Question:
Did any of you have to come up with $$$$$ before surgery even if your insurance
covers 90% of the costs? My Hospital wants me to come up with 1500 up front. I was hoping they would let me make payments. I don't have 1500 to give to them. Because they concider this an elective surgery I have to pay the 10% up front. UGH! HELP! — Lisa T. (posted on December 3, 2001)
December 3, 2001
I was going to have to pay a $2500.00 deposit until I talked to my
insurance company and they told me that the plan I had, had a $500.00 out
of pocket limit...So all the hospital required from me was a $500.00
deposit. Hope this helps...
— roshelle P.
December 3, 2001
something else I just thought of is that my insurance said that when gbs is
approved by them it is not considered a "elective surgery" (they
do not cover anything elective) it is considered a "medical
necessity". So I don't think the hospital could classify it as
"elective". Talk to your insurance company, mine was very
helpful. When I called the hospital back with the info from my insurance
co. they changed their story and then accepted the lower deposit.
— roshelle P.
December 8, 2001
Hi, I have bc/bs of california and i have to pay 6000.00 to the surgeon and
just got a letter from the reg of the hospital and have to pay almost 400
for them .....its gonna be worth it though it was my choice to go to the dr
i choose...
— Deanna Wise
December 13, 2001
My doctors insurance just went sky high, so he now charges a flat up front
$5000 fee.
— Brenda S.
April 7, 2002
I just went to the hospital for my pre-op last week and they said I had to
put 2400 up front that day. I explained that I didn't have it and asked
about payments and got payments set up.
— vicki R.
April 10, 2002
What is your maximum out of pocket on your insurance plan. Maybe you
should inquire with your insurance co. This may help.
— Tina K.
June 23, 2002
June 23, 2002
Hi Lisa,
I just found out this week that I too would have to pay $1500 up front as a
deductible even though my Insurance company swore up and down that I would
have no co-pay for this surgeyr if it was doctor recommended by my primary
care physician, which it was. I have Blue Cross of California, an HMO. I've
mostly discovered that they are really great at diseminating misinformation
to their members. Anyway I'm calling them back on Monday to investigate
further and maybe file a complaint. I mean here we are trying to make life
changing decisions and they don't know what their doing! It is very
disheartening. So now I'm trying to figure out where I'm goin to get the
money if my IRS Refund is late. It just hppens to be $1500 dollars this
yea. I guess I shouldn't complain. Only I was hoping to save that money for
the plastic surgery for later, if this is sign of things to come. But I
think some hospitals will work out a plan with you for making payments.
You might want to try calling you hospital's billing department to see what
they say. good luck! Deb.
— Debbie H.
August 31, 2002
I recently have the same problem. I was just told by the doctor's office I
would have to pay $3000 up front to have the surgery. What do we do if we
don't have the money? I have Aetna PPO. Any suggestions?
— Penny S.
August 31, 2002
Its extremely common. I know here in my state one of the only docs who
does it in my area won't even see you for a CONSULT in order to talk
one-on-one with him unless you hand over $2000 ... period. They don't care
what insurance you have, what your deductables / out of pocket expenses
are, nothing. They figure THAT is between you and your insurance. I guess
maybe its because insurance companies are so touchy on the WLS thing but it
still seems EXTREMELY TACKY for a surgeon or hospital to not be willing to
work with you on such an important and necessary surgery. I know how
frustrating it is to try to come up with a chunk of money quickly. It can
seem almost the same as saying you needed ten times that much. Count your
blessings though, many of us are out here without insurance and at minimum
we're talking 12-15,000 and praying that no complications arise. But for a
smaller amount like you're talking, if you don't have time to save it up,
can you borrow it from friends/family, or use a credit card? (Just some
suggestions.)
— Shelly S.
September 23, 2002
I SURE WISH I HAD SUCH A SMALL PROBLEM. MY INSURANCE WON'T EVEN APPROVE AND
IF THEY DID YOU CAN BET MY LIFE I WOULD COME UP WITH $1500.00. IT IS YOUR
LIFE.....PAY THE $$$.
— JO S.
September 23, 2002
Hi, my hospital sprang this 1500 dollar fee on me 2 weeks prior to surgery
date at my preop testing. I called the insurance company and the head of
the dept at the hospital and refused to pay. They told me I would end up
having to pay it - I countered with how would they know up front what my
total bill and out of pocket expenses would be? I finally won this and
paid nothing up front. So far I have been out only my $350 dollar
deductible and am glad I did not pay the up front fee - the hospital told
me that it would not refund it to me if my out of pocket was less than
$1500. I am using that money for a cruise in January! Sometimes the the
loudest complainer gets the breaks.
— Pam W.
October 28, 2002
I am having to put up $6,700 for the surgeon and $1,175 for teh assistant
surgeon. This is because my primary insurance will not pay due to an
employer exclusion and the secondary will not pay more than a certain
percentage due to the surgeon being a non-participatory..... or not a
prefered provider. Should the secondary insurance pay even less they
indicate that they will not ask me fo rmore money. This is at San Diego
Alvarado Medical Center.
— Sandra C.
November 25, 2002
I was originally told that my copay would be $3000. Then I wasn informared
(4 weeks prior to surgery) that my surgeon requires that I pay $10,000 (the
surgeons fee) up front, at the preop visit. He is "out of
network" on all, if not most, insurance companies. They have a
secondary company that you can finance the balance with, but usually it
does not cover all of that $10,000. The insurance company (BCBS PPO) only
reimburses $1600 of the surgeon fees. Be sure you ask and know your costs
up front before you get in financial trouble!!
— Michele B.
January 16, 2003
I know your frustration, I found out today that BTC of Wylie TX has
recently changed their payment policy. Before they didn't require anything
up front. But since they were haveing a hard time getting the people to
pay after the surgery they now want $$ up front. They can't even tell me
exactly how much because I have a $400 ded. and a "No Limit" of
out-of-pocket amount. So whatever the ins doesn't pay I have to pay plus
the $400. Normally BTC would take the out of pocket amount and take a
precentage off of that plus the ded and make me pay that but they don't
know what they are going to do with me since I don't have an out of pocket
limit. However the good news is that I found out about www.carecredit.com
this is a medical credit card that you can apply for. You can apply for
the exact amount that you need upfront and then pay the card off. I found
a Dr. that would pay the interest fees for one year with this method. I'm
looking into it. Good luck
— jovialkiki
March 20, 2003
3/20/03
I have to pay my surgeon a $3000 down. If my insurance pays then he will
reinburse me. I can't compain I just want to feel better and stop the
carousel. I can't afford it but I can't afford to die either. I have kids
to raise. Regina Pinder
— Regina P.
March 20, 2003
Lisa,
I had to come up with $3,000.00 out of pocket and then I had to travel out
of state to get it done, had to go to California to have surgery was out
there for a total of 14 days, so that was also added expsense there. In all
total I think I spent about $4500.00, It took me a couple of months to save
up for surgery, (Eating Top ramen) as my last couple of meals just to make
ends meet but I was determined. I figured it's allot better shelling out
the $3,000.00 the then the self pay amount of $18,000. I prayed every day
and did so much over time it was unreal.....Hang in there you'll get
there..... On the trip back from California, after surgery we must have
been riding on fumes ... cause we were truly broke afterwards.
Much love and hugs.... Post op 10 months down 127 pounds
Just an FYI, I would do it in a wink of a eye..... Save , Save, Save..... I
wrote it all off on my taxes and I'm actually getting money back this year
! An added bonus !
— tannedtigress
March 20, 2003
Lisa,
I had to come up with $3,000.00 out of pocket and then I had to travel out
of state to get it done, had to go to California to have surgery was out
there for a total of 14 days, so that was also added expsense there. In all
total I think I spent about $4500.00, It took me a couple of months to save
up for surgery, (Eating Top ramen) as my last couple of meals just to make
ends meet but I was determined. I figured it's allot better shelling out
the $3,000.00 the then the self pay amount of $18,000. I prayed every day
and did so much over time it was unreal.....Hang in there you'll get
there..... On the trip back from California, after surgery we must have
been riding on fumes ... cause we were truly broke afterwards.
Much love and hugs.... Post op 10 months down 127 pounds
Just an FYI, I would do it in a wink of a eye..... Save , Save, Save..... I
wrote it all off on my taxes and I'm actually getting money back this year
! An added bonus !
— tannedtigress
April 5, 2003
I am going with Dr. Derrick Martin in Dayton, OH. He charges nothing as
long as your insurance covers. The only thing I am responsible for is a
$200 co-pay with Humana, and that will be billed to me by Middletown
Regional Hospital. Another surgeon I considered in Georgetown, KY (name
unknown) would have charged me $5900 up front. A surgeon in Edgewood, KY
wanted $30 for an informational packet, $95 for the Psych Eval, $125 for a
dietician consult, and then $1200 for 2 years of aftercare. The aftercare
included a membership in a gym. PTL I chose Dr. Martin. I don't know about
everyone else, but I'm not able to afford a lot of $$ out of pocket. Also,
just a word to the wise: be very careful with Care Credit...
— Scott B.
April 15, 2003
I switched surgeons in order to keep from having to pay $4500 up front for
using an out-of-network surgeon. My advice would be to be careful because,
if a surgeon does other types of surgery besides bariatric, they may be
considered in-network by your insurance company for the other types of
surgeries, but out-of-network for bariatric surgery because they have
decided to opt out of the insurance network for their bariatric procedures.
That's what happened to me and it was a confusing mess! For almost a
month I was back and forth between the insurance company, which firmly
maintained that my surgeon was in-network and that my surgery was 100%
covered and the surgeon's office, which kept insisting my insurance company
would only cover $1500 of the $6000 surgeon's fee, which is why I would
need to pay $4500 up front, all the while me not knowing whether I was
going to end up having surgery through that surgeon's office or not and
wondering whether or not I should be making arrangements for a medical
leave with my employer, etc. All has turned out well, though. I found
another surgeon that isn't demanding $4500 out-of-pocket. However, it was
still VERY frustrating to go through the entire approval process only to
receive a letter asking for an excessive amount of money that most people
do not have--thus the very reason behind health insurance--and then to be
set back by having to go through the new surgeon's pre-surgery regime.
Basically, it put me back at square one. But I made a few choices that
turned out to be the right ones and I got lucky. In the end, I think the
decision to switch surgeons may turn out to be the best decision I made in
the process.
— Amanda S.
April 15, 2003
Had to pay $3000 up front plus $200 psych eval and $125 for the original
consultation.
— sandy L.
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