Insurance Is Evil

[shangefan 193]

Well, I learned today that my insurance, CareFirst BCBS, has an exclusion for bariatric surgery. I am totally frustrated. In 2009, I was in a different job with different insurance that had no coverage, so I paid cash for a band. It worked well for a year, at which time I moved to another city. I got off track and never recovered. I have now regained 40 of the 60 pounds I had lost -- and I already was not at goal.

The band is simply not working for me and my doc recommended a revision to the sleeve. Now I find out the insurance won't pay. I paid $11K for the band (which feels like a waste of money) and i just can't pay that kind of money again. So I guess I will look at the possibility of going to Mexico. All of the accounts I have seen from people who went there are positive.

I guess I am really just venting because I am super disappointed. I had planned a trip to Hawaii for later this summer, but I think I need to cancel that and shift the money to pay for the surgery.

[Artsy 48]

I've read somewhere on a blog here that there is some type of loan company for the surgery or perhaps some of the surgeons in Mexico work out an arrangement. IDK but it's worth looking into.

[Back~To~Amy 307]

Unfortunately, it is your employer who is evil. They choose what coverage you do or don't have, .it the insurance company. My company gave us bariatric coverage but it is so crappy that cash pay is cheaper! Good luck to you!

~Amy

[shangefan 193]

My initial assumption was that my employer chose not to include the coverage but I spoke with the member services person at the insurance company and the insurance coordinator at my doctor's office. Both told me this: WLS is not a mandatory coverage in DC. Because I work for a small employer, it isn't a situation in which they choose a list of options. Rather, there is a package that the insurance company has already put together and the coverage isn't even an option for them. Larger employers get to negotiate packages, so some opt to include it.

Now, this could be a crock, and it is totally different from what I thought. But I cannot imagine why both the doctor's office and the insurance company would have told me that were it untrue.

At any rate, whatever the reason, I don't have the coverage.

[FatGirlSlim 115]

I am so with you!!! Insurance and these employers (I work for the federal government with their strict guidelines) and the devil. After two denials from Kaiser because of fed guidelines I just said forget another appeal and started researching going to mexico. And since I have has previous surgery in Mexico it was a no brainer!!!! Back to Mexico I go! I hope you are able to find a solution !

[TinaMari 75]

How do you find out about having the procedure in Mexico?

[FatGirlSlim 115]

I had a friend who was approved through Kaiser. Once she found out they denied me she suggested Mexico. Since i had had another procedure in Mexico I didn't give it a second thought. I started my research to find the right doctor for me!!! So here I am..... Just six days from my sleeve

[shangefan 193]

I actually never thought about surgery in Mexico until I started reading about it on this forum. Then I realized it makes perfect sense. I am a former journalist, so I knew that Medical Tourism is big; I just had never thought of partaking in it.

Kisha, you are gonna do great!

[FatGirlSlim 115]

I actually never thought about surgery in Mexico until I started reading about it on this forum. Then I realized it makes perfect sense. I am a former journalist, so I knew that Medical Tourism is big; I just had never thought of partaking in it.

Kisha, you are gonna do great!

thanks!!!! I am so excited!!!