United Healthcare and Gastric Sleeve

Hello everyone,

I am having sleeve surgery next Friday. I know UHC covers 80% of the surgery and was wandering if anyone who has UHC and has had the sleeve done would share what their total out of pocket expense was. I went to the Hospital today and they told me my part on day of surgery was around $1200. I should have asked more questions but assumed that was just my total part of the bill but now thinking that's just a deposit and possibly might get a huge bill later. There's also a disclaimer at the bottom that says this estimate is facility charges only. Physician, Anethesia..., and all other prof. provider fees are bills separately... Any input would be greatly appreciated.

Well, if you ask your surgeon, the hospital, the anesthesiologist, radiologist if you will be having an upper GI afterward to test for leaks, etc. what they estimate the total cost to be, you can do the math to figure out what your 20% will be.  But they are just giving you an estimate because there are variables they can't predict.  Like, usually they bill a certain amount per hour of OR time.  They can tell you the surgery usually takes 60 to 90 minutes but there is always a chance something will cause your surgery to take longer, which would increase that cost.  They bill you for all the meds you get while in the hospital, but they have no way of knowing for certain how many doses of pain meds you'll end up requesting and whether or not you'll be really nauseous and needs meds for that or for something else.  They can tell you the average number of nights patients stay after your surgery but if you have a fever or some other problem, you might need to stay an extra night, which could increase the cost a lot.  Or you might even end up needing to stay in ICU a night, which costs a lot more than a regular room.  I get that it's very hard to plan when you don't know exactly what it's going to cost, but there really are a lot of variables that are very hard to predict.

I got my DS through UHC and I had to pay a deposit to the surgeon, but got it back 2 mos later.

UHC has hundreds of plans and each one can have different benefits.  It your cost may also be impacted on what the hospital and physicians charge and any contractual terms.  Your costs may be wildly different compared to someone else with insurance administered by UHC.  The only way to get a decent estimate of your out-of-pocket cost is to call UHC and have them estimate your benefits (will depend on deductible, out-of-pocket max and covered benefit).  You also may need to speak with the hospital and surgeon.  Also, know that any unanticipated complications could increase your cost.  The key is your individual out-of-pocket max on your policy.  That is the most you will be responsible for paying, regardless of the final cost of the procedure.  Good luck.

Maryann

UHC plans depend a lot on your employer.  But if you have a max out of pocket for a year, I would plan on reaching that.  I certainly did ($3500).  

Thank you for the replies. I should have asked more questions. I know that UHC pays 80% and I have to pay 20% but I don't think there is a cap on how much I have to pay. I'll have to make some phone calls next week.