Total Cost of Surgery

akjustagirl
on 3/6/12 3:22 am
RNY on 04/09/12
I have been under the very wrong impression that my surgery was much less expensive than what it is looking like.  I am very lucky that my insurance pays 90%.  However, I thought that my 10% was going to be about $1000.  When I called for pre approval my insurance company gave me the quote for just my surgeon by mistake.  So I saved my $1000.  My surgery is scheduled for 4/6 and the hospital just called me to see about getting their portion of the 10% and they said that it is an additional $3000.  Making the total $40,000.  The hospital also explained that their normal cost for this surgery is $60,000 but that my health plan gets a large discount.  Considering that I am having lapriscopic bypass and will only be in the hosptial overnight, this sounds way high!!  Any opinions?
    
newme_38
on 3/6/12 3:31 am - Randallstown, MD
VSG on 06/12/12
WOW!!!
I'm also being told that my insurance pays 90%, with an expectation to have to come out of my pocket with about $1300.  Stating some is for the doctor and some is for the hospital.  Your post makes me want to check into it further.  when I go to my next appointment next week.  I'll ask again!!!!
oxfordcat
on 3/6/12 3:32 am - NJ
My surgeon fee was 15000.  His asst another 15000.  THe hospital was about 40000 for the stay and other fees.  The hospital is in network so they take whatever the insurance company says is appropriate.  I met my out of pocket max for the year so i had no co-insurance on the hospital stuff.

My surgeon is out of network.  So of the 15000, insurance said 3900 is appropriate.  They paid at 60%, i owe my deductible (350, plus 988$ for coinsurance). THey won't pay for the asst fee

So, it is just right. 

Good luck.  Make sure everyone is in-network....
"Something has changed within me. Something is not the same". Elphaba    
countrytat
on 3/6/12 3:55 am - OH
VSG on 01/31/12

The EOB I got in the mail said the total was 49,100$....My insurance pays 90% and my deductible is 1000$. My surgeons fee was only about 4500$ and everything is in network, so myout of pocket expenses for the surgery is 1150$, So I think I got pretty lucky!

        
Paul C.
on 3/6/12 4:04 am - Cumming, GA
 If it makes you feel better your out of pocket is about what I spent on a bike and various race gear for this year 
Paul C.
First 5K 9/27/20 46:32 - 11 weeks post op  (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03      
      First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (
PR 2:24:35)   
First Half Ironman 9/30/12 7:32:04
Nell R.
on 3/6/12 4:07 am - Hewitt, TX
This certainly makes me grateful for the insurance I have (Tricare Prime) I only paid $35


 

miranda22144
on 3/6/12 4:09 am - OK
Does your insurance not have an out of pocket max? My out of pocket is 1000.00 on top of my 500.00 deductible.  I just met my 500.00 deductible yesterday when I registered for my sleep study, and my insurance pays 90% so I owed 180.00 on the sleep study alone.  Being my out of pocket is 1000.00 I will only have to pay 820.00 for surgeon, hospital, etc. (or this is what they have been tellingme..... I hope its right :S )
akjustagirl
on 3/6/12 4:22 am
RNY on 04/09/12
I do have an out pf pocket max, however, this particular surgery is not included.  Surprise, surprise...

    
miranda22144
on 3/6/12 4:47 am - OK
OH, well that stinks.  I havent personally found that out yet, but my surgery is still 6 weeks away.  I may end up being in the same boat I dont see how they can do that if they approve to cover your surgery, you would think all the coverages would be the same! Thats irritating!
fullhousemom
on 3/6/12 6:07 am
 I was a DS cash pay and paid $7000 for my surgeon and $11,800 for the hospital. Amazing how costs increase when the word "insurance" is involved.  
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