$60.000.00 limit for life

Been doing the 6 month diet from the dr and two days ago United Health Care nurse called to remind me that my 6 months was almost over and it was time to get things moving. So today I contacted a surgeon to set up an appointment. They got my info and check to see if I was covered. I got a call later that said "well yes you are but no we can not do your surgery cause you have a limit of $60,000.00 and sorry but our dr knows that it will be way over that amount for life. The surgery is $37,000 and then there are test in the furture like blood work and that does not even cover should you have any complications after the surgery so SORRY but we can't help you.  I then tried to call back two times to get more info from the office manager cause she told me I could if I would like and each time they told me she would call me back in 10 minutes well no call. This surgeons office told me that no dr would take my case as it was just not something they will risk knowing that it could go over that amount.  So whats a girl to do???????

Thats crazy!

I found out last week from United Healthcare after doing the whole 6 month thing, tests and all that my husbands company has a wls surgery exclusion.

So I'm doing it as a self pay, different doctor same city $16000 for RNY , if there are complications I pay 60% less but I don't have to have money in an escrow account for this.

I'd look for a new doctor.

Lifetime coverage limit of $60,000? I have never heard of such a thing (not that I'm an expert or anything). Skip the surgeon's office and call your insurance company directly to find out more about this.

I agree, 60K is nothing when it comes to medical expenses, I have never heard of an insurance company having a lifetime max that low.  we have cigna, and our max is unlimited! Thank the good lord!  Also seems odd to me that the surgeon would care what your max is, as long as the ins agreed to pay for what he is doing, know what I mean?  I mean, lots of people switch insurances every few years or so.

I was not suprised I have been dealing with this crap for over 5 years now trying to get approved. Each time when it looks like it will happen something sets me back. Last time I went for 9 months waiting and jumping through all their hoops only to find out right before getting a date that there was a clause that nobody could locate 9 months earlier. Then got a new policy that said again it would cover had them check for clause said not one and that it covers.
Only now that I am ready to find the surgeon they find that the employer wrote a limit of $60,000 for life on it . So now I have to find someone willing to take me and I am a revision from a VBG.

Hello-
I agree with the posts above! You need to find a new surgeon. There are plenty of good surgeons in Texas (as I see this is where you live). I can help you find a good surgeon - I work for a company that helps cash-pay patients and their surgeons be covered for complications in that case that they happen. We approve only the best surgeons in the country and then they are able to package complication protection into the price you pay for surgery. This means that if a covered complication occurs in within certain time frames, you will not be responsible for the financial cost of the treatment of those complications. Please email me and I'd be happy to direct you to one of our surgeons.

Also, it is very common for insurance companies to have lifetime limits to what they will pay for surgery, but usually the limit is much lower than $60,000. Most qualified surgeons will be able to help you stay within the limits of you plan and/or set  you up with a financial protection and/or payment plan if there is some reason that you go over that amount.

I've worked in Weight Loss Surgery for a long time and would happy to help you out in any way that I can. Please contact me directly for additional help.

Best,
Billie

60K for a lifetime is not much....this seems odd.  I am no expert but have taken care of my parents through a LOT of health issues and found that most insurance is a 1 mil or 5 mil lifetime....