Aetna Denied / Now Self-Pay

[az062217vsg 40]

Unfortunately I just got word that Aetna has denied my request. My BMI is too low and I don't have a qualifying co-morbidity. I'll be moving forward with self-pay. My question for others is, where have you applied for/received financing (if you have needed to)? My surgeons office recommends Prosper Healthcare Lending, but depending on the interest rate I might look at my credit union. Any feedback is appreciated!

Edited May 9, 2017 by LorinEliz37

[YeaMe 246]

One thing you can inquire about is whether you have a hiatal hernia. Most overweight people do. I was in the same boat - fat but healthy. I had my hiatal hernia repaired at the same time and the insurance picked up a lot of the hospital, 2/3rds of the anesthesiologist, and part of the surgeon's fee. Instead of paying $15,500 out of pocket, I paid $5,500.

[az062217vsg 40]

7 minutes ago, YeaMe said:

One thing you can inquire about is whether you have a hiatal hernia. Most overweight people do. I was in the same boat - fat but healthy. I had my hiatal hernia repaired at the same time and the insurance picked up a lot of the hospital, 2/3rds of the anesthesiologist, and part of the surgeon's fee. Instead of paying $15,500 out of pocket, I paid $5,500.

How are hiatal hernias diagnosed? I had an upper endoscopy, and they didn't mention a hernia, just inflammation and a polyp that they removed.

[YeaMe 246]

The endoscopy is how they detect it. My previous doctor never mentioned it to me but when I got a copy of the report, it was there.

[az062217vsg 40]

6 minutes ago, YeaMe said:

The endoscopy is how they detect it. My previous doctor never mentioned it to me but when I got a copy of the report, it was there.

I'll ask for a copy of the report! Thanks.

[az062217vsg 40]

Moving forward with self-pay. Just paid the anesthesiologist, $1025.

[Yari1985 1]

How much was the surgery for self pay? Good luck on ur journey

[az062217vsg 40]

36 minutes ago, Yari1985 said:

How much was the surgery for self pay? Good luck on ur journey

It will be just over $18,000. Thanks!

[GassyGurl 428]

If you feel up to traveling, you can get done for 10000 or less here in the US. Las Vegas is about 10k, Florida is about 8k, and Texas is somewhere in that price range too. NC has an office that has a 9995 special. They cater to traveling patients. My surgeon is 18k too, but I get denied there is no way I would pay. Dr umbach in Vegas is a center of excellence, my local Dr is not.

Sent from my XT1254 using BariatricPal mobile app

[St. Louis Samantha 4]

I have the exact same story as YeaMe. My insurance wouldn't cover bariatric surgery, so I paid out of pocket. Afterwards, I asked the hospital to bill the insurance for some blood work, which I considered standard health care. Apparently, they sent the whole bill to the insurance, and the insurance paid 2/3 of the bill! They did not approve the surgeon and anesthesiologist charges, but everything else. So the hospital is sending me a refund for the difference ($11,000+). Needless to say, I'm very pleased and surprised.