disappointed with quote/ insurance

mom23reds
on 4/24/09 7:04 am - Bryan, TX
I went to the surgeon at the end of January regarding hernia repair and asked if we could also submit to insurance for a panniculectomy. He agreed that the pannus was indeed a problem and that removal of that would be necessary to ensure that the hernia repair wouldn't be pulled out by the weight of that excess skin hanging off my belly.

I expected insurance to balk, but they approved abdominoplasty and panniculectomy in 4 weeks. Hernia repair doesn't require pre-authorization. Then when the hospital called to pre-register me, they tried to tell me that I would have a $726.60 co-pay for the hernia repair and $1400 for the abdominoplasty/panniculectomy because it's cosmetic. I told them, "Wait a moment. I have insurance authorization that this is medically necessary. Who do I fax this to?"

So I faxed them the letter I had received. The called back and said, "Yep, your total cost out of pocket is $726.60."

I had surgery on April 8th. I haven't seen any insurance bills yet, but I'm sure they'll be pouring in soon. It will be interesting to see how much insurance was charged.

My surgery was 5 hours. It was a hip to hip cut and they did not move my belly button because they COULDN'T based on how the hernia was. My hernia was about the size of a canteloupe. They also removed 8.6 lbs of skin from my belly.

It's slow on the recovery, but I am happy to not have the belly from helly hanging down halfway down my thighs!

Good luck!
 
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