So devastated

[BinIA 8]

I've spent months reading everything I can about VSG. I researched doctors. Finally made the call. Looked at my husband's insurance and after he changed jobs this new employer does not allow BCBS to cover any weight loss program/surgery or complications.

So the surgeon's office doesn't seem to be that interested in working with a cash patient. It's 20K up front in two different checks - one to hospital and one to dr office. Does not include appointments with the surgeon which run $150-$550 per appointment depending on the 'level of care' they provided.

I don't want to go out of state or country.

I just assumed we had good insurance. I'm feeling really devastated and defeated. I had worked myself up to this ... I talked with my husband about it. I did so much research but didn't even think that our insurance wouldn't cover it. So stupid of me.

I guess back to nutrisystem ?

[The Candidate 3,215]

I'm so sorry for the disappointment. I can only imagine how awful it must of been. I hope that you don't give up though. Your circumstances might change eventually. My heart goes out to you.

[TXTinana 269]

I was much like you before (ohhhh...going to Mexico for surgery...so taboo) but I finally did a lot of research, spoke to people who had been, and felt more comfortable with going ahead and scheduling a Mexico surgery. I know it is scary to think about at first but is that absolutely not an option for you?

[BrownEyedTxGirl 139]

What state are you in?

There are some great doctors in Texas and cash price (all inclusive) runs between $10 - $15K.

Also a lot of Texas surgeons do what they call a Hiatal Hernia cash price that can run between $2100 - $5000.

Basically if you have a hernia they bill the insurance for the hernia repair and you pay cash for the sleeve portion of the procedure. And yes it is totally legal!

Stay positive...I know it's hard but don't give up!!

[BinIA 8]

I just would rather have access to my surgeon if some sort of complication comes up down the road. Otherwise, who do I go to? I mean, my primary doc is great but ...

I'm in Iowa. Texas isn't a terrible distance. Do you have any recommendations or referrals for TX?

After I got done with my pity party ...I called a couple more places here in Iowa. The third place I called is 17K which includes Blis, 2 night hospital stay, and post surgery office visits. The pre-surgery visits {3 of them} run from $180-$220 with a 30% cash discount. Which is nicer than the first place which did not include post surgery visits and their pre-surgery office visits were 150-550 with NO cash discount.

I really LOVE how these places websites say that people 100 pounds or more overweight have a 98% chance of losing that weight without surgery. Making it medically necessary. But then on the phone tell me they offer no health credit or cash discounts because this is 'elective - not necessary surgery' ... maybe that lady was just a jerk.

[Ms. Nunya 126]

I just would rather have access to my surgeon if some sort of complication comes up down the road. Otherwise, who do I go to? I mean, my primary doc is great but ...

I'm in Iowa. Texas isn't a terrible distance. Do you have any recommendations or referrals for TX?

After I got done with my pity party ...I called a couple more places here in Iowa. The third place I called is 17K which includes Blis, 2 night hospital stay, and post surgery office visits. The pre-surgery visits {3 of them} run from $180-$220 with a 30% cash discount. Which is nicer than the first place which did not include post surgery visits and their pre-surgery office visits were 150-550 with NO cash discount.

I really LOVE how these places websites say that people 100 pounds or more overweight have a 98% chance of losing that weight without surgery. Making it medically necessary. But then on the phone tell me they offer no health credit or cash discounts because this is 'elective - not necessary surgery' ... maybe that lady was just a jerk.

Dr. Kim and Dr. Nicholson.. Both in DFW and both have the "making surgery affordable" option with the hiatal hernia. Good luck!

[OutsideMatchInside 10,166]

Open enrollment is coming up soon. Maybe your husband can get a plan just for himself and you find a plan on the healthcare exchange that covers WLS.

[BrownEyedTxGirl 139]

@@BinIA I met with Dr David Kim, Dr Clayton Frenzel and Dr Nick Nicolson. All three are in the Dallas/Fort Worth area. I would trust any of the three but had to make a final decision. You can google all three and they have websites that show their cash price and what it covers.

I totally understand not wanting to travel too far but just thought I would throw it out there as a possible option!

[BobrobynR 17]

I had surgery with Dr Kim October last year. Love their practice. Totally recommend. They have cash price of $4900 with the HH repair and payment options with care credit. Top notch after care support.

[%#LoosingIt?!&- 16]

I'm right with you- juts found out my insurance doesn't cover any WLS even though there are price quotes on my insurance website. My husbands doesn't either! Beyond upset and feel defeated. I felt like sleeve was my drop dead last option and I'd come to terms with it. Even gotten excited about it!

My plan is to casually research self pay in U.S. And Mexico. I won't make a decision until my 2016 insurance plan is announced because I've proposed WLS be added (maybe 50% chance they'll add it). I'm not opposed to getting a new job to switch ch insurance even but it's hard to ask in the interview - "by the way I want the job only if the insurance covers WLS. Oh and I'll be needing a few weeks off for recovery."

Doesn't sound like a viable plan but neither does going into major debt for the full pay option.

[BinIA 8]

Thanks all. I'm researching the texas options. I do really like the sound of Dr. Kim and his version of the gastric sleeve.

Feeling a little more hopeful.

[BinIA 8]

And ... my husband who is an officer at his company {though he just started a few months ago} spoke to HR today about the exclusion and gave him documentation that I found.

The HR guy told my husband that there is an appeal process and that other excluded items have been approved to be covered in the past so he is going to start the appeal process for me to have this surgery.

I don't know how long that will take as it is an internal thing - BCBS of OK clearly has coverage available for bariatric surgery so this just comes down to the employer.

http://www.bariatric-surgery-source.com/support-files/bariatric-surgery-insurance.pdf

[theatrejo 29]

@@BinIA I know financing it isn't a wonderful option, but there are places that give loans for Bariatric Surgery. Care Credit is one of them.

I have BCBS too and they dont cover a thing! I believe they are going to cover the stress test, but thats it. Everything else I am financing.

Im in Houston Tx - Using Dr St Laurent

[Catherine Davis 36]

And ... my husband who is an officer at his company {though he just started a few months ago} spoke to HR today about the exclusion and gave him documentation that I found.

The HR guy told my husband that there is an appeal process and that other excluded items have been approved to be covered in the past so he is going to start the appeal process for me to have this surgery.

I don't know how long that will take as it is an internal thing - BCBS of OK clearly has coverage available for bariatric surgery so this just comes down to the employer.

http://www.bariatric-surgery-source.com/support-files/bariatric-surgery-insurance.pdf

Move to Australia and have it done! ☺️. Seriously though, I will be out of pocket around $5000 all up, and here in Australia you just choose a health insurance package which covers Bariatric and wait 12 months for the waiting period to be over. It is so much easier than all the annoying assessments etc you guys have to endure, we are so lucky here. Wishing you a good outcome "hugs" ????

[linzlou2000 193]

In VA the doctors office an all inclusive self pay rate. It includes pre, hospital, and post care. Call around!!!! Fingers crossed it works out for you.