WLS Cost
Hi! I’ve been a lurker and have learned so much from everyone. Soooo,
thank you! My question is this: My insurance will not pay for my
surgery. If the same thing happened to you, how did you manage to
cover the costs?
Thank you so much-
Sheila
December 28th, 2003 at 6:20 pm
I had no insurance and had surgery at Alvarado Hospital in San Diego (where
Carnie Wilson did). I chose Open RNY and that was $20,000 cash. A Lap was
$28,000 (the money was *not* the reason for choosing Open, either). The
money, in three cashier’s checks (one for the hospital, one for the surgeon,
one for the surgeon’s assistant) was due 3 days pre-op… not a day before,
not a day after. There are no payment plans at Alvarado.
$20,000 is the standard cash price around the country for Open RNY. (And if
you have insurance and they paid for your surgery, your bill will look quite
inflated compared to a cash pay patient… hence $50,000 bills and more for
the same surgery. This is how hospitals get their costs paid from insurance
companies.)
I am blessed in that I had the money, but know of others who borrow from
family, borrow off credit cards, take out bank loans, mortgage the house,
sell a car, cash in investments, and more to get the money to have WLS.
My RNY was worth 10 times what I paid.
Barbara Herrera
San Diego, CA - 41 years old
Open RNY April 5, 2001
Dr. Julie Ellner, Alvarado Hospital, San Diego, CA
04/05/01: 344# / BMI: 63/ Body Fat: 75%
04/05/02: 172# / BMI: 31.6/ Body Fat: 28%
04/14/02: 165# / BMI: 30.2
One Year Re-Birth Day: healed of ALL co-morbs, mobile beyond every
expectation, every pre-op dream surpassed a million-fold, and smaller than
any memory.
December 29th, 2003 at 1:08 am
I wanted to share my experience on cost of Open RNY. I did not go through a
clinic, but rather chose a single surgeon who has performed WLS for 30 years.
My insurance covered both the procedure and follow-up visits, as this was
how he billed. Most insurance companies use usual and customary charges, so
reduce what is billed. Doctors, hospitals, and clinics either accept the
insurance and therefore accept the price reductions or they do not accept the
insurance (along with the price reductions).
In my case I had a distal Open RNY, was hospitalized in a private room for
four nights and have had six follow-up appointments thus far with six more
scheduled over the next year.
The combined billing from all aspects of my surgery was a $14,200. My
insurance paid only $9,200.
I share this as if I were in a situation where I was a cash payment, I would
approach this process a tad bit different. Before disclosing I did not have
insurance I would find out which insurances are accepted. I would then
contact the insurance company to find out what they pay. THEN….I would
attempt to negotiate a price for my surgery, hospital, etc. My suspicion is
a win-win for all exist. The patient pays less than the stated price and the
doc, hospital, etc get more than the slashed insurance agreements.
The insurance I have is Cigna HCN. This is an insurance whereby the
doc/hospital either accepts it or doesn’t. I have found very few places that
don’t. Accepting it means the price reductions occur.
Other folks on this list may have different insurance carriers that do the
same thing…and my bet is they would be willing to share the names of their
carriers.
Good luck to you,
Pam
Open RNY 6-18-01
December 30th, 2003 at 5:19 pm
Do not forget to factor in the possible tax savings
from taking a medical deduction for the direct and
indirect costs associated with the surgery. Things
such as mileage, parking, and even the cost of
medically necessary furniture and other “applicances”
or necessary equipment or supplies can be rolled into
your deduction (you also can include these costs
associated with pre and post op visits to the doctor)
Depending on your tax bracket you could possibly get a
significant portion of your expense back in the form
of reduced taxes. The IRS has online information on
this type of deduction. Good luck and peace.
Bill from CT
December 30th, 2003 at 10:43 pm
My company was Mutual of Omaha. They approved the surgery in 2 days. I
personally spent about $200.00. I had complications and the hospital bill
alone was $305,000.00. So I consider myself lucky that I had Mutual and the
people there were great! -
Not all people are as fortunate with their insurance carriers.
RNY 3/22/01
Lost 93% of excess weight - - so far.