Just got insurance approval!!!

seminole · March 28, 2006

Well after 2 weeks of papers into the insurance I got my approval for the surgery . Now I have a couple of concerns. I do not live in the USA. I was planning on going to Mexico if I was self paying. The insurance will pay 100% if done "in network" in the states. I have had my mind so set on my self pay date of May 2006, that now with the insurance I know the possible date will be later . If I get it " out on Network" the insurance company will only pay 50%. What would you do :help:?

Angels · March 28, 2006

No doubt, I would just have to wait a little longer if the insurance is paying. Use your money to do something else special or just save it. Having it done in the states also allows you to seek follow-up treatment that which is also paid by most insurance companies. If you have waited this long a little longer with alot of money in your pocket is definately worth it!

shackdog · March 28, 2006

I am self pay, and I aggree with Angelu. Let the insurance pay for this and use your money for other issues. You could even help any of your friends who need the band and can not afford it. I was give this gift from a christian friend who payed for my entire procedure and all the docs I needed to see/20,000.

This is a gift of life think about it..........

Mvpo8961 · March 28, 2006

I was in a similar position except I live in the US. I had already been approved to self pay and had a date set for surgery. Found out I would be eligible to apply for ins to cover it. So it was hard but I decided to wait for insurance. Don't get me wrong everyday I think about why didn't I just go ahead and do it rather than wait. But in the end I know that waiting is better for my family and myself. If I had to do over I would still wait for ins. M:D

TheWomanWithin · March 28, 2006

Grats on your approval! what you have to decide is how long do you want to wait for surgery.

Some insurance co's have so many pre-requistes (sp?) that you have to do before, like a weight loss plan via a doctor for months.

First find out what your particular insurance carrier requires, then figure out which doctor you want to go to, then call them and see what they require before surgery.

I know with Dr. Grossbard here in Florida, it was going to be quite a few tests I had to go through (x-rays, blood tests, endoscopy (?) and some others) and his waiting period was quite long, but in his affiliate office of Dr. Ortiz, I only have to have those done the day before surgery at their facility and scheduled surgery within a month.

Good luck and I am with the others, more money in my pocket is worth the wait - going to need $$ Im sure after losing weight )

karenj · March 28, 2006

girl, come to the states. come to texas. you can stay at my house while you recoup!!! save your cash for new clothes!!! heheheheh

mini_me · March 28, 2006

check into things, perhaps you will find a highly recommended surgeon who has openings in his schedule.

My surgeon was very highly recommended, and I was still able to pick my surgery date. he was booked for a week after my consult, but i had no problem scheduling at my convenience beyond that week.

LET THE INSURANCE PAY!! Save the money and buy yourself a skinny vacation for your first goal celebration!!! Good luck to you.

seminole · March 28, 2006

Hey,

Talked again to my insurance company and a few different hopitals in the New York area ( none were in my companies network). One thing for sure it seems to be alot of red tape to get this procedure done in th US without spending a couple of weeks in , pre op appointments and finally surgery. My company is checking into the Mexican possibilities . What I have been told is that they will pay airfare for me and another person to go the procedure "out of thier network ". They will pay 80 % of the procedure. They will pay for one follow up visit and also 170.00 usd per day for hotel and food the days I am not in the hospital. this will add up for me only paying about 2500.00 usd. This is also getting it done in one week and not over a possible two week period.

If they agree to Mexico and the other information above I will get it done sooner rather then later as it is only about 2500.00 usd.

What do you all think abot this now?