5'10" - 550lbs / Dr. Quinones

[james1112 14]

I bet my Drs office could get it covered! I had Blue Cross Blue Sheild out of Az I had my surgery done in Ca and they covered it I only had a 36 BMI all my blood work was perfect but diabetes runs in my family and they got mine covered no problem.

The Dr is Awesome I was home in 2 days and I feel amazing....

yeah they told me it's because of the state I live in.... Which makes no sense to me I asked if I could go to another state to have it done but they still will not cover it.... I fought with him for way too long.... Trust me going abroad was not my first choice but I can't stop I have to keep moving forward

[BeagleLover 1,020]

@UrCaliGirl... I do have insurance but they will not cover it because my weight is my only health issue.... I've tried 3 times but they will not cover it so my only option is self pay.... it has not been easy to find a doctor in the u.s that would do it for me... The couple I did find wanted over $25,000 for the VSG....

I suggest you try the Lindstroms. They have helped many who have been previously denied, get approved:

http://www.bariatricpal.com/topic/321485-approved-after-2-denials/?hl=%2Blindstrom

[peteyrulz 82]

I suggest you try the Lindstroms. They have helped many who have been previously denied, get approved:

http://www.bariatricpal.com/topic/321485-approved-after-2-denials/?hl=%2Blindstrom

Me too! Another vote for Lindstroms. There's no cost to call them. Kelley is very helpful & friendly. They charge a flat fee.

[della street 213]

If your policy excludes it, then now amount of appealing will get it covered. It sounds like James has done his homework on this already. We can go round and round about how they "should" cover it, but some policies, especially those of companies that are self-insured (but may be administered by BCBS or another company...) simply choose not to. As in my hubby's policy. WLS is SPECIFICALLY EXCLUDED. So no amount of appealing will get it covered by them. Hang in there James! Lots of folks on here have gone to Mexico and been happy, so just do as you are doing - plenty of research, then make the best decision for you and your health--good luck!

[Nevermind 117]

Yes, please continue your Quest to get healthy. Might I suggest one of the surgeons in Texas. I went to Dr. Nicholson (check YouTube) or do a search for Nick Nicholson. There are surgeons in Texas that are very reasonable. Please search the surgeon you mentioned on various gastric sleeve forums, not just this one (Google)....I'm sure there are many people who had great success with him but I've read about serious issues too. Good luck.

[BeagleLover 1,020]

I suggest you add this as a possibility... Mexico isn't the only choice.

"60 Minutes" did a special on Medical Tourism, specifically havng surgery in Bankok Thailand at Bumrungrad Hospital.

https://www.youtube.com/watch?v=zzsXNCwgfuM (one eighth the cost of U.S. ?)

[Rebirthnow 17]

There are many insurance companies that have a bariatric exclusion in the policy due to the contract your employer has with the insurance company. It doesn't matter if it's BCBS, Aetna, Cigna, UHC, or Joe Blow down the street, your employer negotiated the contract with the company. If there is an exclusion it will not be covered even if you can prove medical necessity. There are lawyers that will take the case and try to get it covered but that often is a long process and still no guarantee. I work for UHC and it is excluded, therefore I am self- paying.

Hope this helps!

[WL WARRIOR 692]

James,

I don't know where you are at in Missouri, but Dr. De La Torre is excellent and does both gastric bypass and sleeve in St. Louis and Columbia. He did my sleeve Oct. 7 at the University of Missouri Hospital in Columbia, Missouri. He has a great reputation for the large number of surgeries he has performed with little or no complications.

[james1112 14]

yeah they told me it's because of the state I live in.... Which makes no sense to me I asked if I could go to another state to have it done but they still will not cover it.... I fought with him for way too long.... Trust me going abroad was not my first choice but I can't stop I have to keep moving forward

If your policy excludes it, then now amount of appealing will get it covered. It sounds like James has done his homework on this already. We can go round and round about how they "should" cover it, but some policies, especially those of companies that are self-insured (but may be administered by BCBS or another company...) simply choose not to. As in my hubby's policy. WLS is SPECIFICALLY EXCLUDED. So no amount of appealing will get it covered by them. Hang in there James! Lots of folks on here have gone to Mexico and been happy, so just do as you are doing - plenty of research, then make the best decision for you and your health--good luck!

Thank You.... it does suck paying insurance premiums for years and the time I need it most they won't cover it because of where I live.... But it is what it is.... I'm no longer going to let this stop me....

[james1112 14]

James,

I don't know where you are at in Missouri, but Dr. De La Torre is excellent and does both gastric bypass and sleeve in St. Louis and Columbia. He did my sleeve Oct. 7 at the University of Missouri Hospital in Columbia, Missouri. He has a great reputation for the large number of surgeries he has performed with little or no complications.

thank you. ... ill check in to him

[Rebirthnow 17]

Thank You.... it does suck paying insurance premiums for years and the time I need it most they won't cover it because of where I live.... But it is what it is.... I'm no longer going to let this stop me....

I couldn't wait any longer either! My surgery date is Nov 4th!!

[james1112 14]

I couldn't wait any longer either! My surgery date is Nov 4th!!

that's awesome....

[sweetcheeks709 38]

Good luck with whatever you end up doing! I am personally going into the next state, and that's because it's the closest bigger city to where I live, which is out in the middle of nowhere. It's 90 miles away, but he's has a really comprehensive program and he's really nice. Again, good luck

[Georgiagirl27 17]

I used Dr. Quinones and he was wonderful. I weighed 230 and now weigh 150. My surgery was 2/15/14. I have lost 80 pounds in 8 months and I feel so much better. Bill was my coordinator. He was Also very helpful If you have any specific questions for me felt free to message me and good luck to you!

[Georgiagirl27 17]

By the way , I went alone to Tijuana and never felt scared or threatened in any way. My husband was totally against this at first but we have two daughters and he had to stay with them. I didn't tell any family members about my surgery so I ended up going alone . I did my research and made the right decision for me .