Taylor5

Everyone has been really helpful to me so far. I am close to pulling the trigger on going to Mexico over Christmas for The Sleeve!!! We will be flying out of Philadelphia and into San Diego, and I am looking for others familiar with Trans Con flights especially in regards to comfort. I have herniated disks in my neck and lower back, sciatica, and Fibromyalgia. Normally I don't even travel by car for more than an hour due to pain. However, as I am self pay for the procedure, and things are not working out with my nearby facility, this seems to be my best next option - especially as I can purchase Complication Insurance that will cover me after I return home for 6 months, to have care in the US, not having to fly back to CA/MX. I have been trying to Google as much info on airlines as possible. Am even willing to spring for business or 1st class (up to a point, can't spend more than about $3,000 total for me & my husband r/t) since the surgery cost is less in MX. I really need seats that recline, preferably have foot rests - would love ones that go totally flat, but seems they are either only out of JFK or transatlantic. Plus, any other experience you have pertaining directly to flying after being sleeved would be helpful as well, since I have no experience with that yet! Thank you!

Yep, I checked already...4-5 days, and the total price was almost as much as a 1st class air ticket. Wouldn't mind a train adventure some day, but not to and from surgery, I don't think! Looks like we're doing 1st class. Damn shame I won't be able to eat anything good, but oh well, hardly the point, right? Omg, I'm gettin' sleeved!!!

Makes sense, thanks!

Did not realize this, very good to know. Thank you!

Yes, in my state it is particularly difficult unless you are on Medicare, Medicaid, or work for a large company who chooses to cover the procedure for all of their employees. As an individual or small business, you cannot purchase an insurance plan that covers it anymore. But they will pay for you to keep getting sicker, which makes no sense...

I thought once I got my loan to self pay for VGS that everything would just fall into place. Wrong. To begin with, my loan approval amount was just shy of my quoted cost at the nearby facility where I want to go - Reading Weight Center/Tower Health/Dr. Leon Katz. Also, the interest rate - insane. But nobody else was turning cartwheels to provide a loan, so I sucked it up and figured the end result would be worth it. Send several messages to surgeon's office to let them know definitely self-pay since my insurance excludes the surgery. Takes them forever to get back to me each time I reach out. They remind me my insurance will Not cover any complications related to this surgery either during/after or down the line. Just seems wrong since my premiums are more than my mortgage, but that's a different rant. So I ask if they offer complication insurance? She doesn't think so... Is there any wiggle room in the hospital's fee (the largest part of the bill)? She doesn't know but gives me the # for billing to ask them. I call billing & they can't help me unless I have a question about a bill for services I've already received?? Meanwhile, I have reached out to several facilities near and far for comparison. Most have lower fees for the entire procedure and some say they offer complication insurance. Most places haven't gotten back to me after 24-48 hours {doesn't install confidence about their response post-op when you have returned home & have questions}. The couple that have, I asked the one in FL if I have a complication, do I have to return to FL for help? What if it is emergent - as I am in PA? She does not know, she will ask and get back to me, but still hasn't. So discouraged. Bad enough to pay a fortune for crappy insurance that won't cover the surgery (yes, already looking to switch for open enrollment, but we are self employed, and No plans in our area cover the surgery for our type of plan). Then actually get a loan (but feel sick about monthly pmt) - still can't get excited because no one seems to want to answer questions or help me get moving with this!! I never would have worried about "what-ifs" for complications since I've several types of surgery w/o any, but they make a point of bringing it up, so I have to worry now. How does anyone Ever know What to do? -sorry so long-

@Sparker7, yes that is what I figured. Trying to weigh pros and cons of multi stops such as collecting baggage/getting to new gate, etc. with having that ability to be up and walking around/switching positions for a while. I haven't flown since 2006, so I am really out of practice. That high pain tolerance is a blessing, I used to enjoy that as well, but I over-did things and eventually a piece of disk broke off in 2006 & pinned down my sciatic nerve. I had to have a stat discectomy, which has been followed by 2 more back surgeries, and now have a fusion on the horizon because things never seem to go back to "normal" after a certain point. And I was at 135 lbs when I hurt my back, so being 70 lbs heavier is not helping!! Best of luck to you with your back and your surgery

I have filled out an application and am waiting to hear back from them, so thank you for that tip! Have also used this and found one provider who may work out for after care/follow-ups. He is about an hour from me, but better than nothing : ) (Other providers were listed but have since moved to different locations and one seems to have retired, which is a real bummer since he was the closest). Thank you again as this information is really helpful to my overall decision making process

@Lovergurl, do you mind if I ask about pricing at OCC? We have decided to look into a few places in MX . I will look into them more thoroughly this week, but a few didn't have prices listed so I thought I would reach out and see if you or anyone else was comfortable discussing pricing for the sleeve? Thank you!

@GassyGurl, thank you so much! That is a LOT of good info I did not know. Especially that there was a way to maybe find a local doc willing to see me for follow-up. Not sure if I mentioned it, but my local hospital/surgeon said you have to be at least 90 days out before they consider seeing another surgeon's patient. I will look into all of this asap, I really appreciate it!

Fair point...

@Apple203 that is for sure!! We are self-informed gurus!

My family doc likes to refer for everything - I swear they won't even look at a mole anymore! It's like I can count on them for a respiratory infection or UTI, other than that, expect a referral. I see more specialists...it's crazy. I do see my primary on Monday to discuss all of this. My 1st plan is to get her on board w/surgery to begin with - I don't see why she won't be, especially with all my back problems - but I've only been seeing her for a couple yrs (prev long time pcp retired) and we've not discussed my weight that much. Once I have her on board maybe I can go back and say local place isn't working out, if I went to MX would you help w/pre-op testing and post-op follow-up? But I have a strong suspicion going out of country will make her uneasy. She could surprise me though. @Apple1I'm going to talk to my husband about MX and the Bariatric Pal set up. It could end up being my best option if my doc will help with follow-up/aftercare. I live in SE PA, between Reading & Philly. We just moved closer to Reading, so I'm hoping to fly out of Allentown as I think it will be less congested than Philly and hopefully have shorter lines. I really appreciate the help everyone is providing. It's amazing to have people to talk to who really get how I feel : )

@GassyGurl, I've been in touch with Dr. Wizman's office. They said he is $10,600 for the sleeve plus $2,100 for BLIS. I feel that's a fair price, but when I asked if I would have to fly back to Florida for complications, the office staff didn't know anything about how BLIS works. I assume I would, my understanding is it's the surgeon who is insured, you are "extending" your contract with them, so to speak, using BLIS. But if it's an emergency, like a blood clot or leak, do you really have time to fly to Florida? Not that I wouldn't love to stay there for 3 months, but I wouldn't be saving enough money to make that possible!! No, I didn't contact my insurance co myself to ask about complications. So far I am taking Drs office word, plus on Ins website, when I look on my profile and my covered/non-covered services, what counts toward co-insurance, etc., it says that anything I pay toward services that are non-covered under my plan do not count toward co-ins or deductible (I don't have a deductible, but I guess for those who do). Just the way everything's worded makes it seem very negative. Like some, I'm a little afraid to call and ask and "tip them off" that I'm having the surgery bc if they don't know maybe they would cover some things just thinking it is basic health care related. But you're right, in the end I will probably have to call anyway! Surgery at my local hospital was quoted to me as $16,880 for Surg/Anesth/Hosp, but now they are saying they need to recheck cost of hosp & anesth and nut will be an extra $800, plus the co-pays for the other stuff (END co-pay will run me $100). It's adding up higher every day...

@Berry78, @Apple1, @Lovergurl and @Kat410, Thank you all for your responses and feedback on your successes in MX. I have considered it because I know others have had good results, but it was kind of a last resort idea for me - for one because I have a lot of back issues/chronic pain and don't know how well I would do on the flight there. To be honest, Florida is pushing it between the airport and the flight, but I was also supposed to be doing an intrathecal pain pump trial soon and thought that might help me survive the flight if I end up having it implanted. Now my pain doc isn't getting back to me to schedule that (really not my month for success w/drs I guess). I finally decided today to say scr^w the consequences and book w/my local hospital to have access to the support group and follow up care. Turns out the woman I've been assigned to recently fractured her foot, and then had a death in the family. So that is partial cause for no return calls. They let me schedule a nurse phone health history next Friday 10/27, then a surgical consult with an internist there on the 31st, but said they can't schedule my nut appts til after that and she has no openings til Dec as of now. They are still making me do 3 nut visits, even though self pay, prob a month apart, and even though my ins is supposed to cover that they said they checked and they don't and cash price is $800 for 3 visits!! Also, since so many ppl need appts, they are thinking of doing "group nutrition" classes, so if they do, maybe I can come in sooner than Dec - maybe. I'm thinking - why would I pay $800 for 3 nut visits to begin with, much less 3 Group nut visits? It just seems like a lot of money to me, and on top of the self pay price. She also said "Kay", who is "my person" there, will be in a couple days next week, and she needs to check with the hospital about pricing because they don't know how much anesthesia fees are or the hospital fee - But all 3 fees are broken down in the info packet I got from Kay at the seminar! Surgeon/Anesthesiologist/Hospital. And, she said they are going to set everything up and bill to my ins co anyway, as if they were going to pay, even though we know they won't because it's flat out excluded. I have no idea why. One of the only perks of being self pay is supposed to be a few less hoops to jump through. Now I feel as though they are purposely creating more or acting unsure of pricing all of a sudden! Maybe they don't want my money?? Honestly, maybe they just don't get that many self pay patients and they don't want to deal with the hassle so they are trying to wear me down. Well it's working, because I feel like just giving the loan back and calling it a day. As a long time chronic pain patient I am used to having to constantly advocate for myself, but sometimes it just gets to be too much. I'm sorry to include you in my pity party - I know it is pathetic. I didn't even question anything she said on the phone because my mind was spinning thinking, "This doesn't make any sense!" Now I'm thinking of everything I should have been saying, of course! I don't know, I guess I'm going to sleep on it. I will probably look into Mexico more - maybe I will end up going there...But I can't see any of my current doctors being helpful with that. They will probably say I'm making a mistake, so getting help from them may be hard. Thanks so much for listening though. I just don't know who else to talk to. No one in my circle really needs to lose weight, much less go to this extreme. They just won't get it. It's a really lonely place to be sometimes...

That's awesome they combined your surgeries, but definitely a headache waiting on reimbursement! Yes, BLIS is what I have been asking about! I can't find anyone local to me who offers it. It's definitely worth the cost for what it offers, but not as helpful if I have to drive or fly several states away to return to the surgeon for follow-ups or complications. My local surgeon won't see other docs' patients until they are at least 3 months post-op and out of the immediate danger zone. I mean, I don't blame him, but if he offered BLIS I wouldn't need to look anywhere else!

Thank you : ) My thinking is similar, although they require all fees paid before they will schedule the surgery, so offering to do so is kind of a moot point. But I am still trying to negotiate it based on the fact that they promote their self pay prices as being fair due to being half of what they charge Ins Cos. However, I used to do medical billing and I know Ins Cos only pay half or usually less of the amount they are billed, so I feel that should be taken into consideration at least. Taking off even a couple thousand would leave a little cushion in case of complications. I brought that up w/the bariatric lead and that's when she transferred me to Pt Access, which turns out to be hospital billing...who said they can't help unless I already have a bill, lol.

I know, I know, Thank you for listening!!

Thank you! I had looked into Mexico for my dental implant surgery - which we are just finishing up payments for now. My case ended up being too complex to have done there according to the staff where I planned to go, but I had seriously considered it. I admit to feeling a little more hesitant due to the nature of this type of procedure, but I wouldn't rule it out altogether. Hearing about others with positive outcomes definitely helps. At this point all qualified surgeons are on the table (no pun intended, lol).

Oh, I didn't realize Dr. Taggar didn't have the insurance. And probably Dr. Wizman's price is higher than that sweet little deal I'm guessing. Ugh, so hard to know what to do! Thank you for the info though, I really appreciate it! I will reach out to the office and see what they have to say : )

Good Morning Everyone & Happy Friday! This is my first time on this website as I have recently started researching WLS and would appreciate any advice out there, but especially from those in my area (I am in PA, at the Berks/Chester County line, in between Reading & Philly). My first question is if anyone started out in my situation: We are self-employed and have "individual" health coverage. We are on IBC with the Keystone Health Plan East *** Platinum Plan, and I am wondering if anyone has ever had this surgery covered by an ***? Just investigating my personal page on the IBC website shows me a list of exclusions, and bariatric surgery is listed as an exclusion. I guess I was just questioning whether that is a flat out, hard rule, or if there are opportunities for coverage depending on circumstances? I know I can't be 100% sure without calling & talking to them, but they have given me bad information about how to get claims reimbursed before that never panned out, so I am not sure I really trust them. I just thought if Anyone had used KHPE to pay for their surgery, it would give me some hope that it is possible. If not, my husband and I are seriously considering a switch for just me to Personal Choice PPO for January. We were already considering that because of back problems I have so I would have more choices in facilities I could go to, but this could definitely help push the decision over the edge. The last part of this is wondering what the best facilities are in the area and recommendations for trusted surgeons? Just in my initial searches I am coming up with Barix in Langhorne, who I already contacted and am waiting to hear back from, Main Line Health at Bryn Mawr Hospital, Reading Hospital Bariatric Facility - but more specifically Dr. Leon Kratz, who seems to have an excellent reputation and is closest to me, and then there are a few I have seen in search results but have not actually looked up yet, which include Pottstown Hospital's Program, Abington Hospital's Program, and Wellspan out of the Lancaster area. Appreciate any advice/feedback you might have! Thanks, Taylor (Taylor5)

Diana_in_Philly, Thanks for the info - we were actually just notified by IBC that we are no longer in their coverage area now that we moved from Chester County to Berks Co, but since they took so long to tell us we still have to wait for open enrollment. Looks like we will be going with Capital Blue Cross, which stipulates it is a non-covered service "unless medically necessary". All other plans through our broker and on open marketplace for individuals or families do not cover it at all. You have to be on an employer paid ins. plan (with 50 or more employees, I believe, bc we are self-employed and looked at small business plans as well and none of them covered it) and your employer has to choose the option to cover it. I was completely baffled that I did not have the option to add the coverage to my insane premiums which are already more than my mortgage, but apparently in PA that's the breaks. So, now I will be further investigating how "medically necessary" their medically necessary means for the new plan. If that doesn't pan out, possibly some sort of financing, but seems a little out of reach at this point. Also currently battling severe chronic back/other pain right now and am having to consider spinal fusion surgery, which I don't want to do - especially when I know recovery will be much more likely to have a good result if I am closer to my healthy weight, but since I don't know if I can get the WLS yet I may have to do the back surgery first (I've already had 3, but this is the most invasive by far). Anyway, thank you again for sharing your hospital info. All my current docs are HUP-affiliated in the suburban hospitals they took over, but downtown is definitely the way to go if you can do the commute. Congrats on your success so far. Looks like you've come a long way : )

James, thank you for your thoughtful help & information. Sorry I did not reply sooner. Somehow I missed that you had responded. UPMC is University of Pittsburgh Medical Center - apparently has an excellent reputation, but a 5-6 hr drive from me unfortunately. But I appreciate the advice on a Center of Excellence! Will definitely keep all in mind as I continue my research. Have a great day & Congrats on your successful outcome!

Thank you so much, happy to be here! That is pretty much what I expected, but at least lets me know how much work is ahead of me. Better to be prepared! Congrats on your success so far : ) Have a great day!