i was just wondering if there is anyone out there that has tri care prime, we are retired military, i just found out that tri care prime does not cover the nut counseling so i have to pay out of pocket with that, so i was wondering if anyone has had it done on base? i know they have lost of different types of nutritional counseling done on base at the base gym as i have gone to one for a dibetic class a long time ago...
i have my first drs appt tomorrow and will find out for sure what this $600 out of pocket charge if for me...but i think its for the nutritional and maybe the phsy eval..

thanks for any help on this matter, it seems like there are quite a few of us on here that tri care prime.
debby

so i was wondering, have you had to pay anything out of pocket except for the co-pays of $12.00? i am also on tri care prime and i am just starting this, and i got from my surgeons office, an estimated amounts due that are out of pocket, they said $612 for the surgeon for his deductalbe and what ever the anesthes is that is not covered or what ever thier deductable is...and it said i had a $25/00 co pay for the hospital overnight stay which i knew i had that but....i am not sure about the other $600 as a deductable to the surgeon.
i only have 2 drs to choose from and this one is one of them,

thanks so much for your help,
debby

I am brand new to the forum as a member.  I attended my first information session on weight loss surgery yesterday and I am ready to get the ball rolling.
I already know that my insurance does not carry a "bariatric rider" to the policy, so I will be a self pay.
I would like to have the RNY.  I am wondering if anyone here has been a self pay for this procedure.  If so, how did you go about financing it? What were your costs, etc?  I realize that every case is different and costs will vary, but just lookinf for some insight into this process.  Thanks!

Hi Dana,

It varies from hospital to hospital.  I had my surgery in March of '09.  My MOOP was $1,800 and I DID NOT have to pay up front, only a small portion of it ($238) to get my surgery schedule.  After surgery, I got billed from various people (hospital, anesthesiologist, etc) and I paid the $1800 after the fact.

All three of my children have also had surgery (in 2010).  They went to the same surgeon, same hospital.  For them, they required the payment IN FULL before they would schedule the surgery.  So their policy changed within a year !  I guess it was because people were not paying their bills after the fact.

You should ask that question Tuesday for sure because the insurance coordinator will be able to tell you!

Good Luck !

Nan 

 

Ok, I've met my deductible of $630 and some of the 20% that goes toward my maximum out of pocket.  So, my MOOP balance is about $3,000.....how does that work?  Will my dr's office require that I pay that up front?  Or will I be billed after surgery?  I'm using Dr. Nick Nicholson, if that helps, and I'll be seeing the ins. person there on Tuesday, but just wanted to have an idea of what to expect when I go!!!  Thanks a bunch!