Sleeve Not Covered

[TajMonet 0]

I'm at the beginning stages of my WLS. My insurance company BCSBS OF GA doesn't cover the Gastric Sleeve Surgery . I'm to going Emory Mid town in Atlanta. I'll be a cash patient . Will BCBS at least pay for the anesthesia ,and blood work? How much are the hospital and doctors fee?

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[Malin 470]

I have Alabama BC/BS. they paid for the blood work & tests, but nothing else. I had to pay everything else to include the anesthesia. I used my medical flex spending account to cover the anesthesia. Every doctor & hospital is different.

[TajMonet 0]

I have Alabama BC/BS. they paid for the blood work & tests, but nothing else. I had to pay everything else to include the anesthesia. I used my medical flex spending account to cover the anesthesia. Every doctor & hospital is different.

Thank you

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[RickM 1,752]

Do they not cover the sleeve itself, but do cover other WLS such as the bypass or DS, or do they exclude all WLS? If they exclude WLS in general, then there isnt much that can be done and you are doing the right thing by going self pay. If they do cover other WLS procedures but exclude the sleeve, then that is something that can be appealed, usually successfully; it just takes a bit more work.

[TajMonet 0]

Do they not cover the sleeve itself, but do cover other WLS such as the bypass or DS, or do they exclude all WLS? If they exclude WLS in general, then there isnt much that can be done and you are doing the right thing by going self pay. If they do cover other WLS procedures but exclude the sleeve, then that is something that can be appealed, usually successfully; it just takes a bit more work.

They don't cover WLS at all .

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[cat17 57]

I'm sorry to hear that! My sleeve was not covered either, so I searched out MD's that had a bundle cost. I paid one fee for everything, including two nights in the hospital. Your surgery office should be able to tell you how much all of it will cost. I chose to have mine in florida, because it was over $10,000 less than my state!!

[augustgirl 58]

My sleeve was not covered at all because I was not approved by my insurance. My bmi was not high enough. I self paid, the hospital I chose was 20,850.00. My insurance did pay for the initial dr exam and cardio and pull visits but nothing else.

VSG date: 11/22/16

HW: 225

SW: 222

CW: 214

[TajMonet 0]

I'm sorry to hear that! My sleeve was not covered either, so I searched out MD's that had a bundle cost. I paid one fee for everything, including two nights in the hospital. Your surgery office should be able to tell you how much all of it will cost. I chose to have mine in florida, because it was over $10,000 less than my state!!

Wow $10,000 less , what state do you live in ?

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[jennyqp 62]

I live in Florida. Self pay for everything was $10,000. My insurance paid for medication afterwards

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The other option is Mexico? Maybe $6000?

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[suzzzzz 1,005]

Your surgeons office needs to give you a cash pay price. Then you can compare prices with other doctors. Also, some of them allow for a lower cash price if you also need a haital hernia repair because that part is covered by insurance. So basically, the sleeve surgery is a piggy back on the other surgery so surgery costs for sleeve are less.

[ppressey24 254]

This is crazy to hear so many ppl have to pay for this surgery out of pocket. I guess im blessed to be divorced right now. I was on bcbs through my husbands job for 23yrs, and we divorced 4yrs ago after finding out i have progressive Ms. Just another thing he couldnt support me through. I applied for my disability and my pcp referred me to bariatric and my medicare paid for the surgery. I dont know where id be right now if i had to pay out of pocket.

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[wilson06 31]

Have you decided to look at other surgeons in the area and also consider financial assistance with the hosptial. Sorry to hear that. I can ask my surgeon to see if bibs will approve. I know he takes all the insurance and they get people approved. Search for Paul Macik at Northside Hospital. Also check to see if Dr office offer a credit care card where you can apply for that. Also check into your flex spending acct too. Best of luck.

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[sleeveisa 333]

I'm sorry, my. 1st insurance denied me once and weeks later it got approved. My bmi is low but I have medical conditions and my dr appealed it for me. Do you have medical conditions that can help with the approval?

Good luck

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[TajMonet 0]

Have you decided to look at other surgeons in the area and also consider financial assistance with the hosptial. Sorry to hear that. I can ask my surgeon to see if bibs will approve. I know he takes all the insurance and they get people approved. Search for Paul Macik at Northside Hospital. Also check to see if Dr office offer a credit care card where you can apply for that. Also check into your flex spending acct too. Best of luck.

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Most Dr's take BCBS but the type of plan I have no WLS of any type is covered with no negotiations . Sad thing about it is I work for a hospital

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