Jump to content
×
Are you looking for the BariatricPal Store? Go now!

insurance changes new doctor fees!



Recommended Posts

I am one month from completing my original 3 month pre-op requirements only to learn that BCBS has changed their requirements to 6 month minimum. Due to my job that moves my surgery from July to November or December. On top of that there is a new $5000 surgeon copay, new deductible and 20% which will be around $7000. Am I crazy to now consider having the surgery in Mexico for affordability?

Share this post


Link to post
Share on other sites

I am one month from completing my original 3 month pre-op requirements only to learn that BCBS has changed their requirements to 6 month minimum. Due to my job that moves my surgery from July to November or December. On top of that there is a new $5000 surgeon copay, new deductible and 20% which will be around $7000. Am I crazy to now consider having the surgery in Mexico for affordability?

OUCH! sounds like Mexico is a definite possibility...

Share this post


Link to post
Share on other sites

OMG!!! I am so sorry. I have Empire BCBS. Which BCBS do you have? Which doctor are you using? I sure hope this isn't the case for me.

Share this post


Link to post
Share on other sites

It is pretty unfortunate you had to put up with this, but this 'co-pay' has been something that they have wanted to implement for a while. Expect those fees to stick around or even rise. Until there is some reform by the government, insurance companies will make you jump through so many hurdles to have a procedure that can give you a better quality of life, and that can even save it.

Take things calmly, maybe you can find some loop-hole to go through. This may just be a minor set-back. Stay focused and you will eventually have your surgery.

Share this post


Link to post
Share on other sites

Nope..you're not crazy. That's what I am doing. Tired of fighting w/BCBS and am headed to Mexico in 9 days :) My Mexican surgeon has done far more sleeves than most US surgeons...so, as crazy as it sounds to go to Mexico to have most of your stomach removed..I am doing it!!!

Best wishes to you!!

Share this post


Link to post
Share on other sites

I have BCBS of Delaware and am switching to Aetna *** because of their restrictions. But we are now in open enrollment. Is there a possibility you can change insurances?

Share this post


Link to post
Share on other sites

I have BCBS of Delaware and am switching to Aetna *** because of their restrictions. But we are now in open enrollment. Is there a possibility you can change insurances?

Share this post


Link to post
Share on other sites

Wow, that insane. What has insurance come to?

Share this post


Link to post
Share on other sites

I feel your pain. I ended up paying about $3k out of pocket. My $1200 surgeon and $500 asst. surgeon costs went up to $1700 for the main surgeon and $750 for the asst. by the time they finalized me for surgery. It was major sticker shock but I found out about the increases the day I was given my pre-diet to start. This is their flat charge they charge regardless of what insurance pays them. Above and beyond. I came home and had to do some long hard thinking about going to Mexico and would have it not for the additional delay. I'd endured too many of them and decided that paying it and getting it over and done was the way to go. But if you are further out, I'd really consider the option.

Share this post


Link to post
Share on other sites

i am a teacher so we have BCBS TRS active care. According to others I have spoken to almost every insurance provider will be joining the bariatric surgeon copay next year or shortly after. June 2 is my "last" wt mgt meeting so I will wait to see if I am approved or not. My decision will be made from there.

thanks for all the posts and support.

chelle

Share this post


Link to post
Share on other sites

I have BCBS Tennessee and though the sleeve is excluded, my surgeon thought we could get it paid for on appeal. Of course, insurance only paid 50% of the allowable charges which was about the same amount of $$ as it was going to cost in Mexico. I'm an impatient person and didn't want to waste any more time so I cancelled all further appointments and scheduled surgery with Dr. Aceves. Best money I've ever spent and I got a much more experienced surgeon to boot.

Share this post


Link to post
Share on other sites

Not insane....but keep in mind....there are complications with this surgery. IF you do develop one after having surgery in Mexico your insurance likely WILL NOT cover anything related to it once you are back.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×