Ofcourse there is Mexico which charges less than $6K, but I dont think i could ever do that.
Sooo I think you should look up different surgeons and ask for prices. This way you can pick one who has a lower price, if you are required to pay a percentage. OFcourse, find one you can trust!!!!
There are also different financing options out there. Like CareCredit.com and MedicalFinancing.com
When you choose a surgeon, ask about financing, and they will tell you which financing option they offer.
Hope this helps!
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Old 03-29-2013, 07:04 PM   #6
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I live in Canada, so depending on which way you go about it, it's different. If you qualify, you can have WLS done for free in Canada. The catch is that there is an average waiting period of 3 - 6 years. And that does who any good?

I qualified, but wasn't willing to wait. So I did my research and decided to go the Mexico route. I found an amazing surgeon, and applied for a medical loan to pay for my surgery. I took the remaining balance out or my RSP's to cover the entire cost.

It wasn't cheap, at all, but my life is worth every penny.
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Old 03-30-2013, 11:33 AM   #7
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I paid for my own, as my insurance covers nothing to do with weight loss (but all of the complications of obesity cost more over a lifetime :/). I would do it again in a heartbeat, but my fiancÚ was supportive. If he hadn't been okay with it, I don't know. I probably would have one less person around. J/K. It would have caused tension, though. Good luck to you!
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Old 03-30-2013, 11:34 AM   #8
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Oh. Bring your hubby to a seminar with you. Show him the success stories here and on VerticalSleeveTalk.com. Let him see you're not crazy, just done being sick.
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Old 03-31-2013, 11:03 PM   #9
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Amy, I see that you live in Chesapeake. I live in Suffolk. Where did you have your surgery and who was your surgeon?
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Old 04-07-2013, 01:22 PM   #10
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Quote:
Originally Posted by Joliebug82 View Post
I paid for my own, as my insurance covers nothing to do with weight loss (but all of the complications of obesity cost more over a lifetime :/). I would do it again in a heartbeat, but my fiancÚ was supportive. If he hadn't been okay with it, I don't know. I probably would have one less person around. J/K. It would have caused tension, though. Good luck to you!
I was a self pay also and would do it again in a heartbeat also Joliebug! I took out a loan and I actually feel happy when I have to write that check lol. I'm smiling right now just thinking about it I feel so much better and have done so much since having the surgery that when I write it I think about how much I've accomplished so far and makes it that much easier to write. My dad just had the surgery also and he was self pay and he says the same thing.
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Old 04-10-2013, 03:35 PM   #11
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I live in Canada and in my province they cover the entire cost for Gastric Sleeve and RNY, but they do not cover any costs for the LapBand. With Sleeve and RNY the wait lists are atrocious but LapBand is less than 6-8 months. I have choosen to go the lapband route and the cost is $15,000 but I see it as a very valuable tool to regain the rest of my life.

You'd pay more than $15,000 for a car ... so I think it is worth the life investment.
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