Upfront costs beyond insurance coverage:
Hi,<br> Have any of you had to shell out upfront
monies for your RNY (or other) surgeries beyond what
insurance covers??? I’m looking into the duedenal switch
surgery and there is an upfront cost of $4,500 or more,
depending on surgeons. Your feedback would be
appreciated.<br><br>Tim
July 9th, 2003 at 1:59 am
Hi, Tim.<br><br>My surgery (Gastric Bypass-open)
is 11/22/99. I have to pay for the entire thing
except around $4000 from my so-called insurance. The
surgery is around $20,000. I have to come up with $2800
the day I get there.<br><br>T.
July 9th, 2003 at 6:24 am
I had no upfront costs and my insurance paid 100%
but I have never heard of the surgery you are having
(or considering) doe anyone else know anything about
it? I would like to know what it is… and how it is
different from a RNY or VBG<br>I will look for a
response!<br>Cindy
July 9th, 2003 at 6:02 pm
Hi Tim<br> I have done a lot of research for RNY
or VBG surgery but have never read anything on
duedenal switch surgery, I’d like to know more about it.
But as for upfront cost, my insurance company will
pay 100% percent. The only upfront cost I’ve heard
about is for doctor’s that are out of your insurance
network, they will ask for upfront money or arrangements
to pay the difference (it falls under your
deductible). Good luck<br>Trudy
July 10th, 2003 at 4:43 am
My doctor’s surgery of choice is the pancreatic
duodenal switch. I just looked through my old papers for
the handout on it but can’t find it. From what I
understand, (don’t quote me please) the duodenum is bypassed.
This is supposed to be a more intense operation than
the RNY but is also more sucessful at keeping the
weight off. With this one its nearly 100 percent for
keeping the weight off. A huge problem is the
malabsorption rate, the lactose intolerance, increased vitamin
difficiency,and other difficulties that I am not remembering. My
insurance co. claims that the switch is too experimental
and would not approve that one, even though I wanted
it. It is also practically double the cost of an RNY.
Hope that helped a little bit maybe?<br>~Laura~
July 13th, 2003 at 12:55 pm
Tim,<br><br>The only out of pocket expense I’ve had are my $5 co-pay.
Everything else has been covered by my insurance, but that is specific my
employer / plan.<br><br>Mike
July 14th, 2003 at 4:57 am
Hi Tim,<br><br>While doing my
homework on the<br>surgery I discovered that most surgeons
in Michigan have<br>upfront charges. This is because
the insurance<br>reimbursement is lower than the
charges. The only two surgeons<br>I found that accept the
insurance reimbursement as<br>payment in full were Dr.
Scholten in Grand Rapids and Dr.<br>Ali in Port Huron.
Neither of them perform the<br>Duodenal Switch.
July 17th, 2003 at 7:48 am
Thanks Bob,<br> I appeciate you checking that
out! I’ve got an appointment with Dr. Ali on Nov. 9th.
Wish me well. I hope I can get all my ducks in a row
and have it done before summer. <br><br>Take
care,<br>Tim
July 18th, 2003 at 9:14 pm
Tim<br> I had a friend’s daughter go to him for
the surgery and she ended up in the hospital for 2
weeks and they had to go back in because he left a hole
in the stomach and it was leaking. and he tried to
tell her it was a previous problem and not from the
surger. I also heard from other people (Hear say) the
they know people who had problems also. I know after
my friends daughter surgery she was really sorry
that she went to him. Also I have talked to some
people from this area who had Dr Sapala went to Dr Ali’s
support group and they were smobbish and did not make
them feel welcome. That is all that I know about him.
I hope this helps in your decision as to where to
go.<br><br>God Bless<br>Pat in Mi