Houston17 115 Posted March 3, 2013 So, I have been denied twice and my appeal was just denied by UHC! My BMI is about 38 and I was diagnosed with high blood pressure in 2011. Insurance is stating that I would have to have the co-morbidity for 5 years in addition to the 5 years of weight history since I am below a BMI of 40. I have struggled with weight my entire life. I am 49 years old and I don't see this changing. I've lost weight several times over the years just to regain it, plus more! My parents both died in their mid 60's. both had high blood pressure and were overweight probably about the same as me as far as BMI. So, my question is..... Looking back at what you achieved, would you have gone through this having to pay yourself? I am not comfortable at this point going to Mexico so I will be checking with my doctor to see what he will charge me with no assistance from insurance. I am guessing around $20k. Thanks in advance for your feedback! Share this post Link to post Share on other sites
FishingNurse 1,211 Posted March 3, 2013 I was lucky and insurance covered me but YES I would self pay if I wasn't covered. Best thing I have ever done for myself! Share this post Link to post Share on other sites
Sarah78_RN 66 Posted March 3, 2013 I was lucky and insurance covered me but YES I would self pay if I wasn't covered. Best thing I have ever done for myself! Me too! Share this post Link to post Share on other sites
Ms.AntiBand 2,984 Posted March 3, 2013 Yes, and I did pay. Share this post Link to post Share on other sites
Lissa 2,631 Posted March 3, 2013 I did self-pay, $12,500. I wanted the surgeon that I got and was willing to pay for it since my health insurance has a total exclusion for bariatric surgery. For me, going to Mexico never crossed my mind because Dr Domkowski came SO highly recommended. My best friend is an ER nurse and had worked with him previously. Between her endorsement of him and his amazing success rate, I was sold completely. I still feel it was the best decision I ever made and worth every single penny! Share this post Link to post Share on other sites
janarae 93 Posted March 3, 2013 I was self pay for my band and revision,Mexico both times. You do not sacrifice your quality of care by going there, you only spend less Revision 1/31/13 by Dr Cabrera and Venezuela in MX 1 amytug reacted to this Share this post Link to post Share on other sites
ProudGrammy 8,322 Posted March 3, 2013 would you have gone through this having to pay yourself? Houston17 Hi Tex i also was fortunate that my WLS was completely covered but - i would have thought about "it" WLS longer and harder due to the considerable cost wouldn't be second guessing the surgery itself - just the financial responsiblity if you get over your fear of Mexico i "think" people pay prices from $7,000 - $12,000??? obviously much cheaper that US My answer to your question - would i have proceeded with surgery if i had to pay for it???? Yes Share this post Link to post Share on other sites
Texasgeo 49 Posted March 3, 2013 I am paying about $11,000 cash for mine. In Texas. And the way I look at this way, if it gives me 10 more years with my kids it is worth every cent. Share this post Link to post Share on other sites
janarae 93 Posted March 3, 2013 I paid $5,600 for a revision, for just the sleeve is $4,500, that included transportation from airport to Mexico, 3 nights in hotel and 2 nights in hospital. Revision 1/31/13 by Dr Cabrera and Venezuela in MX Share this post Link to post Share on other sites
shelbyshumyers 12 Posted March 3, 2013 My insurance wouldn't cover the actual surgery (i had the sleeve) I had a Hiatal hernia as well so my insurance ended up covering part of it so my total out of pocket was $7200! I am from TX as well! If you have heartburn or reflux a lot then you prob have a hernia! Share this post Link to post Share on other sites
Takingcontrol 467 Posted March 3, 2013 I'm from Houston area too & was lucky that mine was covered by insurance! But it was a battle! My insurance didn't cover it...so had to switch to hubby's insurance & it did...but I had to jump through the hoops!! Bottom line..if his had denied me again ( I had to appeal)... I was prepared to self pay! I was that determined! Now, post surgery....YES...I would def self pay! It's the best thing I have ever done for myself! Share this post Link to post Share on other sites
mikeross 216 Posted March 3, 2013 My insurance would have covered it but I would have waited years for the actual surgery. I'm from Vancouver,bc and I believe the wait times are 3+ years, last I checked. Wasn't willing to wait so I paid out of pocket. Share this post Link to post Share on other sites
Deanne 22 Posted March 3, 2013 I would have had to wait several years if I wanted my insurance to cover it so I paid for it myself, but if it gives me energy and the ability to play with my grandaughter then it is well worth it. Being 1 month out, I'm not there yet..lol Share this post Link to post Share on other sites
Amie 90 Posted March 3, 2013 I didn't have to do this but I would have if I had lost to much weight on the 6 month supervised diet. I could not fall below 40 bmi because I have no co-morbidity issues. But I have heard of someone using ankle weights for their weight-ins. It would have worked for me because at all my appointments they weighted me with my clothes and shoes on. I just think the numbers game is a little ridiculous, I love how insurance companies make you wait to get more unhealthy before they will cover it. Anyway Mexico is a great option, my mom is planning on heading down there for her sleeve. Dr. Kelly is $5500 doesn't include the flight. In my opinion the Mexican surgeons are just as good as the ones in the states maybe even better as they usually have done a lot more of these surgeries. Good luck. I hope everything works out for you. 1 RebecaSparkles reacted to this Share this post Link to post Share on other sites
Sarah78_RN 66 Posted March 3, 2013 My surgeon has a cash cost of 9,995. Share this post Link to post Share on other sites