Cost Of Complications/follow Up Care Covered By Us Insurance?

[Facing50 21]

Hey you guys,

I was diagnosed with diabetes about 5 mos. ago, which is when I started thinking of doing the sleeve. Other issues: I have serious sleep apnea, high cholestorol (on meds for this, plus the diabetes) I am 50, BMI of around 32, family history on dad's side of serious diabetes and heart disease/triple bypass-valve replacement.

Was hoping that my insurance, Kaiser would cover the vsg surgery, but they only do so with a min. of 35 BMI, even with co-morbidities. I do not want to gain weight to get coverage, I am already noticing some vision deterioration in one eye. Maybe it is not diabetes related, but it scares me enough that I really don't want make anything worse

So I am just going to pay for it myself in Mexico. The thing I am most frightened of about this is that if I have follow-up issues once I am back in the US - leaks or even more serious - Kaiser won't cover them because they didn't do the surgery. I am not sure that it is worth going bankrupt if something like that happens. Has anyone had follow up care under their State-side insurance after Mexican surgery? I am really, really worried about this and would appreciate any input.

[coolmamma73 129]

Are you assuming they won't do follow up care if its medically necessary or did you ask them?

My insurance won't cover the procedure but they said if I have complications or have to see a Dr or go to hospital they will cover anything out of necessity and I just have to meet my deductible.

If you do have complications, hospitals have to treat you and many times they have financial assistance and can even write off the bill if you qualify.

Good luck in your decision

[HoosierGirl 780]

Hey you guys,

I was diagnosed with diabetes about 5 mos. ago, which is when I started thinking of doing the sleeve. Other issues: I have serious sleep apnea, high cholestorol (on meds for this, plus the diabetes) I am 50, BMI of around 32, family history on dad's side of serious diabetes and heart disease/triple bypass-valve replacement.

Was hoping that my insurance, Kaiser would cover the vsg surgery, but they only do so with a min. of 35 BMI, even with co-morbidities. I do not want to gain weight to get coverage, I am already noticing some vision deterioration in one eye. Maybe it is not diabetes related, but it scares me enough that I really don't want make anything worse

So I am just going to pay for it myself in Mexico. The thing I am most frightened of about this is that if I have follow-up issues once I am back in the US - leaks or even more serious - Kaiser won't cover them because they didn't do the surgery. I am not sure that it is worth going bankrupt if something like that happens. Has anyone had follow up care under their State-side insurance after Mexican surgery? I am really, really worried about this and would appreciate any input.

You are very wise to take care of yourself vs. relying on your insurance company to tell you what is right for you!

I share your concern about potential complications. To try to "hedge" the liklihood of complications I am planning to address them by: 1 - having funds available to travel BACK to Mexico should a complication occur - enough money for an airline ticket and a couple of nights in a hotel. 2 - from what I understand, complications are more likely to occur if you are not following the post-op diet, so plan to follow the plan to the letter. 3 - planning to pay for a couple of extra nights in the hotel just to ensure I'm in the best shape possible before heading home. Hope that helps and you have a complication free experience!

[Facing50 21]

Hi you guys,

Thanks for your responses. I have not talked to Kaiser yet, I am nervous about flagging the issue before anything even happens. I am just nervous because I think I have read in other places that insurers will not assume liability for follow up care on operations that they did not do, and of course it is just something else to be worried about!

Hoosier Girl, good suggestions. I was already going to spend an extra night in the hotel just to be safe.

Best wishes to you both.

[AmandaRaeLeo 2,146]

Hi you guys' date='

Thanks for your responses. I have not talked to Kaiser yet, I am nervous about flagging the issue before anything even happens. I am just nervous because I think I have read in other places that insurers will not assume liability for follow up care on operations that they did not do, and of course it is just something else to be worried about!

Hoosier Girl, good suggestions. I was already going to spend an extra night in the hotel just to be safe.

Best wishes to you both.[/quote']

Perhaps you could request an coverage packet for your plan that details all aspects of your coverage?

Amanda Rae

[Facing50 21]

Excellent point, Amanda, I am going to do that today.