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Post by wanttolose on Apr 23, 2012 15:54:00 GMT -5
So first time I had to reschedule due to an ulcer. Now..... There are no icons to express how I feel. I just got a cost estimate from the hospital and it is over 50 thousand dollars... Yes you read me right... 50K. That sleeve should be made of gold at that price!!! And that is not including the fee for the surgeon!!!!! I can't do this even if insurance covers most of it. I am not even sure of that. I sent the estimate to my insurance and will wait for their advice. It is just unconscionable really to pay that much when in Montreal with the same surgeon it would cost a fraction of the price. I can't succeed with the sleeve if I feel guilty about the tag...
Plus they put gastric bypass on the estimate!!!!!
Does nothing for my fear management!!!!! I will update as soon as I know....
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Post by MsVee on Apr 23, 2012 16:54:15 GMT -5
Some of you know this program has been going on for a while, but I wanted to post about it again (posting about it was not permitted OvertHere, so if you see someone who could use this information, please feel free to copy this in a PM to them). In order to qualify a new hospital for COE status, which requires an onerous number of surgeries to be performed at that hospital in a certain amount of time WITHOUT the benefit of doing insurance-paid surgeries which require COE status there, a vetted DS surgeon has arranged with this hospital to offer a VERY special pricing program for self-pays (or those who have been denied and want to have surgery WHILE appealing). For contractual reasons, these prices and who the surgeon is have to be kept in confidence - therefore, in order to learn more, you must send an email to coehospital@yahoo.com, and sign a confidentiality agreement first. This program has the following general requirements: * BMI < 60 * virgin DS * virgin VSG * lap band revision to DS or VSG with NO erosion Please tell anyone you think could benefit from these extraordinary prices and access to a vetted DS surgeon in the US. Please don't bother asking ME any further questions - I can't and won't answer them. But trust that I wouldn't be doing this if it weren't someone I would recommend. Edited to fix a typo - the prices may be cute, but not enough to call them pricies.I HAVE BEEN ADVISED THAT THIS SPECIAL PRICING PROGRAM IS ENDING SOON - SURGERIES NEED TO BE ARRANGED BY 4/30/12. IF YOU KNOW SOMEONE WHO COULD BENEFIT FROM THIS PROGRAM, PLEASE ENCOURAGE THEM TO APPLY IMMEDIATELY!UPDATE - it appears this program is going to be extended AGAIN until the end of June. If you know anyone who could benefit, please have them contact coehospital@yahoo.com. I do not know if you were aware of this offer. I understand it has been extended until the end of June. It is worth investigating it MUST be less than 50,000 (US dollars). The road to surgery for many of us has been filled with obstacles do not give up keep the faith MsVee |
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Post by wanttolose on Apr 23, 2012 17:11:23 GMT -5
Yes, I read Diana's post. But I am not a self pay. I have insurance and I have approval. The problem is that I just can't wrap my head around the cost here even if the insurance says its OK! Especially when in Montreal it costs a fraction of this price. So I will travel and will get reimbursed after and will save my insurance money. Same surgeon, different location.
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Post by Deleted on Apr 23, 2012 17:16:08 GMT -5
Yes, I read Diana's post. But I am not a self pay. I have insurance and I have approval. The problem is that I just can't wrap my head around the cost here even if the insurance says its OK! Especially when in Montreal it costs a fraction of this price. So I will travel and will get reimbursed after and will save my insurance money. Same surgeon, different location. So you are going to cancel a life-saving surgery that you're not going to have to pay for because of how much they are going to charge your insurance company? Permit me to suggest that you don't really want to do this. |
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Post by wanttolose on Apr 23, 2012 17:23:12 GMT -5
No, I am not going to cancel it. I never said I'd cancel or even contemplated that in any of my posts! I will just go to Montreal instead of Dr Gagner coming here and I will pay 13k instead of 50k. Seems like a good plan to me... I work in development assistance and with refugees and I have lived and worked in Africa for more than 20 years and I know how far a dollar can go and yeah, my social conscience even extends to wasting insurance company funds because of ridiculous Swiss private hospitals costs. It may sound self righteous but... I really do feel it. And I don't want to feel guilty after! You are right though! I don't WANT to do this. Who wants to have surgery?? I have to do it though and I WILL do it. Just not in Switzerland...plus even if approved my insurance would pay 90% so even on the out of my pocket part it makes sense for me to travel. Plus Canada is home and I have a very good friend in Montreal who I would stay with. There is no down side here. Only positives. Now that I am over the initial shock of that bill.
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Post by MsVee on Apr 23, 2012 18:10:26 GMT -5
Good luck. I misinterpreted your situation. I was just trying to help. I understand your concern about wasting money. My fear was that you would miss out on this potentially life saving surgery. You must follow your conscience and do what you think is best. I hope everything works out for you.
MsVee
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Post by Deleted on Apr 23, 2012 20:28:11 GMT -5
No, I am not going to cancel it. I never said I'd cancel or even contemplated that in any of my posts! I will just go to Montreal instead of Dr Gagner coming here and I will pay 13k instead of 50k. Seems like a good plan to me... I work in development assistance and with refugees and I have lived and worked in Africa for more than 20 years and I know how far a dollar can go and yeah, my social conscience even extends to wasting insurance company funds because of ridiculous Swiss private hospitals costs. It may sound self righteous but... I really do feel it. And I don't want to feel guilty after! You are right though! I don't WANT to do this. Who wants to have surgery?? I have to do it though and I WILL do it. Just not in Switzerland...plus even if approved my insurance would pay 90% so even on the out of my pocket part it makes sense for me to travel. Plus Canada is home and I have a very good friend in Montreal who I would stay with. There is no down side here. Only positives. Now that I am over the initial shock of that bill. You do know that they don't really pay that amount, don't you? My "bill" was for over $30,000 and the amount they paid was closer to $3,000. Those numbers are all smoke and mirrors...at least in the US. ETA: finance.yahoo.com/news/appendix-removal-huge-sticker-shock-210927457.html |
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Post by wanttolose on Apr 23, 2012 23:52:04 GMT -5
Well here they are not smoke and mirrors. I actually have to pay the bill so I can assure you they would get every penny listed. They send me the final bill, I send it to the insurance. The insurance pays me and I pay the clinic. They don't deal with the insurance directly. I have had two babies here and I can attest that they would actually get the fifty grand.
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Post by wanttolose on Apr 24, 2012 9:19:50 GMT -5
So today's update. We are definitely rescheduling for Montreal. The hospital here would not budge and needed full upfront payment which is physically impossible to arrange before Friday even if I wanted to...but I don't. It gave me a lack of confidence feeling so no thanks for here. I will go to Canada. Hopefully before mid May.
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Post by lwtg1369 on Apr 24, 2012 9:49:59 GMT -5
Sorry for saying it, but I personally don't care what it costs my insurance company. I just got done arguing with them again the other day over covering my surgery, and I calculated that over the last 10 years between what I pay and my company has paid into my insurance, it totals about $111,000 to them!!
So all I'm looking for is a portion of what we have Paid In back to me and a great surgeon and hospital in order to save my life.
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Post by Deleted on Apr 24, 2012 10:04:18 GMT -5
Sorry for saying it, but I personally don't care what it costs my insurance company. I just got done arguing with them again the other day over covering my surgery, and I calculated that over the last 10 years between what I pay and my company has paid into my insurance, it totals about $111,000 to them!! So all I'm looking for is a portion of what we have Paid In back to me and a great surgeon and hospital in order to save my life. Well, there's THAT...lol I don't know about the OPs situation re medical care is, but I do know that Baltasar in Spain is a LOT less than $50k. And Himpens in Belgium is a DS surgeon...and I do know that he removes bands. In fact, several do: www.dsfacts.com/Duodenal-Switch-Surgeons-from-Asia-Australia-Europe-and-South-America.html |
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Post by lwtg1369 on Apr 24, 2012 10:13:12 GMT -5
Sorry for saying it, but I personally don't care what it costs my insurance company. I just got done arguing with them again the other day over covering my surgery, and I calculated that over the last 10 years between what I pay and my company has paid into my insurance, it totals about $111,000 to them!! So all I'm looking for is a portion of what we have Paid In back to me and a great surgeon and hospital in order to save my life. Well, there's THAT...lol I don't know about the OPs situation re medical care is, but I do know that Baltasar in Spain is a LOT less than $50k. And Himpens in Belgium is a DS surgeon...and I do know that he removes bands. In fact, several do: www.dsfacts.com/Duodenal-Switch-Surgeons-from-Asia-Australia-Europe-and-South-America.html:-) I should have my surgery date by next week....maybe I won't be so fiesty after that! Haha!! :-) |
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Post by wanttolose on Apr 24, 2012 10:13:16 GMT -5
I looked into both Himpens and Baltasar earlier on. I am not compromising on quality by going to Montreal. Same surgeon, just me travelling instead of him. So no difference there. My insurance and I are basically even steven in terms of what has been paid in and what has come my way over the years with a family of five covered. In the final analysis the impasse was impossible to break as the hospital wanted 50K upfront. I don't have that kind of cash lying around and the insurance only pays post factum so there was no way to comply with their requirement (the hospital's). When something like that happens 2 days before you are supposed to have a surgery it really throws one for a loop. At least for me that's how I feel. I now need to take a step back and breathe and replan things - 10 days is not going to change my life - I don't think! There is no loss here.
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Post by Deleted on Apr 24, 2012 10:35:49 GMT -5
I looked into both Himpens and Baltasar earlier on. I am not compromising on quality by going to Montreal. Same surgeon, just me travelling instead of him. So no difference there. My insurance and I are basically even steven in terms of what has been paid in and what has come my way over the years with a family of five covered. In the final analysis the impasse was impossible to break as the hospital wanted 50K upfront. I don't have that kind of cash lying around and the insurance only pays post factum so there was no way to comply with their requirement (the hospital's). When something like that happens 2 days before you are supposed to have a surgery it really throws one for a loop. At least for me that's how I feel. I now need to take a step back and breathe and replan things - 10 days is not going to change my life - I don't think! There is no loss here. Yup...my cousin's late husband worked for UNESCO...they cover almost everything...later. In fact, I think she has to wait until the following calendar year and claim the entire previous year in one filing. Good thing she's a multi-millionaire. |
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Post by wanttolose on Apr 24, 2012 12:00:33 GMT -5
Exactly...I don't work for UNESCO but exactly same insurance claims deal... We are looking at Tuesday in Montreal...to be confirmed....
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