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

Cold Feet... Self Pay And Worries



Recommended Posts

I could use some advice...

I am set for my VSG with Dr. Kelly in TJ on Feb 2nd. My insurance plan does not cover WLS and even if it did (the insurance company has guidlines if it's allowed on your plan), the hoops to jump through will cost us more out of pocket than if we go with the self pay option.

So, innocently cruising this site, I've come across the complication stories and other threads in the other forums which list "insurance not covering complications" as a big reason they won't consider this option which feels like a miracle to me. I thought I'd done my homework, but now I'm waffling... I touched base with my PCP and they're cool to monitor me, I even read my insurance company's Medical Policy, all 30 odd pages of it, and see nothing noted about denying coverage for complications arising from elective and/or overseas procedures. But now... I'm feeling scared and unsure.

My faith and personality want me to be Little Miss Sunshine and trust that this is a God-led solution to a 300lb problem. I feel confident that it's the right procedure for me, that the doctor I've selected is right for me and my needs... etc.

But then I wonder if I'm not sticking my head in the sand. I read the Medical Policy rather than call them because they're notorious for giving you different answers and I'm very afraid to put myself on their radar (maybe I need a tin foil hat?) by asking questions.

How did YOU handle these questions? Maybe you're still living them out and working through them? In the quiet moments of the day, I think it's this specific insecurity... will I be taken care of if something goes wrong... which is giving me cold feet.

ugh.

Share this post


Link to post
Share on other sites

i wouldn't worry i would never say a thing to ins company again so they won't say it was because of surgery they won't know u have half a stomach less they tell someone to to xray u... go to www.gastricsleeve.com and check out that site seems to be alot better than here.. just got back sun at midnight and i feel great......glad i did it.. try that site and i think u will fell better.. good luck.. karensuue@yahoo.com

Share this post


Link to post
Share on other sites

Thank you for the encouragement karensuue!

Share this post


Link to post
Share on other sites

My surgeon had an extended insurance plan For cash pay people Underwritten from an insurance company. I think it costs about $600 to cover me for an entire year post-op. I would ask someone in your surgeons office if they have anything like this available, makes me feel a lot better at night when I go to sleep. I know if I ever have a leak I'm covered it's Good peace of mind and worth every penny.

Share this post


Link to post
Share on other sites

I just asked my doctor if they had a insurance policy to add and they said no. :(

Share this post


Link to post
Share on other sites

Well, I had the same thoughts as you and went back and forth. In the end, my desire for a change and knowing this was the only way I was going to get it. So, I went for it. I'm currently almost 2 weeks out Thursday and feel great. I've been sticking to the plan and have lost over 10 pounds already. hope it continues. it's all a personal decision, just do your homework and know what your getting into...

best wishes,

Traci

Share this post


Link to post
Share on other sites

I could use some advice...

I am set for my VSG with Dr. Kelly in TJ on Feb 2nd. My insurance plan does not cover WLS and even if it did (the insurance company has guidlines if it's allowed on your plan)' date=' the hoops to jump through will cost us more out of pocket than if we go with the self pay option.

So, innocently cruising this site, I've come across the complication stories and other threads in the other forums which list "insurance not covering complications" as a big reason they won't consider this option which feels like a miracle to me. I thought I'd done my homework, but now I'm waffling... I touched base with my PCP and they're cool to monitor me, I even read my insurance company's Medical Policy, all 30 odd pages of it, and see nothing noted about denying coverage for complications arising from elective and/or overseas procedures. But now... I'm feeling scared and unsure.

My faith and personality want me to be Little Miss Sunshine and trust that this is a God-led solution to a 300lb problem. I feel confident that it's the right procedure for me, that the doctor I've selected is right for me and my needs... etc.

But then I wonder if I'm not sticking my head in the sand. I read the Medical Policy rather than call them because they're notorious for giving you different answers and I'm very afraid to put myself on their radar (maybe I need a tin foil hat?) by asking questions.

How did YOU handle these questions? Maybe you're still living them out and working through them? In the quiet moments of the day, I think it's this specific insecurity... will I be taken care of if something goes wrong... which is giving me cold feet.

ugh.[/quote']

Rather than asking WLS specific questions just contact your insurance you a comprehensive detailed coverage policy from them.

Amanda Rae

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

    • BabySpoons

      Sometimes reading the posts here make me wonder if some people just weren't mentally ready for WLS and needed more time with the bariatric team psychiatrist. Complaining about the limited drink/food choices early on... blah..blah...blah. The living to eat mentality really needs to go and be replaced with eating to live. JS
      · 2 replies
      1. Bypass2Freedom

        We have to remember that everyone moves at their own pace. For some it may be harder to adjust, people may have other factors at play that feed into the unhealthy relationship with food e.g. eating disorders, trauma. I'd hope those who you are referring to address this outside of this forum, with a professional.


        This is a place to feel safe to vent, seek advice, hopefully without judgement.


        Compassion goes a long way :)

      2. BabySpoons

        Seems it would be more compassionate not to perform a WLS on someone until they are mentally ready for it. Unless of course they are on death's door...

    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 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

    ×