Insurance says surgery is "excluded". Options now?

[sunshine1531 30]

I have thought a lot about having a weight loss surgery and attended a seminar and now have an appt for consultation with a surgeon. When I spoke with the office they said they accept my insurance (I have United Healthcare choice plus). I called my insurance company today to see if my employer has added that as an option and they told me that gastric bypass and lap band surgeries are "excluded." It seemed like they only offered a physician assited diet but no actual surgery. Now I am discouraged and wonder if it is even worth going to have my consult now. Is it affordable to do payment plans on my own? Does anyone know the approx monthly payment on average for doing a self pay option or know how long most places will finance for? I realize every place is different, but was wondering if anyone else here had to do a self pay option that was manageable without having a large downpayment???

[shmily 424]

I can only tell you that my hospital bill was about $86,000. I have insurance that covered it. You go to the consult, self pay is always cheaper

[alc1071 43]

Sunshine, like you my employer excluded bariatric surgery from their benefits. It didn't matter that I was over 40 BMI with Diabetes, on insulin and a number of other medications for high blood pressure, cholesterol, etc. I met all those typical requirements with comorbidities but my surgeon said it it's an exclusion in my plan it won't be covered. I even tried to appeal it but it didn't matter, it wasn't a covered benefit period. I was so discouraged . . . I stewed over it for almost a year and finally just "bit the bullet" and went forward with the surgery as a self pay. The cost as self pay was $25k. My surgeon didn't offer financing or anything but I did end up borrowing on my home equity to pay for it. Also you may be able to deduct a good portion of it from our taxes (I think you can claim the amount of medical expenses that are over 10% of your adjusted gross income but you'd want to check into that with a tax professional). I would still go to your consult, tell them you think it's an exclusion and ask them about self pay options/costs. Although I hated the fact that I had to pay for it myself, I am so happy that I was able to get the surgery and am very happy with where I am one year post op. Good luck!

[Truckerchic 171]

Sorry to hear, I have been trying for 8 years and was looking into Medical Tourism (Mexico) to have my surgery, they have great programs but at the first of last year my company switched insurance companies and it was covered. Took 10 months and still cost me about what going to Mexico would have been. Just a thought... good luck

[Truckerchic 171]

Oh and I don't think you will find a surgeon to finance here in the US, so you would have to get a personal loan or try care credit