insurance that covers bariatric

[Hynita 113]

HELP I really need to find a insurance company that covers bariatric stuff. I have had a bad slip and I have to have it repaired with surgery its going to cost me 18thousand dollars I have insurance but not that covers any of this. I pay my insurance out of pocket and I dont have a job im a stay at home mom. So is there any insurance out there that I can pay out of pocket that will cover lap band stuff?

[laurigee 545]

Yikes, that sucks! My insurance didn't pay for bariatrics and I was self-pay and this is one of my biggest fears! I had 3 jobs to save up for the first one, I don't know what I would do if I was in your position! I don't have any answers for you, but I hope you find an insurance company! So sorry!

[RebecaSparkles 247]

If you look for full coverage plans with maternity coverage you'll be more likely to have sucess.

I have kaiser permanente va/md/dc and they do cover but I'm not sure if they'll exclude you as a pre-existing condition.

You may have some sucess going with aplace like true results that offers a flat fee for self pay.

I work in the DME medical field and do have experience with patients negotiating with vendors to give you the insurance adjusted prices.

We use a fee schedule that is based off medicare fees. Our " list prices" are 125% of medicare fee.

Example:

Item costs me 20$ to buy from supplier, medicare pays me $100 based on my regions fee schedule. ( i made 80$)

So, if you walk in off the street with medicare you pay me only what your plan stipulates: co-pay, deductable or co-insurance.medicare pays the rest.

But, if you have no insurance I'm to charge you my fee from my fee schedule $125. ( i made $105)

Lets say you have united or aetna the two worst insurances for my field ( they may pay your doctor nice but not me) they pay out at about 60% of whatever medicare pays me - so same item I bill out at $125- which is my fee schedule amount- and get paid $75. ( I made $55.)

So here's where your case comes into play. You ask to pay what the negotiated insurance rate is for the insurance company that your doctor does the most. ( you ask to pay the amount listed in the last example) they may say no , but at least you asked.

Also, go down to the hospital or clinic and ask to speak to that billing person face to face. She'll give you some bs about oh we dont know exactly what the charges are til its over. Bulls$&!t, they can pull an average and base your quote off that. They may give you a 10% margin of error so if supplies are needed or an extra scrub nurse you'll still end up within your means.

Furthermore, if you do have to self pay negotiate, ask for something extra. Always. A room by yourself, a window view anything, make it so even if you have to pay all 18k you get something you didnt have before.

Also, you may have some luck with the state run insurances for the uninsurable -pcip? May of spelled that wrong. But it's based off the fact that you need something and no insurance company will insure you at that level for a resonable amount of money per month.

Please please dont give up! If you ever want insurance advice like this or in more detail I'd love to skype with you!

Message me on here & we'll set up.

Good luck!

Rebeca

[Hynita 113]

Yikes' date=' that sucks! My insurance didn't pay for bariatrics and I was self-pay and this is one of my biggest fears! I had 3 jobs to save up for the first one, I don't know what I would do if I was in your position! I don't have any answers for you, but I hope you find an insurance company! So sorry![/quote']

Thanks and it sucks really bad. :/

[Hynita 113]

If you look for full coverage plans with maternity coverage you'll be more likely to have sucess.

I have kaiser permanente va/md/dc and they do cover but I'm not sure if they'll exclude you as a pre-existing condition.

You may have some sucess going with aplace like true results that offers a flat fee for self pay.

I work in the DME medical field and do have experience with patients negotiating with vendors to give you the insurance adjusted prices.

We use a fee schedule that is based off medicare fees. Our " list prices" are 125% of medicare fee.

Example:

Item costs me 20 to buy from supplier' date=' medicare pays me 100 based on my regions fee schedule. ( i made 80)

So, if you walk in off the street with medicare you pay me only what your plan stipulates: co-pay, deductable or co-insurance.medicare pays the rest.

But, if you have no insurance I'm to charge you my fee from my fee schedule 125. ( i made 105)

Lets say you have united or aetna the two worst insurances for my field ( they may pay your doctor nice but not me) they pay out at about 60% of whatever medicare pays me - so same item I bill out at 125- which is my fee schedule amount- and get paid 75. ( I made 55.)

So here's where your case comes into play. You ask to pay what the negotiated insurance rate is for the insurance company that your doctor does the most. ( you ask to pay the amount listed in the last example) they may say no , but at least you asked.

Also, go down to the hospital or clinic and ask to speak to that billing person face to face. She'll give you some bs about oh we dont know exactly what the charges are til its over. Bulls&!t, they can pull an average and base your quote off that. They may give you a 10% margin of error so if supplies are needed or an extra scrub nurse you'll still end up within your means.

Furthermore, if you do have to self pay negotiate, ask for something extra. Always. A room by yourself, a window view anything, make it so even if you have to pay all 18k you get something you didnt have before.

Also, you may have some luck with the state run insurances for the uninsurable -pcip? May of spelled that wrong. But it's based off the fact that you need something and no insurance company will insure you at that level for a resonable amount of money per month.

Please please dont give up! If you ever want insurance advice like this or in more detail I'd love to skype with you!

Message me on here & we'll set up.

Good luck!

Rebeca[/quote']

Thanks I'm really stressing about this I can't believe how much they want that's more then I paid for the band two years ago. I've found a place about a hour away that wants 11, 500 to remove it I at this point have no other choice but to do that. I really really want to keep it but what happens if it slips again I'm really screwed. And the hospital wants the 18thousand before surgery is even done.