Heartbroke

[KristinaAshley 5]

So I have considered WLS and banding for many years now. I finally decided to get serious about it and spoke with my family Dr. He was all for it and told me that he believed my insurance covered it. I was ecstatic. I have researched everything there is to know about WLS, the bariatric surgeon was even impressed. I’ve been to a seminar and group support meetings and everything keeps telling me that this procedure is my answer to a better life. Well I spoke with my insurance about it and I come to find out that Regence doesn’t cover it. I am so heartbroken. I haven’t cried this much since my son was in the NICU for six weeks. My family doesn’t understand why I am so horribly sad. They are all obese as well. This is killing me. I don’t want to have all of the health problems and die when I’m 40.

[DetroitJenny9701 1]

So I have considered WLS and banding for many years now. I finally decided to get serious about it and spoke with my family Dr. He was all for it and told me that he believed my insurance covered it. I was ecstatic. I have researched everything there is to know about WLS, the bariatric surgeon was even impressed. I've been to a seminar and group support meetings and everything keeps telling me that this procedure is my answer to a better life. Well I spoke with my insurance about it and I come to find out that Regence doesn't cover it. I am so heartbroken. I haven't cried this much since my son was in the NICU for six weeks. My family doesn't understand why I am so horribly sad. They are all obese as well. This is killing me. I don't want to have all of the health problems and die when I'm 40.

[DetroitJenny9701 1]

So sorry to here your new's I know it must be upsetting to find that out after getting your hopes up. Try to focus on a better you! Sorry about the INS Good luck with your weight loss journey.Keep your head up I know it must be hard. Love Jen

[REDsparkles11 2]

Im sorry sweetie! I felt that for a couple days but we found a financing company who works w/ you on payments, because Im a self pay patient. Maybe look into it? I will be sending good thoughts and blessings your way

[JennEdge 2]

A lot of doctors will provide you with different options that they accept for self-pay. The doctor that I went to in Fort Worth, Texas gave me a list of 10 different loan companies that specialized in surgical loans for this type of procedure. It might be worth checking out. I don't have insurance so I saved up what I could, used a considerable portion of my tax return, and then searched for a small loan to finish the amount off. I'm now 3 days post-op and I'm glad that I decided to make this investment in my health and future. All hope isn't lost...just look around and see if you can find a different option. Another perk...as a self-pay patient the tax write off for medical costs should be quite nice next tax year.

[Dave_NW 92]

You might also consider going to Mexico for your surgery. You can have it done there for a fraction of the price of a US procedure. Lots of LBT readers were self-pay and banded in Mexico. Ask for recommendations.

I just did a bit of creative web surfing on the Regence website for Idaho, and it sure sounds to me like they do, in fact, pay for lap band surgery. I don't know your stats, but if your BMI is at least 40 and you have any comorbidities, you should check a little closer. It may be a question of terminology, or the inexperience of the person you spoke with. I'd dig a bit deeper before giving up. Maybe ask your doctor's insurance coordinator to help you. I think the insurance code is 43775 - ask Regence specifically about that code, and see if they give you a different answer.

The website www.obeseinfo.com says this:

Regence Blue Shield:

Per Policy Bulletin 58 insurance requires 6 month diet, psych and documentation of willingness to comply. Sleeve and StomaphyX are investigational and not covered.

Secondly, a lot of people have appealed a turndown, and gotten surgery approval. Have you even asked for an approval for surgery?

Good luck!

Dave

[honk 780]

If you are married could you look at your husbands health insurance? Each isurance is different. Also some employers offer multiple health insurnance policies. Though you can only change policies at open enrolement in Dec.

[ElfiePoo 109]

Something to consider if you do the self-pay route...there will be fills and most likely unfills...maybe a lot. Find out what the doctor will charge for that. You might find the vertical sleeve is a better choice if you're self-pay...even though it is a bit more invasive.

.

[KristinaAshley 5]

You guys are all so amazing. There is a "no obesity surgery" clause in my insurance. Im not married, so no hubby that has insurance either. Im currently looking into other insurances and self pay options. My BMI is way over 40. I have gotten a refferal from my general physician. He is the one that thought my insurance covered the procedure. So frustrating. I am not a quitter and I am not giving up! Thank you everybody for the kind and encouraging words. Yall are the best ever,

[Day Dreamer 23]

Have you looked into http://www.carecredit.com/ ? I went to a seminar on Saturday and a few people were self pay using this financing program.

Good luck!!

[ElizabethNYC 1]

You guys are all so amazing. There is a "no obesity surgery" clause in my insurance. Im not married, so no hubby that has insurance either. Im currently looking into other insurances and self pay options. My BMI is way over 40. I have gotten a refferal from my general physician. He is the one that thought my insurance covered the procedure. So frustrating. I am not a quitter and I am not giving up! Thank you everybody for the kind and encouraging words. Yall are the best ever,

You sound like a strong person. I wish you the best of luck and do NOT give up!!!

[54Shirley 105]

Does your Ins. come from where you work? A lot of times companies offer 2 different types of Ins. when Open enrollment comes around. I know that's time, but ask your coworkers if they have a different Ins., and how do they like it. Call them up, and ask if they cover Bariatric surgery. If they do then you know who to change too, because they have to cover fills too. I hope you are lucky like I made the change for $20.00 a month more,,,,, it was worth it. If not

Take a loan !

[chocolettebelle 1]

You are not alone in this financial situation. I am also a self pay. My insurance nor my husbands will cover it. I will have a hernia repaired which ins will cover and my doctor will place the band at the same time. I will pay the difference. I placed more on my annual health care flex and the rest will be a loan on my 401K. I have had to be a little creative but I feel that it is what I must do.

[MarcyLoo 12]

also does your company have a health savings account option? It's like a flexible spending acocunt but unused amounts ROLLOVER to the next year and so on so you don't lose the money. Mine has a yearly max of $7100, which I opted for, taking $300 out of my pay every 2 weeks but it's pretax income and once the account builds up you can use that to pay for the surgery 9son a couple eyars savings would do the trick). I know YEARS sound slike a long time away, but you can do it if needed. <3 and maybe by then ins will even cover you.

Don;t give up home...there are options.

[KristinaAshley 5]

Thanks guys, I am not giving up. I am looking into any other insurance plans I come across. I am self employed so I have to pay for my health insurance. Does anyone know of any insurance plans that do cover WLS??