Weight Loss Surgery - Watch Out for Those Nickels and Dimes!

 
As I've mentioned before, my health insurance company does not pay for weight loss surgery. That means I had to cover the entire cost of my gastric sleeve on my own. Before making the decision to go ahead with the surgery, I talked to my bariatric health center, and they quoted me a flat rate for the procedure. It wasn't cheap. In fact, it was enough to make a light sweat break out on my forehead. But it was doable.

I obtained a medical credit card and scraped together some money I'd made doing freelance writing and editing projects. Then I paid the center. It was done. My finances had taken a big hit, but at least I had paid everything that was due and could get started on the process of getting healthy again, physically and financially. Or so I thought.

A few days after I got home from the hospital after my surgery, unexpected bills began to roll in. I hadn't yet met my insurance deductible, so I had to pay for my cardiac stress test and my endoscopy, which were supposedly insurance-covered procedures, out of pocket. There went another $1500.

Then I got a bill from the anesthesiologist. Yes, the billing department agreed, they had a contract with my bariatric surgeon, but their contract stipulated each procedure would take only two hours of service. Due to complications, mine had take three hours and 51 minutes. I wrote them a check for $285.

My next bill was from the imaging department at the hospital, where I'd swallowed a vile dye they could track through my stomach to make sure the staples weren't leaking. That one was for $100.  Then came bills from the hospital laboratory and pharmacy. I'm sure there will be others.

I'm still not sorry I had the gastric sleeve. But if I had it to do over, I'd be a much more savvy consumer. I'd ask about extras that might turn up on my bill and not naively assume that the flat rate really did cover the whole thing.

If you're considering paying out-of-pocket for weight loss surgery, speak to the accounting department at your bariatric health center and ask some pointed questions:

• What, exactly, does the flat fee cover?
• What, exactly, does the flat fee not cover? (Ask specifically about anesthesiology, room and board in the hospital, lab costs, imaging services, laboratory, and pharmacy.)
• What, on average, do patients end up paying besides the flat fee?
• Can the surgeon safely take any measures to minimize my out-of-pocket expenses?

If you have more than one bariatric health center in town, do a little comparison shopping. But above all, set aside more money than you think you will need to cover unexpected expenses or to keep yourself on track financially if the recovery period keeps you off work for longer than you'd anticipated.

Weight loss surgery will never be cheap, but with a little forethought and planning, it doesn't need to wreak financial devastation, either.

Comments

[EMR]

I really think BP surgery should be included in all insurance policies. Not everyone needs to get it - or even deserves to get to take advantage of this surgery, but those who do deserve it and are dedicated to taking care of themselves and bettering their lives, should have the chance to get this procedure without spending every penny they have.

[Debra Stang]

Hi EMR,
Thanks for your supportive words. I couldn't agree with you more. And actually, when you figure it up, it would have cost less for my insurance company to just pay for the surgery than for another twenty years or so of medications, tests, and procedures due to weight-related poor health!
Debra

[Day Belly Blast Diet]

My girlfriend is overweight and i can tell she's very insecure about her body.I want to try and convince her to get weight loss surgery but i don't want to seem mean or that i only care about her weight

[Debra Stang]

Some readers may feel differently, but I would advise you not to bring up weight loss surgery with your girlfriend. If she's already feeling insecure, that could really hurt her feelings. And it's not like the surgery is a secret. I'm sure she knows about it, and if she's interested, she will probably bring it up to you. Hope this helps.

Best,
Debra

[Jen]

I'm shocked that your insurance company did not cover your procedure. I had the procedure done almost 6 weeks ago, I was 266 pounds and did not have diabetes, high blood pressure, or most of the other diseases/conditions that being overweight can cause. The only condition I had was sleep apnea and my insurance covered the procedure at 90%.
My research showed that the procedure could cost anywhere between $12,000 to $30,000 so I set aside $3,000 in case I was on the high end. I had to stay at the hospital an extra night after surgery and I ended up back in the hospital a week after the surgery for 3 days. I have received and paid about $750 in bills for my portion, but they are all from the surgeon, radiology, anesthesiology, pre-surgery tests, etc.
I am scared to death of the day I come home and find the bill for my portion of the hospital stays. I just have a feeling that some loophole is going to far exceed my little $2,250 stash I still have set aside.
I'm curious, did you appeal the insurance company's decision. I am told that many people have had their procedure covered after appealing, sometimes more than once!