Price Tag Realness

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Today’s food choices, from upper right: scrambled egg with ham and cheese; Boar’s Head Maple Glazed turkey slices; barbecued boneless chicken thighs with pinto beans; Rudy’s smoked ham with pinto beans; Trader Joe’s dark chocolate caramel wedges (I ate 1 serving, which is two pieces); multivitamin and calcium supplements x2. Not pictured: a single serve container of organic applesauce.

I gave into my hormones and ate some chocolate today.  Not chocolate nibs, some actual chocolate.  I know there are some that during this phase of their sleeve life would gasp in horror that I am eating chocolate (OMG WTF U DOING), but the dark chocolate actually quelled any craving I had to eat any more food this evening.  AND I was under 800 calories today, so I don’t feel the least bit bad about eating the damned chocolate, especially since I ate a single serving and not the entire friggin’ container.

One of the things no one ever talks about is just how much this sleeve REALLY costs.

I know it’s not polite to talk about money, but I’m about to get real with y’all here:  money matters when it comes to your health.  Either you have the money to take care of yourself, or you don’t.  I was at the point with my health where money was no object:  I just wanted to finally be successful at losing weight so that I could head off larger health issues later on.  It was time for the last resort method of weight loss–surgery–and I had no real choice, other than spending the rest of my life frustrated by my multiple failed attempts at weight loss.  With the sleeve, I at least have a decent shot at avoiding more major health issues down the road.

Having said that, I will also say that I do have insurance through my employer via BCBSTX.  I am lucky in that my coverage is actually pretty good.  It is better than most, but not as good as some.  But some coverage is better than none, and I was NOT about to have surgery as a self-pay in Mexico as some people resort to.  I’ll be the first to admit that there are some things I am a snob about, and dammit, my healthcare is one of them.  I am VERY particular about the things I look for in a healthcare provider/facility, mostly because I have been very, very spoiled by the doctors who have been my primary caretakers my entire adult life.  They set the bar pretty high, so I have a certain level of expectation when finding a new provider.  Thankfully, my surgeon met those expectations.  I also live in an area with an abundance of outstanding doctors and hospitals.

That said, let’s talk about money.  That’s what you really want to know about, right?  How much this surgery really cost?  Here you go…what my insurance company was billed:

holyshit-surgerybills

Needless to say when I checked on my claims, much cursing ensued.

Doing the math…the total comes to $86,925.04.  Those are all the charges for the actual day of surgery.  Here’s how that breaks down:

  • Hospital stay and OR charges:  $42,896.54
  • Pathology work:  $1554.50
  • Internists that came to see me both days I was in hospital:  $474.00
  • Anesthesiologist:  $4250.00
  • Surgeon’s fees:  $30,300
  • PA’s fees:  $7450.00

Thankfully on the day of surgery I met my out of pocket maximum, which was $2000 under my old insurance plan.  I had already met my $1200 deductible back in February when my sleep studies were done.

Now the question becomes well, then what all did YOU pay for?  Of the $86K+ that my insurance company was billed, I have paid a little over $600 for the surgery itself so far (the hospital overbilled me and then refunded me since I’d met my OOP the day of surgery).  I have yet to receive a bill from the anesthesiologist’s office, or a bill from my surgeon.  I am expecting to pay roughly $3700 in total for both of those bills (which is what I estimated I’d owe).  So in all, I will have laid out $4300 for the surgery alone.  This doesn’t count the psych evaluation, sleep studies, initial and second consults, pre-surgical lab work, upper GI series, and pre-op clearance from my PCP.  If I include all of that stuff, that bumps the total spent to about $8000 total.

$8000 with insurance coverage.  For sleeve gastrectomy surgery at a Bariatric Center of Excellence with one of the best surgeons in the country.  The way I see it, it’s a small price to pay for a shot at a longer life, a healthier life, and a smaller me.  I never for a moment considered paying less for the same thing, especially not in a foreign country, in an effort to save a few dollars.  I still came out cheaper than my surgeon’s self-pay patients (who pay a little over $12,000), and had the exact same surgery as they did.

I would do it all over again in a heartbeat.  I am worth every penny of that $8000.  My health is worth it.

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2 responses to “Price Tag Realness

  1. My insurance covers half of anything related to WLS. Fingers crossed, a lot of the pre-op testing is billed under different codes because of all my co-morbidities. But half. So with your surgeon, that would be $20k just for starters. I BELIEVE my surgical coordinator told me it was $20k for the surgery itself. I am so angry at the insurance company about this (would they cover knee replacements at 50%?) and my hope is that by January I can switch to a new provider. But my parents have offered to pay, which is unbelievably generous. It also makes me anxious because I dislike putting them in this position.

    • Thankfully, my plan covers bariatric surgery like any other surgery, except that there is a separate $5000 copay that doesn’t count toward the OOP or deductible. BCBSTX did not use to cover bariatric surgery of any kind, and then when they began coverage, they required a 6 month supervised diet. They dropped that requirement last year, so I am lucky I had my surgery when I did! I am also lucky in that my new plan (still with BCBS) has a much higher deductible and OOP, so I’m glad I did the surgery when I did.

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