Purple lady

Does anyone know if bariatric surgery done in Mexico qualifies as a health expense? In other words, can I legally pay for the surgery using my HSA funds?

I ended up getting my sleeve in the US. I was fighting for insurance approval and finally won after multiple appeals. So I did pay my copay with HSA. However I knew I could use HSA for surgery in the US. The question about using it in Mexico I guess I will never know.

I just got a denial letter yesterday. I don't qualify on BMI alone (>40), but have hypertension so I hoped to qualify with that plus a BMI of 36. I plan to appeal and my dr. referred me to Lindstrom. May I ask how much that process cost to have them advocate for you? Thanks! I believe their lowest fee is $300. Sent from my SM-T800 using the BariatricPal App

I just got a denial letter yesterday. I don't qualify on BMI alone (>40), but have hypertension so I hoped to qualify with that plus a BMI of 36. I plan to appeal and my dr. referred me to Lindstrom. May I ask how much that process cost to have them advocate for you? Thanks! I would rather you speak to them directly regarding costs. But I will tell you they have flat rates, not hourly like most attorneys and I found it very reasonable. The fee they quote depends on how much assistance you need/want. They did multiple appeals for me and I only had to pay once due to the flat fee. Sent from my SM-T800 using the BariatricPal App

Appeal, appeal, and appeal some more. You should receive a denial in writing and that denial should have a specific reason. Call insurance again and demand a written denial. I went through 3 denials and then appealed to an external review board and got my denial reversed. I think many times insurance hopes you will get discouraged and give up. So appeal until you don't have any appeals left. I used Lindstrom Obesity Advocates to help with my appeals. I highly recommend them if you choose to have outside help.

I called WLIA for an estimate and I was told self-pay rate would be about $20,000.

I did self pay with Dr. Daniel Fang through the Bridges Center. St. Lukes Phoenix has a flat rate for self-pay and it was $13200 for the sleeve. I have not been billed the surgeon's and anesthesiologists fees but I estimate them to total around $3000.

One thing I notice post op is that all my protein drinks have a slight metallic/chemical taste that I don't recall from drinking them pre-op. Anyone else experience this?

I was having trouble getting fluids in until today. I have barely any incision pain, just the far left one when I laugh or sneeze. I do get sleeve pain if I take too big a gulp of water or drink too quickly. The magic number for me is 3 sips in a row. More than that, it hurts. No sore throat but bone dry mouth for days. It is getting better now that I am getting my 64 oz. Today is the first day I was able to meet my fluids goal. Low energy and I feel like sleeping a lot. Each day I feel significantly better than the day before.

NPO means nothing by mouth, including Water. Sent from my SM-T800 using the BariatricPal App

I posted the same question to a local FB group and others had not gotten a call but still had their surgery. I guess it depends on the surgeon's practice. I was given the opportunity to ask questions during my pre-op testing. Sent from my SM-T800 using the BariatricPal App

I've had Hint flavored Water, SF Jello, apple juice. I'm hungry! Sent from my SM-T800 using the BariatricPal App

I had someone suggest that if I just continue the pre-op diet I wouldn't need surgery. I was very quick to point out that this liquid only diet is not sustainable, at least for the amount of time it would take to lose more than 100 pounds. Sent from my SM-T800 using the BariatricPal App

I am Monday too. Can't wait! Not nervous yet, just excited. Probably won't sleep much Sunday night. I'm sure the nerves will kick in at some point. Sent from my SM-T800 using the BariatricPal App

Mine is Monday too. I had a 2 week liquid diet pre-op. Clear fluids only on Sunday. So tomorrow is my last day of those nasty shakes. I am so busy looking forward to having a break from shakes that I am not nervous yet. I know I will be on Sunday night. So I already have all my pre-op instructions but I was a little surprised I didn't get a reminder call from the surgeon's office. Did any of you get one? Sent from my SM-T800 using the BariatricPal App

Hi fellow sleevers! I've been lurking since June and now for my first post. So I completed my insurance requirements today. My advocate told me the insurance approval paperwork would be submitted as soon as she received my NUT's report. That's the only document missing. She expects to get the report tomorrow (09/23). You've probably had this question asked about a million times before -- but I did not see an answer for my insurance specifically so here goes: if you had BCBS of AZ how long did it take to get your approval? Of course I want to have my surgery yesterday. Sent from my SM-T800 using the BariatricPal App

Well I got a denial about 4 business days later. I was told I only had to do 8 weeks of supervised diet (I have the policy in writing). In the meantime, the policy was changed so when my request was filed they said I had not met the diet requirement of 6 months. Doctor's office said it has happened before and they were able to reverse the decision because the member had been told the same thing I had. So my request is now under appeal and included in the appeal is the copy of the policy I was given. So I am hoping that works. However I am getting tired of waiting and I also want to get it done this year because I have almost met my out-of-pocket max. I am afraid that insurance is just trying to wait me out so that I have to go to next year, when both my deductible and out-of-pocket are much higher. I will also have to repeat all the clearances because they will expire soon. I want BCBSAZ to cover this just on principle but I am considering Mexico at this point.

I agree with @losergrl75. Let's say the total bill for all services is $20,000. Assume everything is in-network. Insurance would first subtract your remaining deductible. 20000 - 1400 = 18,600. You have now met your deductible of 3000 by paying the 1400. The remainder of your bill is 18,600. You most likely have some kind of co-insurance requirement. So let's say that is a 20% co-insurance. 20% of 18,600 is $3720. 3720 owed plus 3000 already paid is 6720 which exceeds your OOP. So you would only be responsible for $3000 of the co-insurance plus $1400 deductible = $4400. One thing I have noticed is that you are getting a lot of services in a short time frame, it takes a while for your insurance company to catch up on your deductible balance. So perhaps when the hospital checked your deductible did not reflect $1600 already met. Sent from my SM-T800 using the BariatricPal App

That's good to hear. I'll start stalking my email about mid-week next week then. Will post when I hear something. Sent from my SM-T800 using the BariatricPal App