Question:
Anyone had complications when you were self pay & did your ins pay?

Denied by ins for rny, if self pay and A) released with no complications then develope some will ins pay? and B)what if complications arise during initial stay will ins pay? Thanks for any info, Kathy    — k J. (posted on September 3, 2003)

September 3, 2003
I havent been either; but I have been in 'insurance' IF you were self pay because YOUR insurance does not cover the proceedure they WILL NOT cover any complications directly related to the proceedure (i.e. strictures/blockages) now if you had to take a prescription later say for Iron - they would pay since that could have been caused by something else). If your self pay I would be careful! Now this will not STOP other insurance companies from paying; I.E. your 'switched' companies during your open enrollment... complications would be covered.
   — star .

September 3, 2003
I guess I got lucky; because I was self-pay and am quite certain that if some complications were to arise during the initial surgery than it would not be covered; however, I had two strictures as a post-op and they were covered by my insurance. I have Kaiser which is an inhouse HMO and my PCP thought for sure that they wouldn't cover it and they did!! I do have out of network benefits though and since then I moved to Florida and had to find a new surgeon to follow-up and they are even paying for those visits! I'm very suprised...happy, but suprised! Good luck to you! I am 5 months post-op down 105lbs and think I would do it again even if it did send me into BANKRUPTCY...it was worth the risk! Feel free to e-mail me anytime. Denise-Open RNY -105lbs
   — denisel