Question:
How can you afford surgery?
How do others afford this? Can't seem to find insurance that will cover. I have looked into several different insurances and none of them seem to cover?I found a wonderful Dr. in Pittsburgh, PA. Dr. Schauer. I am very confindant in him which I think is so important. The only problem is I cannot seem to find ANY insurance carrier that will cover the majority cost of this surgery with him. I fit all of the criteria. The job that I had perviously had Aetna health insurance, since he wasn't in the "network" they will only pay 70% which means that I will likely end up with a $10,000+ bill in the end. Then with the new employer I am looking into starting with they offer either Cigna or United Health Care or Aetna also. Which I thought were pretty good programs. Well, I called the Drs. office and the same situation. He's not in the network and I will have a $10,000 bill in the end! HELP!!! How do people afford this? I called to see if I could possibly set up payment arrangements and was told majority needs to be put down? I am so disappointed!!! There is no way I can afford $10,000+!! Any suggestions PLEASE??!! Now, I haven't seen the Dr. yet for my 1st appt. He's very hard to get into. Should I wait until they file the insurance paperwork and then take it from there? If so, what should I do from there? I have talked to my insurance companies and was also told this by the Drs. office so I can get an idea of what to expect. So I assume this will be the case through out? I'm so frustrated!! — Allison T. (posted on October 6, 2001)
October 5, 2001
Hi Allison, do you attend dr schauers support group meetings the first
wednesday of each month. If you dont you REALLY should. Last wednesday I
told the funny story (OUCH) of my dog mistaking the JP drain bottle for a
ball and trying to run off with it:( Brought the house down in laughter.
Anyhow I have UPMC insurance which covered 100% of the surgery and
everything but the TV in my room. UPMC approved me in 2 weeks without a
hassle. You might ask the schauers office which insurance companies cover
100% and go from there.
— bob-haller
October 5, 2001
I agree with what Donna Brandt said yearly max for a PPO. I had Aetna HMO
and had no problems. I searched several phyician bariatric websites to see
who performed weight loss surgeries in a 2 hour radius of my home. Then I
checked the Aetna website or provider book we all receive to
cross-reference the docs. If I only went to docs in the Philadelphia area,
I would still be waiting until 2002 for an initial consult. I went the
other direction and got in with an experienced and excellent surgeon very
quickly. I know that some people do want certain docs, but due to your
situation, I would suggest exploring a little more. Best Wishes!
— Molly S.
October 6, 2001
Assuming you do all what is said below and still have to come up with 10k,
try the following: borrowing from your 401k, joining a credit union and
getting a loan, borrowing from friends/family or seeing if they can get a
loan for you and you pay them back (borrowing money is such a sensitive
subject so you may want to think about that). You will have probably a 6-8
week wait with Dr. Schauer's office after you send in all the paperwork.
Then they'll call you and set a consultation appt then if you qualify,
surgery could be within the next 6-8 months. All total maybe 10 months to
1 year wait. You could possibly save the $10,000 in that time. Get a
second job, sell avon, Mary Kay, Tupperware...anything that can bring in
some extra income that you will put away just for this. In the meantime,
set up your appointments and be happy that you'll have a lot of time to
save money (a lot of people are dismayed by the wait time with Schauer --
although I hear it is worth it!) Pray (if you do) for an opportunity to
present itself for that $10k or for insurance coverage. See if you can
switch to a traditional plan (one that has a higher deductible, but that
lets you choose whatever doc you want -- a lot of companies have those but
don't advertise them as an option). Check your HR coverages book to see
what it says about WLS. If worse comes to worse, find a surgeon in network
that you feel comfortable with and go for it! Good luck and God Bless!
— Kimberly L.
October 6, 2001
I changed jobs just to have this surgery ( I'm a teacher so it wasn't too
hard) I researched the school districts, to find out what kind of insurance
they had. I now have Aetna HMO ( never had HMO in my life!!) they pay for
the whole darn thing except for $240 ( co-pay). In Jan., I will switch
again, I don't know what co. they will have so it's very urgent for me to
have my surgery ASAP. hopefully God willing it will be at the end of this
month/ beg. of Nov.
I know how you feel. With my old ins. co. I would have had
to pay at least $10,000. Teachers don't make that kind of $.
Some people told me to sell my house, take out loans, I refused, I'm not
going to make my entire family live in an apt. because I am so selfish. I
waited and saved 10 years
for my brand new dream house ( and that was just the cash down payment) One
suggestion I can make to you, is that if you REALLY want the surgery, find
a doc. in their network,that does the surgery that you can accept, and
just
get it done. The sucess of the surery is the most important
not how "wonderful the doc's bedside manner is. ( although
that would be great too. My doc. is a Lap surgeon, he does
many other proceedures other than Gas. Byp. He's a professional. Nice guy,
but not too friendly/personalble.
Who cares????? I probably will only see him several times
this year, and I'm done with him. So if you're not that
picky, find an "in network Dr./ Surgeon" and you won't have to
pay as much. Also, you can serarch " find a doc" on this site
and there will be a list of insurance co. that
do pay for your doc. Good Luck
— Cindee A.
October 6, 2001
Some people take out a loan against their home equity (they advertise all
the time by saying "Need money for college? or a new boat? or kids
going to college? Come in for a home equity loan") Don't own a home?
Do your parents? Get them to take one out, sign a promissory note to pay
them back. Sell your vehicles, downsize on what you own - raise money like
people do for other needed medical emergencies and life-saving procedures -
enlist the help of people around you - educate them first so they
understand the 'medical necessity' of this procedure - that it can and will
SAVE your life! Do whatever it takes!
— Cindy H.
October 25, 2001
Humana covers it if your BMI is greater than 40% or you are 100 lbs over
yourideal weight. OF course, you'll have to check your policy for
specifics.
— [Anonymous]
October 25, 2001
Check the policy carefully, and ask questions. You may be responsible for
30% of the bill, but you may have a $2,000 out-of-pocket maximum - this
overrides the 30% you owe...
— M. A. B.
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