Question:
Self-pay WLS patients please help
I am a 31 year old with a BMI of 35 with a few co-morbidities, but my insurance will not approve me. I have sent an appeal letter that came back denied. My doctor is going to write another letter, but the office staff has mentioned self-pay to me. He wants $3600 for his bill, but I am wondering about the hospital bill. Can you tell me about how much it will be (for a lap) and how you paid for it? Does the hospital need some money down? Any info would be helpful! Thanks! — Renee B. (posted on December 7, 2001)
December 7, 2001
Mine was open not lap but I was self-pay. The lady at the hospital was
really nice and at first told me they'd like 10,000 dollars down if at all
possible. I had only that much to put down for everyone including the
surgeon and his assistant and stuff, so I asked her if 6700 would be ok and
she agreed to it. So that's how much I had to put down and I still owe
14,000. I had to stay 5 days and get a transfusion too, so I think that's
why the bill got to be so high. Hope that helps a little.
— Jennifer H.
December 7, 2001
My daughter's self-pay lap RNY cost $18,500. It was an all-inclusive
contract fee which covered the surgeon, assistant, anesthesiology, and
hospital.
— Diana T.
December 7, 2001
Think very hard before you self-pay--complications could ruin your finances
for life. I have two tips 1) ask the hospital/dr. if you can get an
all-inclusive package that includes everything up to, say, 3 months
post-op. My surgeon offers a package that costs $24K lap and is
all-inclusive like that (of course I'm in Northern California--things are
very expensive here) 2) I say again, think very hard before you self-pay.
Can you afford it if you have to be in the hospital more than the allotted
time? What if you develop complications? My endoscopy was $3500. See how it
adds up? If you have the money--GO FOR IT. It IS cheaper than a car if
everything goes right, but if something goes wrong...it can be more
expensive than a house! Not trying to discourage you--just presenting the
"voice of reason." Now that I've presented that voice--I
self-paid (originally-long story) and I couldn't have afforded it if I had
had major complications.
— sandieguy
December 7, 2001
Many dr's have a flat fee, as you mentioned. Also, many hospitals will
give discounts and flat fees wether you're there for 1 day or 10 days. I'd
call the hospital that your dr does the procedure and find out what the sum
of the charges would be if you were self-pay. Also, tell them you want NO
surprises. I've heard of people getting extra bills for Central lines and
things like that. Get a flat fee and get the name of the people you talk
to.
— [Anonymous]
December 7, 2001
If you self pay, don't forget to deduct the costs on your yearly income tax
returns. Information about this is in the AMOS library.
— [Anonymous]
December 7, 2001
I am going to have an open VBG (SRVG) in just a few days. My insurance
company (we are self-insured) has a policy exclusion written into the
contract that says they will NOT pay for WLS surgery, they don't care how
sick you are!!! I probably could have taken legal action against them and
started to pursue that but dedcided it would be cheaper to just pay for the
surgery myself than fight a legal battle and pay an attorney. My surgeon
charged a $275.00 initial consultation fee that is not included in his
total fee. That's $3500. The anesthesiologist is giving me a discount and
charging $950.00 and the hopital bill is $11,500. I think it's worth it and
will be money well spent even though it pi---- me off that insurance says
NO!
— [Anonymous]
December 7, 2001
You could appeal the situation to your employeer who may pay the premiums.
If your a valued employee tell them your considering changing jobs to get
insurance that will cover surgery. Hire a attormney to get approved, there
are ones that specialize in this area. Get a part time job with benefits
with a company that approves WLS. Dump the 2nd job after surgery. These are
ALL options t you. Around here self paay is around $50,000 for everything,
if you have NO complications. Have insurance pay the bill....
— bob-haller
December 7, 2001
My surgeon charged 5500.00 due upfront. The hospital charged 12,000.00 -
6500.00 was due upfront. The anesthia was 650.00 due upfront. Now I also
had to have my gallbladder removed which the insurance had to pay 3500.00
surgeon fee, suppossed to pay at least a portion of the hospital fee and
all of the anesthia. They haven't paid the hospital yet. They say the bill
is pending. That included 4 days hospital stay weather I needed them or
not. I went home on the 3 morning. I had open RNY. No complications.
— [Anonymous]
December 8, 2001
Hi, don't give up yet. Although I am not self pay, I did want you to know
that I am the same BMI as you, and I was approved very quickly by BCBS ppo.
I still have to pay $7800 UP Front. Don't give up on the insurance just
yet, a good surgeons office can make all the difference on getting you
approved. You also have the other option of changing to another insurer. (
It is a heck of a lot of money, after all. ) You will find that if you are
self pay, most doc's will give you a bit of a break. Best of luck, I know
all the neato people on this site will come up with some good ideas for
you!
— Michelle P.
December 8, 2001
renee i am self pay here is my thinking my doc normally charges 3800 but
since i am self pay he is going to give me a break the hos is going to let
me make payments if i have to pay the rest of my life it will be worth it
i believe my doc is going to charge me 2000 to2800 is what the nurse said
— sandy E.
December 10, 2001
My total bill was just over 30,000 dollars. This included everything. My
hospital stay was only 3 days and the hospital bill was 24,000. I think it
depends greatly on the hospital and the area they are located. My surgery
was at MCV in Richmond Va. But I would be very cautious about self pay.
My sister in law had complications and her hospital bill alone was over
40,000 dollars. I would definitely check with the hospital and see if they
can give you some sort of contract. (Personally, I would say making
payments for the rest of your life would be well worth it.)
— sgibson71
December 10, 2001
The hospital I went to wanted $10,000 up front, and billed the remainder
(almost $6,000) because it depends on how long your hospital stay is (mine
was 3 days and was largely uneventful). The anesthesiologist was $1,100.
The surgeon was $4,200 and wanted 1/2 up front ( and pay out the rest over
a 1-year period). I traded in a life insurance policy for the pre-surgery
payments, and I'm scrambling a little right now because I'm unemployed. If
I had a regular paycheck the payments would not be extreme. Good luck with
yours - Keep smilin', Margie
— Marjorie B.
December 19, 2001
I had my surgery here in Mexico City, the hospital was around 7000 and the
doctors team like 5000. i was there for three days. it was excellent. The
hospital is The American British Cowdray Hospital in Mexico City. and the
Dr. is Miguel Herrera. I recomend him and the hospital 100%
— maureenmosti
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