I'm scared

Julie J.
on 2/24/13 4:10 am - NV

I went to the seminar for the VSG on Wed night. My doctor requires it as step one to getting the surgery. Something that was brought up was co-pays for the hospital and Doctors. I had not thought about that. I have traditional Medicare. I don't know what I will end up having to pay. I am on SSDI and am a single mom. It scares the heck out of me that my portion will be too high and I will never be able to afford the surgery. I am desperate as I have severe arthritis and degenerative disc disease and the extra weight is making it so much worse. Does anyone have traditional Medicare, and if so, how much did you have to pay out of pocket??

claimmaster
on 2/24/13 4:17 am, edited 2/24/13 4:19 am - OK
VSG on 07/05/13

You would have to pay 20% of Medicare's approved amount.  Your doctor's office should be able to tell you how much that is.

Antimony40
on 2/24/13 4:19 am - VA
VSG on 12/06/12 with

most surgeon's have a person in their office who specializes in insurance issues--talk to that person and get them to walk you through what you should expect!

 HW 286.7--SW 264.4--CW 184.2  M1-24.8//M2-14.8//M3-7.6//M4-10.0//M5-3.8//M6-8.4//M7-6.4//M8- 4.8//M9 +1

Julie J.
on 2/24/13 5:15 am - NV

Oh poop:( The doc said the surgery is 16k. There is no way I can come up with 3200 bucks. Now I am getting very worried.

mickeymantle
on 2/24/13 6:32 am - Eugene/Springfield, OR
VSG on 07/22/13

talk to the insurance person , what the charge the insurance company is not always what they charge people that pay there own

 also they may have plans to pay off the co pay, also you can beg borrow and steal from friends or relatives you need this surgery

check with your state disability services they may be able to help pay the co pay

    

   175 lb  lost,412 hw 336sw,241 cw surgery July 22 2013,surgeon Dr Colin MacColl,

 

  

                                                                                                             

 

 

 

a_gritters
on 2/24/13 7:22 am, edited 2/24/13 7:24 am
VSG on 03/19/13

Do you have both part A and B Medicare?  I'm assuming you do not have a supplemental insurance?  It is possible that you could talk to the billing department about how much it would cost you.  Also, some places have companies such as care credit that you can get so many months with no interest to pay off the self pay portion.  Don't stress just yet, do your research.  ALSO, I do believe there are caps for Medicare on the co-pay/co-insurance.  I want to say its like $1200 or somewhere around there, so I dont think it would be 20% of the entire billed amount.

Also, it is 20% of the medicare approved amount as shown below  This means it would be based on the allowable charges that medicare allows for the dr and hospital and then 20% of that:

Outpatient hospital services

  • You generally pay 20% of the Medicare-approved amount for the doctor's services.
  • For all other services, you pay a copayment for each service you get in an outpatient hospital setting.
  • For some screenings and preventive services, these charges and the Part B deductible don't apply

 

MsBatt
on 2/24/13 7:43 am

9 years ago, when I had my DS, my hospital allowed me to pay their charges in installments, and I only had to pay the deductible, not the deductibe plus 20% like I expected. 

However, the surgeon I chose didn't accept Medicare, and I paid his fees out of pocket in order to get the DS. (I could have had an RNY with a different surgeon basically for 'free', but I knew it would make me miserable.)

Given your BMI, I certainly hope you're researching the DS as well. The DS has the very best long-term, maintained weight-loss stats for patients of any size, but especially so for those of us with a BMI greater than 50.

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