Cost

Hope someone can shed some info. I have actually been approved for RNY surgery however I went out of Network and my insurance will only pay 60% which I was told that would leave me paying about $30,000 out of my pocket. If I do in network insurance only covers for lapband and the surgeon I would have to go to does not have a good success rate. What I am trying to ask I guess is does anyone know what the total cost of the surgery actually is. My first try was $75,000 and I would be responsible for 40% of that. I don't even make $20,000 a year lol lol lol anyways any help or comments would be greatly appreciated. Thanks

I had anthem insurance and i only had to pay about 2,600 i think the total cost was around 30,000. I had surgery at St. Vincents in Carmel. I have a friend who had Siho and her cost was about the same. Good Luck

Hello Donna, Im by no means an expert but there are alot of people who have lost weight with the band. Go into the chat room at night and you will see alot of people who have and they might be able to offer you some insight into your journey. Good luck.

Thank you for the information. Did you have the lap band done? I would not mind the lap band if I did not have to have the procedure done at Bloomington Hospital. They only have one surgeon who does the procedure and there has been many complications with his patients and I have been told by several do not go there. As much as I would like to loose weight I still value my life too much too just go and have it done because that is the only place insurance will pay. Again thank you very much for your information appreciate it.

A women in my pre-op class is having to pay TOTALLY out of pocket (after 3 appeals and denials) and she said it's $25,000. So I have to say that you paying $30k for only 40% seems a high...but different place charge different amounts...or I could be missing some information too.

I just got my hospital bill. It was for just under $30,000. The surgeon's bill, the anesthesiologist bill or any other nick nacks have not come yet. Before surgery, the clinic said that I would be responsible for about $6500, more or less. And I'm in network. The clinic did a great job of explaining exactly what I was going to pay and why. (Deductible, not covered, etc) The pre-op bills are coming in and I've been paying on those, too. Good Luck Rob

Hi Donna, The surgery itself isn't that expensive; its all of the other stuiff (hospital stay, Surgeons fee's, anesteologist fee's, recovery room fee's, RX's, etc) that make it add up very quickly. My total hospital bills were well over $60,000. However, it is all a monopoly and the hospitals end up writing a lot of it off because of insurance regulations and agreed amounts. Although my bills were over $60,000 I know my insurance company did not pay out nearly that much. I agree with the other post to check into the lapband. I have heard some great success stories with it. Best of luck on your difficult decision!! Jaimee

Donna, You might want to check out your medical benefits booklet. On most plans there is a maximum out of pocket for each year that you have to pay. Your deductible is added into it. For instance....my insurance pays 80/20 on weight loss surgery. My deductible is $50 and my maximum out of pocket per year is $500. So, even though it looks like I will pay 20%, I am only going to pay a total of $500. Once you reach your maximum out of pocket expense, the insurance company pays the rest at 100% or at what ever discount they work out with the hospital. My insurance plan is exceptional and most require more in the yearly maximum but it is worth it to check your plan and see. The yearly maximum was designed to insure you do not have a medical expense that could wipe you out. Sort of an insurance on your insurance. The insurance companies also have insurance on your insurance and if you go over a certain amount, they also get reimbursed from their reinsurance. Good Luck! Marianne

so in network you only have one dr to even think about and no choice?

Yes Sweety if I stay in Network there is only one surgeon to choose and one Hospital and only does lapband.