Question:
If there were to be any complications after, would my insurance co. Pay?

   — [Anonymous] (posted on January 15, 2001)

January 15, 2001
I don't post very often, but I was self pay and had complication. I did not try to get insurance approval. Two weeks after the surgery I developed abdominal abcesses and was in the hospital for 8 days. The total bill was 26,000 dollars and the insurance payed without question. I had surgery out of town and was hospitalized in my home town. Good luck.
   — carol F.

January 15, 2001
I had a small complication at about 3 weeks post op. I was having severe pain in my stomach and they thought my gallbladder was going. Turns out it was just a pulled muscle but I was readmitted for 3 days for all the testing. My insurance paid for my open RNY 100% and paid for the additional hospital stay and testing at 100%. I hope that you don't have any complications. Good luck
   — enjo4

January 15, 2001
I was admitted four times post op because of complications...and had 3 endoscopies, MRI's,x-rays, flouroscopies, one procedure for a filter, and another surgery. My ins covered everything but my co-pay, which was 500.00 for each admission. This would be a good thing to perhaps talk to your ins co about...they would have to cover any complications...but do you have a deductible, or a co-pay that you may be responsible for, if you were readmitted? These are some of the questions you might want to ask...Good luck. (by the way...I'm just fine now!!!)
   — lynne S.

January 16, 2001
I think this is one of the big dangers of going self-pay. You may have saved up enough money to pay the "standard" doctor and hospital fees, but what if your surgery doesn't come out exactly as expected? If you have to spend additional nights in the hospital or (heaven forbid!) go in for additional surgeries, the costs can be huge. I don't think your insurance would have to pay for these things, since they didn't approve your hospital admission originally. They might pay some of it, or they might reject the whole thing. If you had some later complications, like a hernia that showed up months after the original surgery, you might have better luck getting your insurance to pay for that. But, like I said, this is the big risk of going self-pay, and is the reason that some surgeons like mine will not even operate on self-pay patients. On the other hand, I have heard of a few surgeons and hospitals that put together a "package deal" for self-pay patients where the price stays the same regardless of complications or number of days in the hospital. You might want to try to find one of those surgeons. Good Luck!
   — Lynn K.