Obama Care options

[TonyaMac 93]

My boyfriend wants the surgery but he keeps getting told his insurance doesn't cover it.

He is self employed so has to use Obama care.

Does anyone know of a certain plan that covers it? He is diabetic and high BP so he is a candidate. We live in Indiana and I have noticed it goes by state for coverage.

Any help or guidance is appreciated!!

[Kindle 8,667]

Yes, it's a state by state thing. I have my own insurance too and my state (Idaho) opted out of WLS coverage. So no, short of moving to another state, there were absolutely no policies available to me that covered it no matter how fat or how many comorbidities I had.

I went to Mexico which in the end was a better option anyways. My surgeon down there was better credentialed with more experience and a lower complication rate than any of the surgeons around here. And no insurance hoops to jump through.

Obamacare insurance sucks big time....much higher premiums with higher deductibles and less coverage than before. NOT a fan! Good luck to your boyfriend.

[Sarah 82 9]

I wouldn't go to Mexico. They're standards aren't like America. I had surgery here with no issues. My best friend had hers in Mexico and has now been hospitalized for over 3 months! One infection/problem after another. She nearly died and has been on a feeding tube ever since.

[Kindle 8,667]

I wouldn't go to Mexico. They're standards aren't like America. I had surgery here with no issues. My best friend had hers in Mexico and has now been hospitalized for over 3 months! One infection/problem after another. She nearly died and has been on a feeding tube ever since.

Who was her surgeon? You can't make that kind of a statement based on one single case. I went to an International Center of Excellence with standards higher than most US hospitals. My surgeon actually taught laparoscopic technique to surgeons in the US and Canada, including Harvard. He worked with the original inventors of the lapband and most recently the Obalon balloon in getting both devices FDA approved. I had zero pain or nausea postop, I was up and out shopping day after surgery and back to work in 7 days. Couldn't ask for better care or outcome.

Now let's talk about the US surgeon who removed my gallbladder. He supposedly repaired an umbilical hernia that I never knew I had because it wasn't visible or palpable for the last 47 years. Now I have a big gaping 1/2 inch hole above my belly button that I can poke my finger through and is bulging with tissue protruding through it because his "repair" of a nonexistent problem didn't work. The best part is he is denying it exists. My PCP confirmed it, an ultrasound tech confirmed it, and even his own nurse confirmed it. I need a second surgery to repair it, and I would go back to Mexico in a second before I let this US Doctor ever touch me again.

So according to your logic, no one should ever have their gallbladder removed or hernia repaired in the US because the surgeons don't know how to close properly.

[Indi 5]

Research alighterme. They have a YouTube closed group. You can talk to current and past patients. Do a lot of research until you're satisfied. It costs 4600 for the sleeve.

[sharonintx 1,275]

I had a great experience in Mexico.

[TonyaMac 93]

I am a paramedic and in nursing school. Every facility has its own infection control issues.

I brought up Mexico to him but he is not on board with it. He is under the impression that it is unsanitary and not an option. I tried to get him to look into a few surgeons there and continuing to do research. I think just like a doctor here research and seeing stats on paper are best.

The issue with Mexico is that they are not required by Medicare, Joint Commission to report their infection rates. Some do it as a personal standard, Those are the guys you want to look into. The ones who do not use an outside source reporting on their infections rates and re-portable complications or events need to be bypassed.

I am going to continue to work on surgeons both in the US and Mexico, but as hoping he could get insurance to cover it like mine did. He did find a surgeon in Dallas that does it for 8500 but I have not gotten the name from him to research that doc. It seems low for the US.

[OutsideMatchInside 10,166]

I wish we could sticky this somewhere. People ask all the time. Indiana Healthcare exchange doesn't coverage bariatiric surgery because Indiana doesn't consider it essential.

http://nofusa.org/news/health-insurance-cover-obesity-treatment/

*States that do not offer bariatric surgery, nutrition counseling, or weight loss programs in the State Health Insurance Marketplace are: Alabama, Alaska, Florida, Georgia, Indiana, Kansas, Kentucky, Minnesota, Mississippi, Missouri, Nebraska, Pennsylvania, South Carolina, and Wisconsin.