Insurance nightmare!

firefly2000
on 2/13/12 2:58 am - NJ
VSG on 03/20/12
 My insurance company will not cover ANY weight loss surgery PERIOD! My question is where do I go from here? I really feel like surgery is the only thing that will help me! Has anyone done self pay for gastric sleeve? If so, how much does it cost? I live in NJ. Thanks, Lesley
AnneGG
on 2/13/12 6:40 am
The cost will probably vary from surgeon to surgeon. Many people go to Mexico because it is less expensive there.

I would suggest checking things out with several doctors, and see what they will charge for self pay.

You also might want to post this question on the sleeve board.

"What the caterpillar calls the end of the world, the master calls the butterfly." Richard Bach

"Support fosters your growth. If you are getting enough of the right support, you will experience a major transformation in yourself. You will discover a sense of empowerment and peace you have never before experienced. You will come to believe you can overcome your challenges and find some joy in this world." Katie Jay

H.A.L.A B.
on 2/13/12 6:46 am
Self pay.  I did that. 
Then - also trying to find anothr job with insurance that will pay.  

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Lori P.
on 2/13/12 10:35 am - Kenosha, WI
My daughter was self pay.  She ended up going to Mexico for her surgery.  She was pleased with the results and has done very well.  She paid just under  $6000

 



     SW 212 / Goal 130 / Current 130


 

 

moringdawn
on 2/17/12 1:49 am
VSG on 07/11/12
Hi, I'm self pay too do you know where your daughter want in Mexico and the doctors name. Im looking at Cancun at Amerimed Hospital.
Thanks
Dawn
devaoner
on 2/13/12 11:58 am
 I know you said your insurance doesn't cover it but has it been deemed medically  for you? Do you diabetes,blood pressure, sleep apnea anything wrong that's documented  by your md? I just find it hard for insurance to not cover something that saves life's. But if you don't have any issues and that's why they don't cover it all dr charge differently you should consulte and price with as many as your can( but price is not everything this is your life). Some dr take care credit and their are some other credit that cover these surgeries that's if you have good credit. And yes some people go for the cheaper route like Mexico because they can't afford it in the US but if down the road something goes wrong are you going to be able to fly back and see that surgeon to fix, or save your life? Just thought I'd say that because I'm two years out and in the beginning I had some small issues and the only dr who would see me is the one whom preformed my gastric. Who knows some people are lucky and have no problems in Mexico but then I know people whom have several issues and almost died. I wish you the best of luck and I hope I could help if you have any question feel free to contact me
MARIA F.
on 2/13/12 12:09 pm - Athens, GA

Devaoner there are millions of ppl out there that have insurance policies that exclude WLS. Walmart for instance. Their insurance does not cover it as well. It doesn't matter how many co-morbidities one has, if it's excluded.........it's excluded.

 

   FormerlyFluffy.com

 

Tea
on 2/13/12 3:10 pm - Moore Haven, FL
VSG on 07/11/12
I have to self pay too due to my insurance also having a WLS exclusion. So after many many many MANY hours of research I found Dr. Washington in Conway, SC (Myrtle beach) and he has great reviews.

Anyway he charges $8000 flat for the sleeve. It is going to be cheaper for me to fly to SC from FL to have the surgery.

I have even thought of going to Mexico too, however my family simply wont help me unless its in the states.... boo

Hope this helps

TEA

HW 311 - (pre opt liq diet 272) - SW 264 - CW 196- GW 150

Lovin my
SLEEVE

ChristineB
on 2/13/12 8:03 pm - Western 'Burbs Chgo, IL
I would urge you to do your research about going out of the country for your surgery. There are many doctors in the US that will not touch a patient that had their surgery in a foreign country. My doctor is one of them. It might look attractive dollar wise to go out of the US but what happens when you get home and their isn't any support for you to turn to for aftercare.

See if you can manage it financially to go with a doc locally by going self pay here in the US.

 
Open RNY May 7
260/155/140 




 

firefly2000
on 2/15/12 9:05 am - NJ
VSG on 03/20/12
 Thank you all for your posts! I am a new member of OH and just learning my way around.

You would think (at least I thought) all insurance companys would cover WLS since many co-morbidities do result with being over weight. But going through this process I have learned that employers can add stipulations to your insurance policy preventing you from gaining approval for certain procedures, such as WLS. The ONLY way my insurance company would cover WLS was if you needed OPEN HEART SURGERY, or if you were on a list for a HEART TRANSPLANT! My thought is that if you need any type of heart surgery you might have benifited from getting WLS way before you got to this point! Anyway, I exhausted all avenues to no avail, so I have excepted the fact that if I want this surgery I have to self pay. BTW, I am a stay at home mom to three beautiful kids, so I am not working at this time. I have an amazing husband who is 100% behind my decision to go ahead with the surgery.

Many of you suggested Mexico for WLS.  Although it may be cheaper, I really would prefer to stay in the states.

I have started to get quotes for VGS in New Jersey since this is where I live. So far $20,000.00 seems to be the going rate.

If anyone has had to self pay in NJ please let me know your experience!
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