Strange Insurance question

Grider
on 5/28/11 1:09 pm - Clearwater, FL
In one of the posts i read a woman was charged 30% of the cost of the actual band itself  by her ins ( BCBS fed) and her reg co-pay for Dr. and hospt, has anyone else ever had to pay for the actual band? I need to know this now before I get too deep into this, it cost her like $2300. ANYONE?
healthyonmyway
on 5/28/11 10:33 pm - FL

I have BCBS federal and my insurance pays 85%. I am newly banded and I haven't received bills yet but that was my original quote. Have your surgeon give you a breakdown and that way you can go in with your eyes open. At this point I will pay payments if I have to:)

      
 4/10/11 Start weight 250; 5/25/11 Surgery weight 237.50        
Grider
on 5/28/11 11:02 pm - Clearwater, FL
Oh so glad you wrote and being in Florida means we have the same Ins- as they vary from state. I have Basic and from all I read, it's the co-pays all I am liable for, except that little "You pay 30% of the Plan allowance for agents, drugs, and/or supplies" or""Medicines and other substances or products given by mouth, inhaled, placed on you, or injected in you to diagnose, evaluate, and/or treat your condition."" I also read IF the nutritionist is not for "diabetic" counseling, they don't pay either. The last class I went to was for diabetes, and it ran well over $600. I am just starting, so I will asl all  the questions, but its good to prepare what those questions would be from others experiences. I am in Clearwater, and pray all will go well. How are you doing?
healthyonmyway
on 5/28/11 11:31 pm - FL
I feel pretty good today. I got to sleep on my left side last night...woohoo. That is where my port and soreness is. Put on my sneakers this morning and walked to the end of the street but it smelled so smoky out I had to come home. But I got out none the less.
Who is your surgeon? Mine is Dr. Jessee.
Keep in touch and I will keep you updated....seriously wish I would have did this 10 years ago:)
      
 4/10/11 Start weight 250; 5/25/11 Surgery weight 237.50        
Grider
on 5/29/11 5:52 am - Clearwater, FL
Good, keep going! I did go to her seminar, but I decided on Dr Aguila because it's very close to my job, and my family is in north Pasco, so for all purpuses and all the diff medical procedures I decided on some one closer. I hear good reviews and again, distance, Yes- I will be asking alot of questions. 10 years i would have love to have done this too! You work in pinellas?
Donnamarie
on 5/29/11 2:26 am - NY
I have BC/BS in NY.  I just got a bill for $28,000.  Ridiculous.  I have been in touch with the billing person from my surgeons office.  I have been told "you won't be getting a bill at all."  It's scary not knowing what the end result is going to be.  She has assured me that she deals with my insurance company all the time and I shouldn't worry.  We'll see!

"Accountability first to yourself, then nobody else matters"

        
Grider
on 5/29/11 5:54 am - Clearwater, FL
WOW i get one of those and they will be paying for heart attack!. I'd call the ins company as well,  BCBS pays for this surgery - someone did not cross all the T's and dot the I's  Good luck! whew!
psychomom
on 5/29/11 7:53 am - China Grove, NC
I have a different ins co all together and am in NC but I will tell you financially I was shocked even though I felt I had crossed all T's and dotted all I's before surgery. When I went in a few days before surgery and was given a sheet that told me what I would owe BEFORE I had surgery in a few days I was shocked !!!! We had to take a loan out of our 401K. These are just a few things I learned and you might wanna double check on them too....
!) Deductables.... almost every ins policy has these that you are responsible for before or when you check in even for out patient. The hospital will want this money upfront so I would call your ins and be SURE what that amt is.
2) I was billed from my surgeons office AND the hospital they were not combined or all rolled into one bill!
3) often with a huge amt like surgery the hospital will want your 20-30% (whatever it is you will owe after your deductable is met) BEFORE surgery since this is not considered an emergency procedure.
I needed to bring like 1500.00 to the hospital with me for my part it was actually more but my maximum family out of pocket limit was met so 1500.00 was the max I had to pay. Not bad for my band BUT when you are not expecting that all at once it can be very stressful to come up with on the fly.
Just check and double check with both your ins and Dr about fees and costs and what you will be responsible for.:)
 
          




           
    
mira
on 5/29/11 2:32 pm - North, MA
There are no strange insurance questions, just stranege insurance companies. You have to call them and see what is exactly covered, what is your deductible,  that is is if they will actually share this info. You have yearly maximum you can be charged.
Mira
Size 8

Grider
on 5/29/11 11:49 pm - Clearwater, FL
I thought the folks at the surgeons called your ins and fixed it all up. It seems to me there should not be any surprizes. This is what scares me, when people get a $2000plus bill they didn't know about.
I know diferrent people have dfferent issues, and medical problems, but I  was trying to see what the standard out of pocket  expense ran for most people, just to be prepared.
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