Paying for RNY surgery??

I'm desperately trying to find a way to have surgery.  My primary insurance doesn't cover weight loss anything, but I do have Medicare and see that they cover 80% (of what they deem appropriate) and it has to be at a center of excellence.  We happen to have one in the town my parents live in.

I called to try to get some financial info.  The only amount I could get from the lady was that I'd need to pay about $1200 toward Medicare deductibles/copays within 90 days of surgery.  She couldn't give me amounts of how much surgery MIGHT cost or what other expenses go along with it.  She mentioned radiology and anethesiology....does Medicare not pay those people??

I have now started looking at Medical Loan places.  One, called CareCredit, the doctor I would have is on their list of people that will work with them.  Has anyone used CareCredit??  Or any other medical loan place to pay for your surgery?

I feel like this surgery is my last hope of having a somewhat normal life (I am the mom of two boys with special needs, so I know "normal" isn't exactly in the cards for us, but.....at least be able to keep up with them would be my dream)

We are deeply in debt due to my oldests medical conditions (we have had to travel out of state for his care for the last 19 years!) as well as my own medical problems.  I'm on disability and my husband works.  We dont' own anything that is actually worth anything ( 2 minivans, both over 10 years old.)  Our house is probably not worth what we paid for it 6 years ago.  It's just like so many other people in the US today.....

Anyway, I know that losing weight won't make me happy (In addition to my other medical problems, I also have severe chronic depression), but I do know that being fat makes it worse.  I was skinny up until I was probably 21 or so (after my first son was born very sick).

Ok, this turned into a bit of a pity party/vent message.  Mostly I just meant to ask if anyone has used the medical loan places you can find online.  Don't want to end up in an even worse financial situation than we already are!

Thanks all!

Shelly

 I have Medicare and they paid for my surgery.  Fortunately, the hospital I went to allowed me to make financial arrangements.  Check and see if that is the case at this hospital.  It would be better to be paying them off (at no interest) then to get a high interest loan.  Care Credit does have some interest free options in some cases if you pay it off in a certain amount of time but you have to go to a doctor that takes Care Credit and your doctor may not.

 Please, work with the hospital for the deductible. Medicare has an inpatient deductible of about $1200, and each of the doctors will be paid at 80%. Is Medicare your primary or secondary insurance? If its your primary, your secondary MIGHT cover the deductible and / or coinsurance. 

Most hospitals will work out a payment plan with you - especially prior to surgery. If you explain what the situation is, and pay, like $100.00 a month, it can be paid off in a year - that is reasonable without a doubt. Many will even allow you 2 years to pay it off, depending on your situation. 

Good luck with your quest. 

Simone

If your surgery is considered inpatient surgery and you haven't been in the hospital in the previous 60 days before your surgery, your Medicare deductible will be $1,132.  For the Medicare Part B costs (physicians' fees -- this would include the anesthesiologist and radiologists) you would owe 20% of the allowed amount, which isn't the same thing as the gross charge. Your surgeon's business manager should be able to give you a ball park figure for what you would owe him with Medicare as your primary. Your docs and hospital will bill your primary insurance first, then Medicare. It's possible your primary insurance will pay some of the Part B costs, which would reduce the amount you would owe.

I would call the hospital back and ask for the financial aid officer. If they don't have anyone with that title, ask for the business office manager, or the patient accounts manager. This person will be able to give you the hospital's policy on the availability of financial aid and payment plans. I would suggest you work with the hospital if at all possible. They probably won't charge you interest on a payment plan while a medical finance company would charge you consumer interest rates like a credit card --probably in the neighborhood of 18%.

Thanks everyone, I will try to contact the hospital again, or maybe call the doctor's office and find out who they suggest I talk to.  I did get the $1,132 amount, just not sure what the average cost of surgery is, so don't know what I need to have.

We owe SOOOO many medical bills.  I hate to owe more and not sure about affording to pay more, but I THINK we could do $100 a month, so if I can get the hospital to agree to that, maybe we can work something out.

What sort of expenses are there post surgery?  I know there is the liquid diet protien shakes type thing and then all the suppliments.  How much do you all pay for that sort of thing each month?

Thanks again,

Shelly

Shelly, I also have medicare but in addition I have an Advantage Plan suppliment insurance.  There is still a deductable but it will vary as to what plan you have in your Advantage insurance.  But it is much less than trying to foot the difference between Medicare and the actual bills.  And as others say, payments can be worked out.

In my own case, my medicare/advantage allowed me to go into the hospital and they billed me after surgery. I'm paying in small payments monthy.  I understand a pinched budget well.  lol.

If you can't work out anything for your surgery before the sign up period at the end of the year I suggest you begin looking into one of them.  There are MANY different plans you can add to your Medicare coverage. Some like my own deducts your premium payments automatically from your monthly SS/disability check.

My own is with United.  The one you see advertized on TV with AARP indorsement.  I've been really happy with it, but there are so many others that may fit you better.  At least if you can't do anything by this year's end you may before long in the next year. 

I really don't want to add to your worries but With the health care plans coming out of DC I would try to do something as soon as possible.  Judging by all other countries' National Health plans we can expect once its implimented to see many things that are important to people with our issues to be bumped to the back of the line for scarce gov. health care dollars.  My sis in law...in England...NEEDS WLS but has been refused.  I could tell you more horror stories but this is not the forum. 

Just try to get "insuranced up" if you can even if you have to pay a small monthy premium.  I would check to see if the one you choose will pay for your surg before signing up because you can't change for a year.  Also take in to consideration the issue of skin removal, because its probably going to be an important health issue later too.  That's my concern now...the skin removal and if its going to be covered.  Most will...some will not but I haven't checked with my own insurance yet.  I think it will because they've been pretty good to ok my needs.  but we'll see...

Thanks.  I have not looked into any of the Advantage plans, since we also have private insurnace.  Just can't afford the plan that MIGHT have approved me (after a YEAR of physician supervised weight loss and exercise).  I really missed the boat with backing off last year.  I should have found a way to borrow the money....  Uggg....but can't go back now!

I'll have to look into the various plans that help cover what Medicare won't.

If I can set up payments with the hospital, that would be ideal.  Guess I have more phone calls to make (I HATE making phone calls, but hate being this heavy even more!)

Thanks again,

Shelly

I have medicare also and am covered by my husbands insurance first, and I was told that I couldn't pick which insurance I wanted to use for WLS, I didn't think my husbands would cover it and wanted to use medicare and they said no, but I was lucky that they did I was in the hospital for 5 days, went to ICU the first night and my bill was 90,000 $

Medicare is secondary for me too.  I already know our primary insurance doesn't cover any weight loss surgeries/treatments/etc.  So that will be denied, but then Medicare will kick in (after it's been denied by my first insurance).

I've not heard of having to pay that much for surgery.  Did you have complications?