chelle622 0 Posted May 20, 2011 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
feedyoureye 3,087 Posted May 20, 2011 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
LR6909 10 Posted May 20, 2011 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
BajaMedGroup 6 Posted May 20, 2011 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
Ricky 6 Posted May 20, 2011 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
wondering1 103 Posted May 21, 2011 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
wondering1 103 Posted May 21, 2011 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
wishes 125 Posted May 22, 2011 Wow, that insane. What has insurance come to? Share this post Link to post Share on other sites
1-4-Many 2 Posted May 22, 2011 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
chelle622 0 Posted May 23, 2011 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
marymoon 18 Posted May 23, 2011 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
doggz109 41 Posted May 24, 2011 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