The numbers are in!!

sanguinarythorn
on 8/28/09 10:48 pm - Newport News, VA
So, all the claims have finally processed through my insurance (Aetna) and here are the final numbers.

Before insurance, all the claims for the surgery, hospital, surgeon, anesthesia and everything in between added up to:

$18,238.76

After insurance, all claims considered, I owe a grand total of... (drum roll please)....

$484.17 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

All I have to say is, thank GOD for private insurance. Here's the breakdown:

Anesthesia:

Before Insurance: $2,535.00
After Insurance: $86.14

(I think they submitted a double claim, I'm going to have to check into this)

Hospital

Before Insurance: $12,663.76
After Insurance: $274.13

Labs:

Before Insurance: $40.00
After Insurance: $32.00

Surgeon:

Before Insurance: $3,000.00
After Insurance: $91.90

Grand Total out of Pocket: $484.17
(deactivated member)
on 8/29/09 12:33 am - West Central FL☼RIDA , FL
WOW you are lucky.
I'm still waiting to hear anything and I don't expect to be covered at all....but it will be a nice surprise if it happens.

Any tips you can share on how you got approved would be appreciated!  I have Aetna too.
Thanks!
sanguinarythorn
on 8/29/09 12:36 am - Newport News, VA
From what I hear, submitting to Aetna is like a shot in the dark. My surgeon's office said they don't seem to have any rhyme or reason to their approval process. Some people that have documented medical necessity don't get approved, and others that just want it done get approved. So... even though I didn't have any documented medical necessity, I submitted a heart felt letter with some pictures, and... low and behold- they approved me. I wasn't expecting an approval AT ALL. I would say talk to your doctor's office and see if they have any experience working with Aetna.
(deactivated member)
on 8/29/09 12:46 am - West Central FL☼RIDA , FL
Just sent you a PM............
Road Less Travelled
on 8/30/09 2:18 pm
VSG on 12/13/10 with
what did you have done?

I too have Aetna and the paid for the band and breast reduction - and I'm going to try for the paniletomy (and I"ll pay for the delta in casts for a Tummy tuck)

July 2007 = lap band ...Sept 2010: lap band removed....Dec 2010 VSG
HW: 283... VSG SW: 244 ..  got down to 170 -- now at 193 and "back on track" ....GW: 155

sanguinarythorn
on 8/31/09 11:04 am - Newport News, VA
I had a TT, but insurance covered a panniculectomy. My surgeon did everything anyway.
Cindy F.
on 8/31/09 4:33 am - Monterey Park, CA
VSG on 09/18/07 with

Wow how lucky is that to only have to pay 484.17.  My insurance will not pay any of it.  Boohoo

That is great news for you!!!

Hugs

 Cindy F  "Life is not about waiting for the storm to pass... It's about learning to dance in the rain" 
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