Insurance won't cover

[HethBo 4]

Hi all! I've been lurking for a while now and decided it was time to jump in. I've been looking into wls for over a year. I'm 5'5 and close to 270lbs. Still not sure if I want the bypass or sleeve, but know it's time to change my life. Problem is my husband's insurance won't cover wls. Has anyone had to pay out of pocket? Any advice??

[MelodyBronson 18]

My ins doesn't cover wls either. The doctor's office that I used are also abdominal specialists/surgeons....I had an umbilical hernia that needed repaired so my approval for surgery was approved for the umbilical hernia.....with this being done, my out of pocket expense was very low....and I was able to get a "medical loan" to pay what I had to pay the hospital for the "extra" staff, etc. needed for the wls. This might be a possible route. Or just getting a medical loan for everything....a lot of the weight loss clinics have partnered with wls medical loan companies.....Some people also choose to go to a dr in Mexico, they charge less and anyone I have ever talked to who went to Mexico for surgery had a great doctor and a great experience. Good Luck with your journey.....I was in the same place you are now....I did a lot of research.....I live in the Dallas, TX area.

[FabNFit@40 52]

As I was doing my research, I came across Alabama Weight Loss Surgery based in Birmingham, they were going to be my back up plan if my insurance did not cover the wls. They are offering the sleeve for $11,900. here's there link. hope this helps .http://www.alabamawls.com/

[Milindia 6]

In 2012 I paid for my lap band out of pocket 13,000 and it was outpatient and 2 weeks ago I paid for a revision to a sleeve out of my pocket as well. My insurance doesn't cover WLS or any complications of it. While it's frustrating to have to pay, I know the money I will save on weight related medical issues will make up for it in the long run. My total for the revision was around 15,000 in the Salt Lake area. That included a 4 day stay in the hospital.

Edited July 7, 2017 by Milindia

[GassyGurl 428]

The best cash prices are going to be Mexic. Other than that, I've seen $8899 with Dr wizman in FL, $9995 in Charlotte and 10kish in Vegas. These are for the sleeve. Some places also fix a hernia via insurance and charge a smaller (5kish) amount for the sleeve.
Hope this helps!

Sent from my XT1254 using BariatricPal mobile app

[Sherrie Scharbrough 311]

There is a card that you can apply forit is called CARE CREDIT. It can be used for anything medical, even for your pets. It is another way to go maybe. Also, have your Baritaric Team send in all of the insurece papers. They usually have a person who does all of the insureance stuff and know exactly what they want or need. Just another way to go. Sorry you are having such a hard time!! Keep on trying, something will come and all will be GREAT!!!!

[Introversion 1,876]

2 hours ago, Sherrie Scharbrough said:

Also, have your Baritaric Team send in all of the insurece papers.

If the original poster's husband has an insurance policy that won't pay for weight loss surgery, I'm assured it's due to a bariatric surgery exclusion. Thus, his insurance won't pay for weight loss surgery under any circumstances, regardless of how carefully the paperwork is submitted or whether an appeal is filed.

If the original poster is willing to travel to New Iberia, Louisiana, Dr. Borland charges a cash price of $9800. If the original poster is willing to travel to Mexico, Dr. Maytorena of Long Term VSG charges a cash price of $2999 all inclusive for the sleeve.

[clk 3,519]

There are a lot of us that self paid here. I did it because at the time, insurance would only cover band or bypass and I was set on a sleeve.

I researched for a year, joined here, lurked, joined discussions, etc. I was between 3 surgeons, 2 stateside and 1 in Mexico. Ultimately, I went to Mexico.

We took out a loan through our bank, and it was simple and painless. It covered the surgery and my flights. The price of surgery has come down considerably in the last seven years.

Whatever you decide, I've never regretted the money we spent. It bettered my life in so many ways.

Good luck,

Cheri

[HethBo 4]

There are a lot of us that self paid here. I did it because at the time, insurance would only cover band or bypass and I was set on a sleeve.
I researched for a year, joined here, lurked, joined discussions, etc. I was between 3 surgeons, 2 stateside and 1 in Mexico. Ultimately, I went to Mexico.
We took out a loan through our bank, and it was simple and painless. It covered the surgery and my flights. The price of surgery has come down considerably in the last seven years.
Whatever you decide, I've never regretted the money we spent. It bettered my life in so many ways.
Good luck,
Cheri

Thank you!! I have it narrowed down to 1 Dr in my town and 2 in Mexico. Never thought I would ever consider going to Mexico for surgery! Can I ask what you did about check up/follow up appts? What if something goes wrong, who do you go to??

[HethBo 4]

In 2012 I paid for my lap band out of pocket 13,000 and it was outpatient and 2 weeks ago I paid for a revision to a sleeve out of my pocket as well. My insurance doesn't cover WLS or any complications of it. While it's frustrating to have to pay, I know the money I will save on weight related medical issues will make up for it in the long run. My total for the revision was around 15,000 in the Salt Lake area. That included a 4 day stay in the hospital.

Thank you! Just a side note, I'm in the Midwest now, but Utah will always be home.

[clk 3,519]

4 hours ago, HethBo said:

Thank you!! I have it narrowed down to 1 Dr in my town and 2 in Mexico. Never thought I would ever consider going to Mexico for surgery! Can I ask what you did about check up/follow up appts? What if something goes wrong, who do you go to??

I let my PCM know what I was doing. She did labs afterward at a few months post op and a year, and followed up on my diabetes remission. She checked my incisions, but I was fine and had no complications. Had I, we're military. I'd have gone to our hospital, but been billed. You would have to find someone willing to operate on you, or if it were an emergency, seek emergency care. It would be expensive, depending on what was wrong.

This is where a lot of the burden falls on you, the surgeon and circumstance. Honestly, I felt confident in my surgeon's solid reputation, and I had a ten day stay in Mexico. But complications would have been on me. I chose someone with a very low leak percentage, no fatalities and an enormous number of positive reviews. I watched and paid attention. Everyone had the same good things to say, even a year later, even those who experienced sleeve regret. Nobody complained about him. He's since passed away. But being cautious about him, and paying slightly more made me feel I was in better hands.

Just my experience. You can't predict, even stateside, if you'll fall in the small percentage that has a complication. But being extremely cautious about choosing who operates on you, and what facility they use is the first step.

Cheri

[NYCGAL000 59]

My insurance doesn't cover it and even if it did, the deductible is so high it would have cost a fortune anyway. I'm having my sleeve done in Mexico Saturday by one of the top bariatric surgeons in the world and its costing me under $5000. America has the worst health insurance in the world if you ask me.