Need some advice plz.

I wanted to ask anyone that know about insurance that can help. I have private insurance. They told me they will cover the wls as long its med nec. But they wont pay for it all. My insurance rep. said that she can find programs that can help paying for this also. They have this Surgical & Hospital Expense Policy, I will like to tell you what they will pay and let me know what ya'll think. $50,$75,$100 Daily Hospital Room Benefit , Up to $1,450 in Surgical Benefits....(1,000 for surgeon benefits), (Ass't surgeon up to $200), ( anesthetic fee $250). Misc. Hospital Expense Benefit ,(No Deducticle; pays 80% of incurred expenses,  and Out patient Hospital Benefit ( No Deductible pays 80% of incurred expenses...pays up to $200 per occurrence. So if you  can understand this and it sound ok Or I need to find something better plz let me. So can start looking now.

Hello Lady. I can't really tell you what would work best for you because I don't what your financial limitations are.  I would suggest that you get a piece of paper and make a column for each program.  Under each program, list what your out of pocket expenses will be and your premium.  Then compare and determine which works for you.  Personally, I'm not famaliar with privately owned insurance. Good luck. MM

it all depends are you going to get a contracted rate or is this with the charged amount? thats really importan because most insurance companies have a contracted rate thats anywhere from 25-60 percent of the charged amount and when you are talking hospital stays and surgery thats a huge difference

thank you for ur responses. this insurance thing is so overwhelming. I just dont know nothing about this and really lost to what your saying. but i write down what everyone tell me so atfer my seminar next week . Im see it the surgeon take it then i se what  they say . I just going to have to give her a figure of how much i think all this cost and see whta my rep say and how much i will have to spend out of pocket. Cuz i really dont have alot.

i just want to clarify what i am saying... i work for an insurance company and i forget that its almost it's own language sometimes... Most people have no idea how there insurance works so don't feel bad. What i was saying before is that most big insurance companies have contracts with the dr's and hospitals that make up there network thats where the terms in and out of network come from. If you go to a dr that they have a contract with then even though the dr would usually charge let's say 500 dollars for a certain procedure because he is contracted with the insurance company he will charge 500 but accept 280 (just for example) and write off the rest as part of his contract with that insurance company. So even though th average gastric bypass surgery if paid out of pocket is about 30,000 most insurance companies will pay about 60% of that... maybe this is all still confusing but it will make a big difference in your out of pocket costs if your insurance company has contracted rates with the dr's... when you meet with the dr i would ask them to do "a pre-determination of benefit's" they will lay everything out for you and they should be able to give you a fairly good idea of what your costs of course nothing is for sure untill its over because anything could come up during the surgery or your hospital stay. sorry about the long response hope that helped a little