Help !!!

I am knew to all of this so forgive me if i sound stupid. Does Most of your alls insurance cover most of your surgery or are you still responsible for most of it? I have Humana and from i can figure out the only pay up to 5000., is that the norm? Or is that a bad plan? Thanks for any help. All of you all are such inspirations to me. Missy

Hey Missy, that doesn't sound stupid at all. I can't help u on this though cause I had Great West Healthcare at the time of my surgery. I had to pay 10% of the surgeons fees. I believe my part before surgery I had to pay Dr Shina was $180 or somewhere in that area. I don't know what to tell u on this. Maybe someone else who has Humana can help u out. I'm sure someone's been in this situation before. Hugs and Best Wishes Ange

Thanks for your help, once again. Missy

I had Blue Cross Blue Shield, so I am not sure either. I do know that a number of people who have gone through the Tri-State Weight Loss Center have had Humana ins. Perhaps one of them will log on and let you know. Hope you find the answers you are looking for. Good luck. Keep trying. God Bless, RJ

Hey Missy, It's hard to answer that specifically per say, because we all have different provisions and all. My husbands insurance is carried by Humana and we ended up having to pay (I believe) about 10% of cost. It's more than I anticipated, but well worth it. I keep praying that the hospital, doctors, and everyone else around it accept my small monthly payments without fuss. $5000 seems a little low to me; could you be reading it wrong? If anything, Humana doesn't mind in the least if you call up a customer service rep and ask them about your coverage. I know my hubby called them on several occasions to make sure we knew exactly what to ask and whom to ask as far as coverage. Also, they offer a web page to assist some basic questions you may have. www.humana.com Good luck to you-- Dee

Thanks Dee, I have pretty much checked everything about the policy and it says for obesity it pays 50% up to 5000. Lifetime max. So thats how I am taking it, is that what it sounds like to you....the even funnier thing is that my Husband works for Humana, so i thought it would be much better coverage then that,thanks again. Missy

wow missy... your husband works for humana and thats all they'll cover. well its still better than what they did for me. I guess thats why I went UHC.

Yeah thats what i thought too....5000.Maximum benifit, 2000 deductible....etc....I guess if i had a choice I would go with better insurance, but I dont. Maybe they will suprise me and everything will be fine. On my Psych and Nutrition eval at Nortons that I paid 140.00 they sent me a check and ended up and covered that, suprised me so who knows. Thanks for your info though, How are you doing?

Hi Missy. I have Humana (my husband's a teacher)too. Our plan pays 90/10 with a $250 deductible and a $1500 out of pocket. After that, it's covered at 100% I paid $200 to my surgeon up front, and $100 for the bariatric center's assessment fees (i.e. psych, nutrition counseling, etc.). The hospital and surgeon (and everyone else) is supposed to bill me for their charges. I received my first Explanation of Benefits from Humana the other day for Norton's Hospital charges. I think my portion will be about $650, but again, that's just for the hopsital. I too will be looking to make small monthly payments. Also, we'll be sending in a financial application to the hospital. They will often write off the balance or let you make payments. You can also talk to your surgeon's office in advance and ask him if he/she will take insurance only so that you don't have a big balance. All they can do is tell you no, or maybe yes! It's worth a shot! Good luck! Karen in Kentucky

Well all of that makes sense , maybe I will call the doctors office, because let me tell you everything I have done re: this WLS, they have deducted right out of that 5000. So its going down as we speak. Thanks for your information though, good luck to you. Missy