Money questions for people with insurance

 Ok, I have BCBS IL. My obesity center told me what I would owe for the hospital fees, and I am ok with that, but boy am I scared about the surgeon fees. If the procedure was already approved by the insurance, would that mean the insurance will be picking up some of the surgeon fees too? Or is that totally different? I think I have confused myself....my consult is tomorrow, but I wanted some insight before I go, this will help me with my questions list I am making. You all always have so much info!

Not sure my I paid nothing out of pocket my insurance covered everything . U will see w/ wls everyone's policy is different some ppl have to
Pay a lot and some don't... Check w / ur policy

Your insurance either covers the surgery or it does not... that means the surgeon. The hospital charges can vary from simply a deductible to only a certain percentage covered. Simply call the 800# on your card and ask for a list of what exactly you will be responsible for. The surgeon's office will usually do this for you. 

I have Independence BCBS - EVERYTHING was covered, except $250.00 paid to the hospital the AM of surgery and my doctor co-pays of 20.00 for specialists. 

My surgeons office was able to tell me exactly (pretty close at least) how much his fees would be.  The hospital was also able to tell me.  Both were very close to the correct amount - I think I got a refund of around $50 from the surgeons office.

Give them each a call, they will be happy to help you out! 

Thanks everyone! I just wanted to be sure that the surgeon fees would be helped by the insurance covering my surgery. They quoted me the hospital fees a while ago before I ever got approval for the surgery. So hopefully they can tell me more tomorrow.

 i also have bc/bs of ct i had to pay $100.00 co-pay.

 That was all? For the surgeon fee?

yes thats all i paid $100.00 paid it to the hosp,all else was paid for 100%. i had it done 1 week before i was 65 y/o so the ins whould pay for it ..

 

Jewelz13 TX Member Since: 05/16/12 [Latest Posts]

Post Date: 7/23/12 5:01 am  CHECK YOUR EXPLANATION OF BENEFITS PACKET UNDER BARIATRIC SERVICES.  YOU CAN ALSO ACCESS YOUR EOB ON-LINE ON YOUR INSURANCE WEBSITE.  IF IT STATES PRE-AUTHORIZATION REQUIRED, THEN CHANCES ARE IT IS.  THERE WILL BE SOME REQUIREMENTS YOUR INSURANCE MAY HAVE YOU DO BEFORE SUBMITTING FOR AUTHORIZATION.  TIME IS OF THE ESSENCE BECAUSE MOST INSURANCES REQUIRE A MEDICALLY SUPERVISED WEIGHT LOSS PROGRAM WHICH COULD BE AS SHORT AS 1 MONTH AND AS LONG AS A YEAR.  SO IF YOUR CONSIDERING THE SLEEVE YOU MAY WANT TO START THIS WITH YOUR PCP.  YOU CAN SEARCH BARIATRIC REQUIREMENTS FOR PRE-AUTHORIZATION ON THE SITE TOO.  MY REQUIREMENTS WERE AS FOLLOWS: -BMI OVER 40 WITHOUT COMMORBIDITIES OR 35-39.9 WITH AT LEAST ONE -6 MONTH MEDICAL SUPERVISED WEIGHT LOSS PROGRAM (COVERED $45 COPAY/EA.) -PSYCHIATRIC EVALUATION($45 COPAY) -TWO YEARS OF MEDICAL DOCUMENTATION SHOWING BMI OVER 40(FREE UNLESS THEY CHARGE) -NUTRITIONAL CONSULTATION (NOT COVERED $300) -CONSULTATION WITH BARIATRIC SURGEON SHOWING MEDICAL NECESSITY($45 COPAY) -MEDICAL CLEARANCE FROM PCP FOR SURGERY ADDITIONAL CHARGES $500 ANNUAL MEDICAL DEDUCTIBLE $5000 ANNUAL OUT-OF-POCKET PROTEIN SHAKES (NUT SAYS IT WILL COST ME AROUND $100/MONTH) VITAMINS(VARIES)   HOPE THIS HELPS!  LET ME KNOW IF THERE IS ANYTHING ELSE I CAN HELP YOU WITH

 This does help. Thank you!