How did you afford it?
on 11/21/13 11:17 pm
I cannot even imagine your frustration and disappointment.
Have you considered a change in your insurance to a plan that does cover WLS? It is open enrollment time for so many right now that you might want to consider that if another plan is an option at your work or that of your spouse.
And on the insurance front...is your policy one that covers WLS and you have been denied, or it just flat out does not cover WLS? You can appeal a decision of denial IF they cover it within your policy.
HUGS TO YOU--I would have been one hot mess if I'd made the choice to do this and then could not do this.
HW333--SW 289--GW of 160 5' 11" woman. I only know the way I know & when you ask for input/advice, you'll get the way I've been successful through my surgeon & nutritionist. Please consult your surgeon & nutritionist for how to do it their way. Biggest regret? Not doing this 10 years ago! Every day is better than the day before...and it was a pretty great day!
I wouldn't have been able to afford it if my insurance didn't pay for it. I'm so sorry you're dealing with this. I would be really upset if my mother said she'd help with the cost and then backed out. Any chance she might change her mind?
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
I had to pay out of pocket for my RNY also. I had family help along with loans and retirement funds. I would sell everything I have if I had to do it again.
Also, people on here have had great experiences and success going to Mexico at a fraction of the cost. Look them up on the Mexico forum.
I know this must be very frustrating, I am sorry!
At my current company, WLS was excluded from the medical plan. However, an employee asked our benefit director about it, and explained the need (his wife needed a revision surgery) etc.. Our benefit director (my peer) called our insurance company and found out that it wasn't very expensive to add the benefit to the plan. Because he had an employee who needed the surgery, he was able to get permission to add WLS to one of our company medical plans.
You might try talking to HR/Benefits and see if this is a possibility, many companies are pushing hard to get employees healthy, and they may not realize they have a exclusion on their plan.
I would try this approach..
Personally, I self paid.. I borrowed from a 401k plan.. I also did a lot of research,and chose to have surgery in Mexico.. I have no regrets!
Good luck!
I'm sorry that your insurance plan does not cover WLS - that is so frustrating for and others in that situation. I know I would have had trouble affording the surgery if my insurance had not covered it. Have you looked into finding a financial counselor that can help you clear up your credit so you can qualify for a loan in the future? (many different social service agencies offer this service for free or on a sliding fee scale) It might take awhile but it should feel good be taking steps in the right direction. Anyway - will be wishing the best for you! Good Luck
Talk to your surgeon's office about self-pay. You might be able to negotiate a much better price.
The economics go like this: Your surgeon already has a fix cost-to-serve in his/her practice. This cost will not change based on adding one more patient (i.e. you). The surgeon also has a variable cost that includes things like his/her time, supplies, hospital charges, etc. If the fixed costs don't change, it is possible that your surgeon will still make money by selling you this service at a substantial discount - all else being equal.
OK -
Try this website:
http://www.medibid.com
It is a service for self-paying patients where doctors "bid" to provide patients with services in a reverse-auction. I think is nation wide, so if there is a doctor out there willing to add you to his/her schedule at a price you can afford, this might work.
If you try it, let us know.