Question:
Has anyone self-paid for WLS, but had the cholecystectomy covered by insurance?
If so, how much did the insurance payment for the gallbladder procedure offset your overall costs for the WLS? My HMO says that I can get part of the hospital stay, anesthesia, etc. covered because of the cholecystectomy, but everyone is vague so far about just how much of a savings we're talking about. I'd love to hear from people who have actually used this tactic. Thanks in advance! — Tally (posted on March 28, 2002)
April 3, 2002
I didn't get any responses when I asked this question, but I thought I'd
share what I learned from my surgeon's office today. I was absolutely
amazed when the doctor (and his insurance specialist) told me that I can
cut the cost of my surgery in *half* by doing the gallbladder surgery at
the same time as the RNY. Wow! I would have been excited if they'd told me
I'd be able to knock $5,000 off the total price, but instead they told me
that my self-pay price for surgery will be about $12,500 to $15,000 TOTAL
instead of the regular $25,000 to $30,000. Quite a difference! I was
skeptical, but they assured me that they've had this situation several
times and that's the breakdown that has typically been worked out with my
HMO. Apparently, when insurance is covering the gallbladder surgery but not
the RNY, my HMO will pay the total cost of anesthesia, one night in the
hospital (out of the two nights my doctor says is typical for his RNY
patients), and a good portion of the surgeon's fees. I'm ecstatic about
this news. I scheduled a surgery date on the spot!
— Tally
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