Question:
Is this too expensive?
I currently have my primary insurance approve me (with a fight) - however ... it has a limit of $30,000. This is for ANYTHING related to the surgery. If I should have ANY type of complications, they will only be covered up to this maximum. BTC has indicated that my surgery will cost APPROX $32,000 -$35,000. ( I don't mind kicking in a couple thousand) However, I am VERY afraid that I might have complications, then put my family at financial risk. I also know that complications are probably not going to happen. I have a secondary insurance that I am waiting for approval on. If they okay it, then I have no problem. If they deny me, what should I do? Would others go ahead and risk it? Please let me know your opinion. Also, anybody have surgery at BTC in Belvidere - what was the final cost? They were very vague, and I got the one answer above, and another quote of almost $40,000 (which blew my mind, cause I thought I read somewhere the average is 15 -20k) Thanks for your help!! — Karen A. (posted on January 3, 2001)
January 3, 2001
My daughter and I had our lap RNYs last January and March respectively.
She was private pay and I had dual insurance coverage. The cost quoted to
both of us by our surgeon at that time was $18,500. That figure was an
all-inclusive "package" price based on a contractual relationship
with the hospitals that this surgeon utilizes...meaning that the fee is
constant regardless of length of stay or complications. This figure may
have changed slightly over the past year, but it is my understanding that
his fees are well below many other bariatric surgeons or groups, and he is
one of the leading surgeons specializing in lap RNY, with international
standing. The recent increased "popularity" of WLS seems to have
driven fees to unreasonable highs in some areas. However, from what I read
on various sites, the figures that your group quoted to you seem to be
fairly middle-of-the-road currently. Keep in mind that the incidence of
complications with WLS is relatively low, and there is still hope that your
secondary insurance will come through for you. I wish you the very best!
— Diana T.
January 4, 2001
I had my surgery at BTC in Belvidere on December 13 of this year. When I
was getting my quotes the said it would be around 23,000. I have BC/BS and
have yet to receive any bills that my insurance didn't cover. I would ask
why there are different prices for the same surgery. You can contact me at
[email protected]
— Robin Q.
January 4, 2001
Surgery next week(yipee) it will cost me(selfpay)$18,400.00. I would really
question why this quoted fee is so high.
— Debora H.
January 4, 2001
I had VBG in Lubbock, Texas on 11/1/00. I was quoted about $30,000. I just
received the billing from the hospital for $33,000. I understood the doctor
is charging an additional $3600. Pre op testing was over $2,000. These are
the only charges I have seen. The good news is that the hospital is
settling for "insurance only". Hope this helps.
— marciejayne
January 4, 2001
Hi! I work for an insurance company and believe me when I tell you that
when we say "30K Max" we mean what we actually have to pay out.
If your hospital is in network with your insurance they will only be paid a
fraction of the bill, they have to except this as payment, because they are
in network and it is a contractual savings between the insurance company
and the hospital. The hospital can not charge you anything over this
amount, except your co-pay and co-insurance. So if the operation cost 30k
the insurance company may only have to pay 15-20k. I wouldn't worry about
the rest. Chances are nothing will happen and the other option is to file
bankruptcy. LOL Hope this helps!
— [Anonymous]
January 4, 2001
I had my surgery at BTC in Michigan, and all my bills added up to about
40K. That includes all the pre-op tests, post-op tests, and an extra night
in the hospital because I was slow to get back on liquids. I understand
the insurance can set a limit on how much it will pay for a certain
procedure, and the hospital may or may not have to accept that amount
depending on if the hospital has a contract with your insurance company.
But, I don't understand how the insurance can refuse to pay for any
complications. Now, they will approve your WL surgery because it is
considered medically necessary. Then if, heaven forbid, you end up with an
infection or blood clot, they won't pay? Those treatments will be just as
"medically necessary" as the original surgery. It seems like
unexpected complications are the main reason we have health insurance in
the first place, so how can the insurance company try to refuse to pay? I
would really question this, and get the insurance staff at your surgeon's
office to question it too. It sounds fishy to me. Good Luck!
— Lynn K.
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