Newbie here...native NCen

I am a newbie to oh, and it only took me a couple of hours to find the 'home' channel. 
I would have found it sooner, but had to go to Walmart before they put an APB out for me.  I hadn't been in a couple of days. 

My name is Hope and I'm a happley married mother of three.  I work at UNC and will be attending an information session on the 23rd of this month to find out more about WLS.

The biggest concern is the money.  I have the State Health Plan, (BCBS) and feel pretty sure that they will allow me to have the surgery, but I don't know how much it will cost me after they pay.  I have heard ammounts from 10,000 to 30,000. 

Does anyone here have the SHP?  and would you mind sharing the sums? 

I'm just looking for information from the 'real' side of WLS.  I know what the Dr's will say, (It's well worth it.) but they are on the other end  of the pay scale than I.

You need to go to your HR department and ask them to explain your policy to you.  Do you have a maximum per year out of pocket?  If so, that should answer how much you have to pay.  I also have BCBS and our max out of pocket is $2500.  So far that is what I've paid. 

Let me know what you find out from your HR department.  Also, BCBS approve me and another girl within one week!!!

Good Luck!!!

Sabrina

Hi Hope,

Welcome to the NC forum and to OH. I know that I'm a bit prejudiced, but I really do think that this is just about the nicest forum on all of OH. I hope that you will find the warm support and information that I have found here. The nice surprise has been the deep friendships I have developed.

UNC has a wonderful program. Each program has strengths and weaknesses, but I know that you will find a number of people who have very successfully used the program at UNC to make their own journey. 

The suggestion to check your deductibles and limits on your insurance is right on the money. You are not likely to being spending anywhere near 10K out of pocket. 

I host a support group meetings in Raleigh and you are most welcome to join any of the meetings. You can get more information by going to my meetup site. 

I look forward to getting to know you.

 

I'm a teacher so I have the SHP and I didn't have to pay nearly that much out of pocket. I think it's been closer to $1500 - $2500. Money well spent!!

Thank you for letting me know.  You have made my day.

Ahh....Clinton.  I pass through there the first week of every August, on my way to White Lake.
We would often stop by Capt. Willie, (Christiopher's now?) and always took home a huge belly full of the best food.  

Thank's again and I look forward to keeping in touch with all my new NC OH friends.

Hope

I don't have the same insurance as you and still have not received all my bills yet (just 2 weeks out) but I do know that my insurance has a maximum amount and more than likely that is what I will end up paying. 

No matter what this costs if I become healthy because of it any amount will be worth it.

My Surgeon is worth every penny he charges, he is great!!!

Sandy

Hello!

I have the State Health Plan and I paid somewhere around $1500 out of pocket.  I only actually paid around $800 up front and I paid the hospital monthly for several months after the surgery.  Your experience may vary.

Good luck

jason

Welcome...welcome...welcome!

Like everyone else, I suggest you check with your HR department on the specifics of your plan to be sure.

I had RNY 3 years ago and i was working for the state at that time so I had BCBS. They approved me within hours (had a BM! = 65)!

Out of pocket was roughly about 1500 and I used my flex account to pay for it. Granted that was not a lump sum, but rather individual bills for the visits and tests.

Hope, I am a Walmart girl too so I love the APB! When I enter the store they say 'cha-ching Valerie is Here! and roll out the red carpet!'

Keep reading and posting and you will definitely get the real side of WLS here from all stages in the process. Take it with a grain of salt and as a gauge because all of our experiences are different and yours will be too. It will give you a true idea of what can happen.

Wishing you all the best!

Hi Hope.  I also have SHP.  Right now I am paying just my deductible and co-insurance out of pocket. Which should be around  $1350 counting the program fee at the doctor that doesn't get billed to the insurance company.  I am using flex to pay for most of it.  I do wish I had added more to my account.  My son ended up having his tonsils out and we paid close to $1000 for that.. Are you on the 80/20 or 70/30 after July 1?  Either way there is a max out of pocket that you will pay. 

I am on the 90/10 so that's why I am pushing to have it before July 1, before they take it all away.  I am not happy about our reduction in benefits.  I know we are lucky to have jobs and the state has fairly good benefits, but we usually take significant pay cuts vs what we would make out side of government work.  But I will stay.. I love my job =)

So as long as you have a BMI of 40+ or 35+ with either sleep apnea, High BP, Diabetes or high cholesterol then you shouldn't have an issue with being approved.

Welcome and good luck in your journey.

Kelly