Self pay- positives?

[ElizabethO 4]

Looks like I'm going to be 100% self pay. Which sucks. It's not fair since my husband and I actually work for a living we can't get Obama care and have WLS paid for. Irritates me beyond no end. Anyways... What are some positives of being self pay?

Any suggestions on new insurance companies in KY that would cover WLS?

TIA!

[daniellepb 58]

Positives of self pay are that you can decide to do it and get a surgery date in 2 weeks!

[FrankyG 1,450]

I was self pay, had ACA (the real name of Obamacare) and it was not covered under the plan we have. It really just depends on the coverage on the exchanges (I'm in a state that refused to set up a healthcare exchange and acts generally pissy about everything that might help others).

Advantages?

You can itemize on your taxes, take a medical deduction and get a bit of money back as long as it is something like 7% or higher of your total income. (confirm details yourself)

No 6 month wait time, and in general, no hoops to jump through. You get a few tests run, and as long as you're healthy enough for surgery, you could go in within weeks of starting the process.

No psych evaluations, no constant back and forth with insurance reps or other paperworky hassles. No having to appeal turn downs and play phone tag for months with insurance and the doctor's office.

You can pick any doctor you'd like, not just one covered by the insurance plan.

If you have points credit cards, you could use them (as long as you have the cash to pay them off shortly) to run up some impressive rewards. I made sure to pay in installments so as to not max out my best card, paid it off that month and then charged up the rest of the amount and paid it off. Didn't cost me anything extra, scored hundreds of bucks in reward.

[TinyTink 268]

I borrowed from my retirement savings. Instant approval, instant loan, and I pay my plan back. To me it feels like "free". Kind of!

[ElizabethO 4]

Wow! All great points. Thank you everyone.

My next question is if I'm self pay will I have to pay all at once? Or will I be able to make payments? If I do payments will they make me wait to pay it off before they do it?

[ElizabethO 4]

I was self pay, had ACA (the real name of Obamacare) and it was not covered under the plan we have. It really just depends on the coverage on the exchanges (I'm in a state that refused to set up a healthcare exchange and acts generally pissy about everything that might help others).

Advantages?

You can itemize on your taxes, take a medical deduction and get a bit of money back as long as it is something like 7% or higher of your total income. (confirm details yourself)

No 6 month wait time, and in general, no hoops to jump through. You get a few tests run, and as long as you're healthy enough for surgery, you could go in within weeks of starting the process.

No psych evaluations, no constant back and forth with insurance reps or other paperworky hassles. No having to appeal turn downs and play phone tag for months with insurance and the doctor's office.

You can pick any doctor you'd like, not just one covered by the insurance plan.

If you have points credit cards, you could use them (as long as you have the cash to pay them off shortly) to run up some impressive rewards. I made sure to pay in installments so as to not max out my best card, paid it off that month and then charged up the rest of the amount and paid it off. Didn't cost me anything extra, scored hundreds of bucks in reward.

So using a credit card? How were you able to do that? If you didn't pay it all off that following month $15,000 would rack up a lot of interest wouldn't it?

[TinyTink 268]

$500 deposit locked in my rate through BariatricPal. You can make payments but you need to be paid before surgery. There was a slight increase if a credit card was used. Good luck.

[FrankyG 1,450]

I was self pay, had ACA (the real name of Obamacare) and it was not covered under the plan we have. It really just depends on the coverage on the exchanges (I'm in a state that refused to set up a healthcare exchange and acts generally pissy about everything that might help others).

Advantages?

You can itemize on your taxes, take a medical deduction and get a bit of money back as long as it is something like 7% or higher of your total income. (confirm details yourself)

No 6 month wait time, and in general, no hoops to jump through. You get a few tests run, and as long as you're healthy enough for surgery, you could go in within weeks of starting the process.

No psych evaluations, no constant back and forth with insurance reps or other paperworky hassles. No having to appeal turn downs and play phone tag for months with insurance and the doctor's office.

You can pick any doctor you'd like, not just one covered by the insurance plan.

If you have points credit cards, you could use them (as long as you have the cash to pay them off shortly) to run up some impressive rewards. I made sure to pay in installments so as to not max out my best card, paid it off that month and then charged up the rest of the amount and paid it off. Didn't cost me anything extra, scored hundreds of bucks in reward.

So using a credit card? How were you able to do that? If you didn't pay it all off that following month $15,000 would rack up a lot of interest wouldn't it?

My doc let me pay in installments. I broke the full amount into 3rds, had the office charge the installment to my card every month for 3 months. I had the full amount in my savings, and would pay off the card in full each month. That's the only way I'd use the credit card (I don't do interest charges!)

Edited December 26, 2015 by FrankiesGirl

[ElizabethO 4]

I was self pay, had ACA (the real name of Obamacare) and it was not covered under the plan we have. It really just depends on the coverage on the exchanges (I'm in a state that refused to set up a healthcare exchange and acts generally pissy about everything that might help others).

Advantages?

You can itemize on your taxes, take a medical deduction and get a bit of money back as long as it is something like 7% or higher of your total income. (confirm details yourself)

No 6 month wait time, and in general, no hoops to jump through. You get a few tests run, and as long as you're healthy enough for surgery, you could go in within weeks of starting the process.

No psych evaluations, no constant back and forth with insurance reps or other paperworky hassles. No having to appeal turn downs and play phone tag for months with insurance and the doctor's office.

You can pick any doctor you'd like, not just one covered by the insurance plan.

If you have points credit cards, you could use them (as long as you have the cash to pay them off shortly) to run up some impressive rewards. I made sure to pay in installments so as to not max out my best card, paid it off that month and then charged up the rest of the amount and paid it off. Didn't cost me anything extra, scored hundreds of bucks in reward.

So using a credit card? How were you able to do that? If you didn't pay it all off that following month $15,000 would rack up a lot of interest wouldn't it?

My doc let me pay in installments. I broke the full amount into 3rds, had the office charge the installment to my card every month for 3 months. I had the full amount in my savings, and would pay off the card in full each month. That's the only way I'd use the credit card (I don't do interest charges!)

That makes sense! Smart! My husband and I don't do interest charges either! Haha. I've got to come up with a plan.

[Positive44 103]

During consult, several required tests and so fourth before surgery. After they told me ins would not pay, I elected self-pay.

Magically, required scope down my throat test gone! sleep test gone! Wait time gone! Seems like anything I wanted was not possible on my own terms including date of surgery!!

I decided to charge the surgery to get Discover Miles points! Then will pay it off in 5 days with another credit card promotion to get zero interest for 18 months.

Honestly I didn't want to pay myself, but I can't force an insurance company to pay. Doing it myself for myself and plan to make the best of it!!!

[CanadaLoser 80]

If you are self paying I'd recommend at least looking into Mexico

[Positive44 103]

My insurance contacted me today and said my doctors office did not file my claim and that I should. They are reimbursing me 80% of what I paid since my deductible is met. So I got the following as a result of self pay:

Points on my credit card

18 months no interest on the balance

And now 80% cash back

And a new life

God is Amazing!!

[FreeTheSkinny66 9]

I am still hoping that insurance will pay, but because I am a supreme worry-wart and I may not be a clear cut case (BMI < 40 and none of the "standard" co-moridities other than joint issues), I have started looking into self-pay. The thing that scares the beejeezes out of me is the potential for complications.

Paying $15,000 or whatever for the surgery is one thing, but what if there are complications.?? Like a leak or something....that's many thousands more. I am not sure those would be covered by insurance. Some surgeons have BLIS coverage, but there are restrictions there, too, no? That is the only thing that would hold me back from self-pay if it comes to that!

Edited March 16, 2016 by FreeTheSkinny66

[Positive44 103]

I totally understand.

[glitterdaisies 10]

I am going to be self pay. Surgeon is requiring 6 nutrition classes and 6 psych classes anyway. He said it will be at least 3 months before a surgery date, insurance or not. [emoji53]