Waiting for insurance vs. self pay.

skinnyjax
on 6/26/17 7:13 am

I am so ready to do this surgery. I have been up and down with my weight all of my adult life. I am always on some sort of " diet ". I recently found out I have PCOS ( at the age of 38) and once I started reading up on it it was like a light bulb went off in my head. That is me ! Every symptom, everything !! I decided that weight loss surgery will be the best way to get out of this cycle. I am sick of diets and my weight ruling my life. I am going through the process of insurance approval but I am scared I will get denied. I am " only " 209 lbs, 5'3 , and " only" have high cholesterol and PCOS. I am so determined I am thinking of taking out a medical loan, but I know I should give insurance a shot first. I just really cannot lose much weight or I will not qualify at all and I would hate to stay this weight longer than I have to just be denied. I am so confused !!?? My surgeons says he feels I am definitely a candidate but to be prepared for a fight with the insurance company.

Highfunctioningfatman
on 6/26/17 8:26 am
VSG on 08/29/16

Your fight will be because of your bmi. Most insurance companies want a bmi of over 40 or 35 with 2 cormorbidities to qualify for coverage. Yours is 37.

I did self pay in Mexico for $4400. It was the best medical experience that I've had. I would easily recommend it to friends.

skinnyjax
on 6/26/17 4:36 pm

That is a great price. Could you tell me who you went to ?

Highfunctioningfatman
on 6/26/17 5:57 pm
VSG on 08/29/16

Mauricio Gutierrez at Trinity Medical in Tijuana. Give me a couple minutes and I will cut and paste from another site.

skinnyjax
on 6/27/17 6:36 am

Thank you so much , and also for your review ! It helps a lot to be able to talk to others who are going through this.

Highfunctioningfatman
on 6/27/17 8:20 am
VSG on 08/29/16

You bet!

(deactivated member)
on 6/26/17 8:37 am, edited 6/26/17 1:37 am
VSG on 03/28/17

I also chose to self-pay in Mexico rather than fight fruitlessly with my insurance company.

skinnyjax
on 6/26/17 4:36 pm

Could you tell me where you went ? I am definitely looking into this as an option.

(deactivated member)
on 6/26/17 4:48 pm
VSG on 03/28/17

I sent you a message :)

jachristmas
on 6/26/17 11:36 am
VSG on 12/14/16

My insurance doesn't cover anything bariatric so I saved and scratched up the money and paid for it myself..best investment I've ever made. My insurance did however pay for some of my pre-op tests and bloodwork as long as it didn't have any references to bariatric. ex. I have a history of asthma so my insurance did cover the chest xray and pulmonary function test I ended up needing. My primary doctor willingly ordered some of the blood work and tests for me as part of a "checkup" and shared the results with my surgeon..so that is something for you to consider as well. If I had known, I would have researched Mexico, but I do like being able to see my doctor once a month for weigh ins and I can call them or stop by with any questions and concerns, and I have access to the dietician there.

~Amanda~

HW at consult #1 5/19/16: 348 lbs.

Consult #2 8/31/16: 331 lbs.

SW 12/14/16: 286 lbs.

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