If your insurance does not cover WLS ...

[pumpkin07 32]

AND if your current insurance also doesn't cover WLS complications, how about considering changing jobs to get better insurance?

My insurance, United Healthcare (Texas) through my husband's employer, did not cover WLS OR WLS complications. I decided to use a local doctor and self pay b/c I would not consider going out of the country b/c what if I had complications and needed my doctor? To me I decided to spend the extra funds to stay in my home town.

SO I self paid $14,500. My experience was no major complications thank GOD.

BUT what if you self pay (went out of country) and after being home a while began to have complications, which of course your/my insurance does not cover. Do you know how much this bill could add up to be - $300,000 or more???? YES, if you are seriously ill. And if you went out of country, you don't even have a doctor here ready to help you...so you have to start from square one.

So the point is, why not just wait until you might change jobs and get better insurance? My husband actually changed jobs anyway recently, 4 mos after my surgery, and I realize now I should have just waited so I thought I would share.

We all think about should I self pay here or there (which I would recommend looking for a super experienced doctor in your area as opposed to traveling to a doctor that will not come home with you).

But WHAT IF you have serious complications...how will you pay for it if your insurance does not cover WLS complications?

Just something to consider. I think I'm fairly savvy, but I just didn't really think through what if I have complications and insurance will not cover it? I thought it would be a risk of less than 50,000. But I have since learned that was a very naive number. It depends how many surgeries you need, how much time in the hospital, etc. It could be half a million dollars...

If you are in the situation I was in, it is like not having insurance when you need it the most, when you are most at risk.

So just give it some thought. Not covering the complications of WLS is sort of worse to me than not covering the surgery. Not to mention it is unfair.

[efresh 0]

Insurance companies in the United States are criminals am sorry to say this. But it is the truth

[mmcclure 3]

My daughter and I are having surgery using a very limited insurance policy that has a definite yearly cap (and it is not very high). I have an HMO that is fantastic, but they don't cover WLS nor any complications from it.

I've been worried about this as well. But, I don't want to change jobs because I love the one I have and the benefits (other than not offering WLS) are wonderful (and I can retire with them). My husband's employer (full-time one; he has two and we are using the insurance from the part-time one) covers WLS but has a rule that, if your spouse can get insurance, they have to take it. That would make mine primary and his secondary so the way insurance works, there would be no WLS coverage (their argument is that if the primary doesn't cover a procedure, there is nothing to pick up, therefore, no coverage for that procedure). Yeah, they have all their bases covered to their benefit, certainly not ours.

It all came down to whether or not we were willing to risk having the surgery vs. the bad health and risk of NOT having surgery. I pay over $125.00 a month just in co-pays for my medicines, plus I can see where my health is getting worse every year (I am 55). My daughter is only 21 and already has asthma and knee problems. She is a beautiful girl, but has low self-esteem and is worth soooo much more than what she is experiencing now.

I just posted a post about being nervous about the surgery and that is true - I am. But, in answering this question, I guess I am also reaffirming why we are taking this risk.

So - God willing, we will have no complications. But, in any event, we will take that risk because the benefits far outweigh the risks. Money is just that - money. Your health and well-being are everything.