Shot down by insurance, guess that's that

[Healthygal 50]

I was told this morning by the weight loss clinic that my glorious version of the UMR insurance will only pay a lifetime max of 3,000 bucks on a bariatric surgery. That's AFTER a 500 dollar deductible, and AFTER a 6 month doctor supervised diet prereq. If I just go selfpay it will be 16,000 dollars. Considering I will have to borrow large amounts of money to get my nurse practitioners education in another year or so, trying to come up with 16,000 dollars for this surgery is a no-go. I'm quite sure we will have to get a new car at some point in the next couple of years, too. There is just no way to make this happen. We have three daughters to pay for, my own education, and a mortgage.

Once again, somehow the insurance actuaries have decided that allowing people to continue being obese is cheaper for them than paying for this surgery...or at least paying MORE on this surgery than that! But then again, "I" am the one who is allowing myself to remain obese, for whatever reasons there are...I am the one who puts the food in my mouth.

No, out-of-country travel is not an option. If I was not looking at trying to come up with tens of thousands of dollars for my future as a nurse practitioner, it would be a MAYBE. But as it is...it's a no way.

So there we are. I appreciate the support you have all give me on here. I guess I'm on my own. Maybe this is the kick in the ass I needed to realize that either I want to be healthy or I don't, restriction or no restriction. I may never be my "ideal" weight, but I can be thinner than I am now, and healthier than I am now. I'll just have to do the best I can.

Love to all of you, and a happier and healthier life than you've ever dreamed.

Cara

[kvdme 64]

I have been in the same boat for years, then at the first of this year, my company in a cost saving measure, switched insurance and guess what? It covered it. They have not had it covered since 1986 and just got lucky or I would not have been able to do it. Things change. Situations change, life changes. Keep looking for that open door and be hopeful. It will happen. I never dreamed it would be available to me and with the obamacare acts going into effect, there are TONS of changes on the horizon. Be diligent and keep looking for the time

[RebecaSparkles 247]

Cara- that really really sucks.

Any chance you can switch insurances? Or perhaps rally your HR coordinator to provide a different insurance option? The squeaky wheel gets the oil. Maybe if enough people complain they'll change?

Or perhaps you can get your own plan just for you?

Sorry to hear that.

I got luck & have only 1000 ded & 30% co insurance but if it had been more than I'd be an out of country surgery.

Start socking away the pennies & seeing what you can do to hustle up some $$.

You can also take it out in your student loans for medical expenses if you're a full time student.

Good luck. Wish you the best.

allons-y

[peachie86 63]

I am sorry your insurance company would not cover all of your WLS expenses. I had to wait several years before my insurance would add a lower BMI. I would ask my PCP every year regarding qualifying for the surgery. My doctor would say no I did not meet the requirements and for me not to gain weight to meet the then 40 BMI. I was able to lose 38 pounds but keep only 25 pounds off for the last 7 years. I was then able to get my diabetes and bp meds reduced. Good luck with your journey losing weight which every way you are able to get it off!

[peachie86 63]

Rebecca,

Good idea regarding the student loans!

[bigsleeve56 266]

There are student loans outside the federal loans that go through the banks a friend got a one time $30000.00 dollar loan that did not affect the federal loans.

[Terri Lynn1383837796 139]

Also, check with Dr. Thomas Borland in Louisiana. $9800 cash price. Best to you!

[PdxMan 4,292]

Dr Umbach in Vegas was $10,400. Has financing options. I would highly recommend him.

** Edit **

Just wanted to add that I took a second out on the house to pay for it. With the money I was saving from eating less, medical costs, etc. ... I was able to pay off the loan in just over a year and today I now pocket the savings. So, long story short, for me, this surgery is saving me hundreds of dollars a month, so don't forget to remember these aspects of the surgery when deciding what to do.

Edited October 9, 2013 by PdxMan

[JollyG 4]

I'm in Australia, no insurance, will travel to Tijuana and be operated on by Dr jaime Ponce de leon - very experienced and well reputed - he will do Sleeve for $5300 US

Going rate here is about $18000 - with no real guarantee it won't cost more for unforseens...

[slvrsax 301]

I am also going to MX. If someone had told me a year ago that not only would I go to Mexico for surgery but that I'd be comfortable with it, I'd of said they were nuts I've done months of research - enough to be comfortable and even excited about my decision. A 401K loan is another option for securing cash, either loan or outright distribution, if no one has mentioned it. I know of at least 2 surgeons in MX who allow you to use health savings accounts. Hang in there and don't give up, there are other options worth exploring