Surgery/Hospital Bill

[TonyaSitler]

My VSG was covered 100% by my insurance. We had already met our deductible for the year. I was just going over my explanation of benefits we got in the mail and OMFG!! The hospital/surgeon billed my insurance for $55,000. That's freaking crazy!!!

[Tesserae]

yup, mine was nuts, too. thank God for our PPO.

[mommyle]

Wow! Our insurance covers it but my out of pocket is still $5100. (and I thought that was steep) On the plus side, since we are maxing that out now, I won't have to pay for any follow-ups or anything else in 2013.

[ACE]

Mine was through medicaid and it was i believe 49,999.00 I was shocked too

[mrswhitty81]

I'm going self pay, from what my dr said is when they bill insurance they charge almost double of the self pay total. its crazy to see how insurance works.

[TonyaSitler]

The agreed upon amount ended up being $12,000. That's still crazy!! For 2/3 of that I could have gone to Mexico for it.

[jknox65]

Mine was 42k and then it was reduced to 21k. After that reduction they said my portion was 1400 and they discounted that. Have yet to get the actual total of what I will have paid but I think it will be around a grand. It is absolutely crazy what they bill out knowing it will be reduced. Why not just bill it at the rate you are going to get in the first place.

However my heart attack two years ago was 49 after reduced billing. SO I think this investment will pay off greatly.

[gettingsleevedintx]

The hospital billed my insurance company over $96K, the final amount paid by Aetna was just over $24K. This was just the hospital bill, not the surgeon or anesthesia! In addition, the billing was so screwed up it took the hospital nearly 4 months to bill it correctly and to ge the claim paid, what a frigging headache that was! My out-of-pocket cost was $5K, but it was totally worth it! I'm almost 5 months out and down over 65lbs. Only 15 more pounds to my goal weight! Woohoo!

[mark!]

So I'm guess it's common practice for insurance companies to have the amount reduced? I say this because my coverage is apparently capped at $25,000 for bariatric surgery, and seeing these numbers, kind of starting to sweat a bit.

[TonyaSitler]

Hopefully that means the agreed upon amount that the insurance will cover. They don't pay the billed cost.

[tmclenn]

That is crazy, no wonder the healthcare system is going broke! How can they do it in Mexico for 5000.00? Makes me question what costs are being charged!

[Cheri]

One more thing that is wrong with America......insurance ripoff!

[healedheart]

I am self pay and mine will be $12k but most doctors in my area were in the low 20's. I am driving about 3 hours to get this price. I wanted to do Alverez in Mexico but they really have no payment options other than cash. It would be $9k with them so I figured to would be better to stay in states and save travel price. Mine also includes one year followups.

[Gwyn]

Mine was about 36k. I paid a total of 1,500 for the whole program including surgeon visits, nutritionists, follow-ups, etc.

[momoftwoboys]

Mine was 100% covered, but they did send me a final bill my insurance ended up paying $11,000 for the procedure. The only thing I had to pay for was my phone and tv and that was $25.