Insurance vs Mexico

[allycatt98 35]

I'm really grateful for the info that you've all generously posted here. It's helped me mentally prepare in so many ways. Now I'm at a crossroads of my own. I'm totally comfortable making my own decisions, but a little feedback from others in the same situation doesn't hurt either.

Synopsis: I live in FL and have UHC insurance with the Bariatric Resource Program. Within a two hour radius, there are only three approved hospitals. I finally decided on a hospital and surgeon only to find out they want a ridiculous non-refundable $600 "Program Fee," in addition to me having a MOOP of $6000. So total estimated costs are at $6600. The alternative path would be venturing to Mexico for either Drs. Lopez or Osuna at Specialized Bariatrics -- estimated costs $4200 - $5000 (surgery, flights and incidentals). Yes, there are flight costs and no follow-up, but considering my initial FL doc choice was over two hours away, I doubt I would necessarily return to him for complications. But if I opt for a Florida doc, I wouldn't be alone. There is a chance that I would be alone going to Mexico.

So what are your thoughts? Would you opt for Mexico for a savings of $1600 - $2000 dollars?

[mmhutch 28]

I just came back from TJ and had surgery with Dr Elias Ortiz. He may cost a couple hundred more than the Drs you are looking at but it is well worth it. My friend used Dr Osuna and received NO POST OP information. She kept asking and they kept putting her off. She had no idea what to follow in terms of food/liquid/protein intake! A Lighter Me is the company that contracts with Dr Ortiz. They are extremely thorough and do not leave you after the surgery. I have a nutritionist that I can call anytime. And my nutritionist sends me a weekly update to my diet according to my surgery date and includes ideas, recipes, tips. I had all my post op care and diet information from her 10 days BEFORE my surgery.

Further, when I shared my friends dilemma with my NUT, she asked for my friends email so that she could send her everything she sends me!

My total cost with airfare and shuttle to and from airport at home was under $5000.

Also, A Lighter Me hires a private nurse to take care of their patients only during third shift. That nurse is in addition to the hospital staffed nurses.

I received better care in TJ than the USA. By the way, I work in healthcare for a surgical group.

Whatever you decide, my best to you.

Feel free to message me if I can answer any other questions for you.

[gohelpyourself 377]

Personally I would stay local even if it cost me a little bit more but that is just me.

[nolagirl 36]

One thing to consider:

The surgeons in Mexico are doing probably 20-50 surgeries a week

The surgeons on the states are doing a few a month. Maybe a dozen? I read a report in the NY times stating you need a surgeon who has done at least 300 procedures. My surgeon in Mexico has done over 13,000. I had 0 post surgical pain and my mom said my surgery lasted about 1/2 an hour. I think doing so many they aRE A LOT more experienced. Personally I'm glad I went the Mexico route.

[1Day1Life4Now 882]

Allycat, I had my surgery here in Mississippi and I have access to all type of follow up and support groups for which I am very thankful. It sounds like the doctors in Florida are holding you hostage by charging those exorbitant fees. I think Nolagirl and mmhutch have some very valid points that you should strongly consider in favor of Mexico. Whichever you choose, I wish you lots of luck and a safe surgery.

[gohelpyourself 377]

I have seen great reviews on Medical Tourism HOWEVER one thing to seriously consider is follow-up care once you return home. If you suffer post procedure complications or side effects the post treatment care will then become your responsibility. Since you do have health insurance.... I think that should be a major deciding factor for those reasons alone.

My surgeon has done hundreds of sleeves and I do not think he is less experienced than someone who has done thousands. I was an ER nurse for 13 years and could start an IV on a mosquito. All the veteran nurses would come to me when they couldn't get a line in someone (that had many more years practice).

The bariatric group I selected was a Bariatric Center of Excellence. Do your research and weigh the pros and cons. Do not make your decision based solely on money. I am not against Medical Tourism by no means.... I am all in favor BUT the cost difference is not that much. I think the extra money you spend to have the piece of mind of having it covered under your own health insurance is a huge plus.

[allycatt98 35]

I just came back from TJ and had surgery with Dr Elias Ortiz. He may cost a couple hundred more than the Drs you are looking at but it is well worth it. My friend used Dr Osuna and received NO POST OP information. She kept asking and they kept putting her off. She had no idea what to follow in terms of food/liquid/protein intake! A Lighter Me is the company that contracts with Dr Ortiz. They are extremely thorough and do not leave you after the surgery. I have a nutritionist that I can call anytime. And my nutritionist sends me a weekly update to my diet according to my surgery date and includes ideas, recipes, tips. I had all my post op care and diet information from her 10 days BEFORE my surgery.

Further, when I shared my friends dilemma with my NUT, she asked for my friends email so that she could send her everything she sends me!

My total cost with airfare and shuttle to and from airport at home was under $5000.

Also, A Lighter Me hires a private nurse to take care of their patients only during third shift. That nurse is in addition to the hospital staffed nurses.

I received better care in TJ than the USA. By the way, I work in healthcare for a surgical group.

Whatever you decide, my best to you.

Feel free to message me if I can answer any other questions for you.

Hi MmHutch,

I'm really surprised that your friend didn't receive any support. Do you know if she went through a coordinator or Drs. Lopez and Osuna's practice, Specialized Bariatrics? Maybe the lack of follow through is one of the reasons why they created their own practice? I haven't even paid the deposit or decided on a date, but I've already received tons of information from their office including pre and post-op instructions.

Regarding Dr. Ortiz, didn't he train under Dr. Lopez? I thought I read in one of the posts that he was Dr. Lopez's assistant before venturing out on his own.

I have the option of requesting a private nurse once I return to the hotel for $250 per night. I haven't decided yet whether or not I want to do this.

I've been a nurse for over ten years so I've seen how the healthcare system here fails people. I spent over seven years in Managed Care so I have first hand knowledge of the insurance industry too. From what I've learned, the care will probably be better in Mexico because the providers and facilities are catering to tourist dollars... That's a lot different than most of the facilities we deal with here unfortunately.

[allycatt98 35]

I have seen great reviews on medical tourism HOWEVER one thing to seriously consider is follow-up care once you return home. If you suffer post procedure complications or side effects the post treatment care will then become your responsibility. Since you do have health insurance.... I think that should be a major deciding factor for those reasons alone.

My surgeon has done hundreds of sleeves and I do not think he is less experienced than someone who has done thousands. I was an ER nurse for 13 years and could start an IV on a mosquito. All the veteran nurses would come to me when they couldn't get a line in someone (that had many more years practice).

The bariatric group I selected was a Bariatric Center of Excellence. Do your research and weigh the pros and cons. Do not make your decision based solely on money. I am not against medical tourism by no means.... I am all in favor BUT the cost difference is not that much. I think the extra money you spend to have the piece of mind of having it covered under your own health insurance is a huge plus.

Belladonna,

One of my points was that the physician I selected in Florida is over two hours away. Therefore if a complication did arise, I would not be going back to him for follow-up. I would seek local care. So either way, I would be on my own for follow-up.

Good point about the insurance coverage for complications. If I use insurance for the procedure, I won't be responsible for paying for any additional charges once my MOOP is met..... Provided it occurs during the same calendar year. I need to research the medical tourism insurance policies for comparison.

Ally

[allycatt98 35]

One thing to consider:

The surgeons in Mexico are doing probably 20-50 surgeries a week

The surgeons on the states are doing a few a month. Maybe a dozen? I read a report in the NY times stating you need a surgeon who has done at least 300 procedures. My surgeon in Mexico has done over 13,000. I had 0 post surgical pain and my mom said my surgery lasted about 1/2 an hour. I think doing so many they aRE A LOT more experienced. Personally I'm glad I went the Mexico route.

Thanks Nola,

That is a good point. The doc I chose in Florida is considered the "grandfather" bariatric surgery here. He was the first in the state to perform the sleeve using the Spider technique. I think he's performed over 12,000 surgeries in addition to being a bypass patient himself. So he's definitely qualified, but that doesn't mean that he's the only one that can perform the surgery safely.

Ally

[allycatt98 35]

Allycat, I had my surgery here in Mississippi and I have access to all type of follow up and support groups for which I am very thankful. It sounds like the doctors in Florida are holding you hostage by charging those exorbitant fees. I think Nolagirl and mmhutch have some very valid points that you should strongly consider in favor of Mexico. Whichever you choose, I wish you lots of luck and a safe surgery.

Thanks 1Day,

The physicians are a bit ridiculous here. The choice to go to Mexico comes with a lot of "what ifs?" Part of the decision making process for me is determining the importance and relevance of each of my questions. If a complication arises, it just happens. I wouldn't necessarily have any more control over the situation in Florida vs. Mexico.

I wasn't planning on having surgery until this summer while the kids are out-of-school. I have a consultation scheduled with the Florida doc in April. I think it would be prudent to keep the consult and get a feel for the doctor. I've had some really bad experiences with some docs that were too cocky to listen to their patients. That's part of my interest in a Mexico based physician. I feel like they will be more responsive to my concerns because they rely on these tourism dollars and are focused on building (and maintaining) a good reputation. Either way, I'm happy that I have time to make a decision that I'm comfortable with.

[mmhutch 28]

Hi MmHutch, I'm really surprised that your friend didn't receive any support. Do you know if she went through a coordinator or Drs. Lopez and Osuna's practice, Specialized Bariatrics? Maybe the lack of follow through is one of the reasons why they created their own practice? I haven't even paid the deposit or decided on a date, but I've already received tons of information from their office including pre and post-op instructions. Regarding Dr. Ortiz, didn't he train under Dr. Lopez? I thought I read in one of the posts that he was Dr. Lopez's assistant before venturing out on his own. I have the option of requesting a private nurse once I return to the hotel for $250 per night. I haven't decided yet whether or not I want to do this. I've been a nurse for over ten years so I've seen how the healthcare system here fails people. I spent over seven years in Managed Care so I have first hand knowledge of the insurance industry too. From what I've learned, the care will probably be better in Mexico because the providers and facilities are catering to tourist dollars... That's a lot different than most of the facilities we deal with here unfortunately.

Hey allycatt98,

Yes, my friend went through a coordinator named Cathy.

My friend will not recommend her surgeon to anyone now. She saw everything I received as a patient from A Lighter Me and recommends them and Dr Ortiz to her friends.

By the way, the owner of the hospital is an Internist named Dr Sammy Tepperman. He does not do the surgeries himself. But when he has a patient that needs it, he refers them to Dr Ortiz out of all the drs that perform bariatric surgery there. Dr Ortiz operated on one of Dr Teppermans's patients while I was there.

I learned a lot while there about things other surgeons have done to rip patients off. I met the patients.

That is why I'm thankful for Dr Ortiz and his group.

$250/nt for a nurse at the hotel seems unnecessary. I stayed in the hotel 2 nights after 2 nights in the hospital. I definitely did not need a nurse. I changed my own bandages that were provided by A Lighter Me. They gave me bandages, tape, pain meds with directions written in them (non narcotic, Toradol) which I didn't need because I had no pain, antibiotics with directions and a bottle of mylanta to take prior to abx. They were in a goodie bag of items for hospital stay.

My driver also took me to a pharmacy where I purchased a supply of Omeprezole that I need to take for a few months. I bought 4 months worth for $60. Much cheaper than Prilosec OTC in Walmart.

The lack of follow through my friend experienced would only be related to the split in that Dr Lopez left A Lighter Me, where they actually take care of their patients. He now contracts with a different group.

[allycatt98 35]

Hi MmHutch, I'm really surprised that your friend didn't receive any support. Do you know if she went through a coordinator or Drs. Lopez and Osuna's practice, Specialized Bariatrics? Maybe the lack of follow through is one of the reasons why they created their own practice? I haven't even paid the deposit or decided on a date, but I've already received tons of information from their office including pre and post-op instructions. Regarding Dr. Ortiz, didn't he train under Dr. Lopez? I thought I read in one of the posts that he was Dr. Lopez's assistant before venturing out on his own. I have the option of requesting a private nurse once I return to the hotel for $250 per night. I haven't decided yet whether or not I want to do this. I've been a nurse for over ten years so I've seen how the healthcare system here fails people. I spent over seven years in Managed Care so I have first hand knowledge of the insurance industry too. From what I've learned, the care will probably be better in Mexico because the providers and facilities are catering to tourist dollars... That's a lot different than most of the facilities we deal with here unfortunately.

Hey allycatt98,

Yes, my friend went through a coordinator named Cathy.

My friend will not recommend her surgeon to anyone now. She saw everything I received as a patient from A Lighter Me and recommends them and Dr Ortiz to her friends.

By the way, the owner of the hospital is an Internist named Dr Sammy Tepperman. He does not do the surgeries himself. But when he has a patient that needs it, he refers them to Dr Ortiz out of all the drs that perform bariatric surgery there. Dr Ortiz operated on one of Dr Teppermans's patients while I was there.

I learned a lot while there about things other surgeons have done to rip patients off. I met the patients.

That is why I'm thankful for Dr Ortiz and his group.

$250/nt for a nurse at the hotel seems unnecessary. I stayed in the hotel 2 nights after 2 nights in the hospital. I definitely did not need a nurse. I changed my own bandages that were provided by A Lighter Me. They gave me bandages, tape, pain meds with directions written in them (non narcotic, Toradol) which I didn't need because I had no pain, antibiotics with directions and a bottle of mylanta to take prior to abx. They were in a goodie bag of items for hospital stay.

My driver also took me to a pharmacy where I purchased a supply of Omeprezole that I need to take for a few months. I bought 4 months worth for $60. Much cheaper than Prilosec OTC in Walmart.

The lack of follow through my friend experienced would only be related to the split in that Dr Lopez left A Lighter Me, where they actually take care of their patients. He now contracts with a different group.

Wow! I'm sorry your friend had such a horrible experience. I know that the docs still contract thru Mexico Bariatrics in addition to their own practice. Maybe I'm getting more attention because I'm dealing directly with the docs? I don't know. This is probably the first negative I've read about them. I'm glad to read that you recovered well after surgery. I'd like to think I have a high pain threshold (after 4 Cesarean sections), but it's still comforting to read stories like yours. I'm going to do some comparison shopping with A Lighter Me as well.

[Kisha Mason 16]

i've been researching the sleeve for well over a year and went back n forth trying to decide whether to go through my insurance or mexico. the main stigma some people are against mexico is becuz of the "what ifs" and uncertainty being in a foreign place vs the US yet people seem to forget the MANY malpractices that also happen right here in the US as well. With going through my insurance co i'd have to be more than just fat basically. i need to have a host of other complications which i dont. so to avoid the extra dance around n wait game of getting approved or not which would take well over 6-9 months i decided to take a chance and im scheduled for mexico april 25th. im SOOOO excited actually. traveling alone for me time!!

[allycatt98 35]

<p>i've been researching the sleeve for well over a year and went back n forth trying to decide whether to go through my insurance or Mexico. the main stigma some people are against mexico is becuz of the "what ifs" and uncertainty being in a foreign place vs the US yet people seem to forget the MANY malpractices that also happen right here in the US as well. With going through my insurance co i'd have to be more than just fat basically. i need to have a host of other complications which i dont. so to avoid the extra dance around n wait game of getting approved or not which would take well over 6-9 months i decided to take a chance and im scheduled for mexico april 25th. im SOOOO excited actually. traveling alone for me time!!</p>

Kisha you're absolutely right. I could tell you stories that would make your hair stand on end. People unfortunately assume that there are safeguards in place to protect you in the States, but that's not always the case. Just take a peek in any nursing home and you'll see what I mean. So medical care in Mexico isn't really scary to me.

My situation is a bit different though. I don't mind waiting six months to complete the nutrition classes and psych eval. I think it will better prepare me for the future and help me decide that this is what I really want. But, that being said the $6000 MOOP has my head spinning. Surgery in Mexico (even with travel expenses) would still be much, much less. The problem is that you end up paying for everything (all the little extras) when you opt for MX. I was told that a Cholecystectomy would be an extra $1000. I already have gallstones... So it's becoming less likely that I will be going to MX unfortunately. By the time all the costs are added up, MX isn't so affordable after all.

So right now I'm in the process of working out a payment plan (or even possibly reduced costs) with the hospital since I will have to pay the surgeon's costs up front.

Ally

[CiCi1965 5]

Hi Ally...

I too am in FL and have access to many local docs thatt do WLS; however, my employer has an exclusion on WLS. I am working really hard right now in overtime to save enough $$$$ to be able to afford to go to Mexico by mid year. Keep me posted on your decision and I'll keep you posted on my $$$$ to goal and who knows, maybe we will end up going at the same time.