please help me out.....

[The B 96]

Okay so, I called insurance in November 2012 and again for the 5th consecutive year I was told NO we do not cover weight loss surgery or anything to do with weight loss period. so my DH and I decided we would pay out of pocket.

I'm excited and am getting surgery in 8 days, guess what.... now my insurance will cover, BUT I have 6-8 months of hoops to jump through to see if I qualify. My Husband says lets just get it done he doesnt want to fight with the insurance, and so sweet he says to me, you have waited so long and worked really hard you've earned just getting it done, we've saved the money and theres no guarantee that the ins. will pay any way.

I won't lie, I don't want to wait, but I worry now if I pay for it out of pocket, if in the future there is a problem leak, slip etc... will my ins refuse coverage cause I didn't get it through them?

I'm curios if anyone here paid for their band and didn't wait for insurance and still have them help later if there was a medical emergency or complication with the band?

Or do I bite the bullet and atleast try to go through my insurance even if it means waiting another 6-8 months? I know it's my decision and in the end only I will know for sure what I should do, but I need opinions from people with experience, PLEASE help me out what do think/know?

Thanks for help!

[A New New Dawn 1,695]

I would urge you to talk to your insurance and ask them these same questions. Also, did you have to go through pre-op testing for the surgery you are already scheduled for? Maybe some of those hoops you would have to go through could already be satisfied with some of the testing you have already completed.

Best wishes to you either way.

[Chandra12 9]

I had surgery last August and also paid privately. It took me a long time to come to the decision to have surgery, and my insurance required a full year of hoops to jump through. My husband said if I want it to just get it. I did have a hospitalization back in December related to my band being too tight. My doctor wasn't on call and out of town. I tried to stay at home and manage but was too sick and ended up admitted with severe dehydration until my physician could remove some Fluid. My hospital stay was covered. I've heard that things like this, as well as band slippage, etc... are typicallly covered because they are considered life threatening. The thing to consider is your insurance company will probably not pay for fills, unfills. Those can get costly. The cost of my surgery covered the first three months of post of fills. I went in several times to try to get to a good spot before the three month time frame lapsed. My surgeon charges $205 per fill so it can add up quickly if you are too tight, have a little fluid removed, then go back in a few weeks to have fluid added. Best of luck to you!!!

[The B 96]

I would urge you to talk to your insurance and ask them these same questions. Also, did you have to go through pre-op testing for the surgery you are already scheduled for? Maybe some of those hoops you would have to go through could already be satisfied with some of the testing you have already completed.

Best wishes to you either way.

Thankyou for responding, I did talk to the insurance their vague or I don't speak their language, but I do they cover the things I was worried about.

Thanks again!

[The B 96]

I had surgery last August and also paid privately. It took me a long time to come to the decision to have surgery, and my insurance required a full year of hoops to jump through. My husband said if I want it to just get it. I did have a hospitalization back in December related to my band being too tight. My doctor wasn't on call and out of town. I tried to stay at home and manage but was too sick and ended up admitted with severe dehydration until my physician could remove some Fluid. My hospital stay was covered. I've heard that things like this, as well as band slippage, etc... are typicallly covered because they are considered life threatening. The thing to consider is your insurance company will probably not pay for fills, unfills. Those can get costly. The cost of my surgery covered the first three months of post of fills. I went in several times to try to get to a good spot before the three month time frame lapsed. My surgeon charges $205 per fill so it can add up quickly if you are too tight, have a little Fluid removed, then go back in a few weeks to have fluid added. Best of luck to you!!!

Thanks

I think your right and I'm pretty sure no help with fills I get them free for a year and my Dr. has a great rate so I'm not terribly worried.

thanks again for help!