Insurance doesn't cover.....now what😩

[Mimi84 0]

So my insurance through my job doesn't cover any bariatric procedures due to my job excluding it from our program. It's really expensive so self pay isn't an option for me. What other route could I take?? I'm so bummed about this

[lindabalseca 373]

So my insurance through my job doesn't cover any bariatric procedures due to my job excluding it from our program. It's really expensive so self pay isn't an option for me. What other route could I take?? I'm so bummed about this

Obesity action coalition has grants for people in need...also check wlsa website they help as well

[OutsideMatchInside 10,166]

Living in Florida self pay is your only option. Florida doesn't consider Bariatric surgery a medically necessary item so marketplace plans don't cover it. Or find a job with insurance that covers it. Good luck.

[Sosewsue61 3,185]

http://www.bariatric-surgery-source.com

This site has some ideas for you.

Do you have existing comorbidities? Type II diabetes, high blood pressure, sleep apnea - maybe you sleep fitfully and don't know you have it, do you have cardiovascular issues? All these lab tests and pre- approval tests for bariatric surgery can be coded for regular medical care of your conditions if your primary doctor's office codes it correctly. Shoot go to your doc monthly for 6 months and record your weight, discuss your weight, discuss your other issues for purposes of billing (ear wax removal, in-grown toenail, allergies). Then go to surgeon's office and ask what cash discount rate is, finance with your 401K, or reg finance company.

Maybe during the 6 month time for supervised visits you get a part time job to sock away for paying cash. Just ideas here.

[Sosewsue61 3,185]

Do you live near any federal government facilities? Federal gov jobs usually contract diff insurance companies and may not follow FL guidelines but follow federal. Change jobs to get it, you will have to wait for enough benefit time to taked med leave, but it might be worth a shot.

[Teaghlaigh 1]

I was going to research a surgeon in Mexico if my insurance didn't cover it. There are a couple of highly recommended centers there and they are about the cost of what you would pay out-of-pocket with insurance.

Sent from my SAMSUNG-SM-G920A using BariatricPal mobile app

[Mimi84 0]

18 minutes ago, Sosewsue61 said:

http://www.bariatric-surgery-source.com

This site has some ideas for you.

Do you have existing comorbidities? Type II diabetes, high blood pressure, sleep apnea - maybe you sleep fitfully and don't know you have it, do you have cardiovascular issues? All these lab tests and pre- approval tests for bariatric surgery can be coded for regular medical care of your conditions if your primary doctor's office codes it correctly. Shoot go to your doc monthly for 6 months and record your weight, discuss your weight, discuss your other issues for purposes of billing (ear wax removal, in-grown toenail, allergies). Then go to surgeon's office and ask what cash discount rate is, finance with your 401K, or reg finance company.

Maybe during the 6 month time for supervised visits you get a part time job to sock away for paying cash. Just ideas here.

I don't really have any comirbidities that I know of, but I am going to look up my past health check ups. I have 44 bmi though I'm only 4'11" so my weight is really high for my height. I plan on going to my HR and presenting a case of some sort or seeing if they are fully funding or self funding our insurance plan. I've been researching so hopefully I can come up with something. Thanks for the feed back

[Introversion 1,876]

53 minutes ago, Mimi84 said:

I plan on going to my HR and presenting a case of some sort or seeing if they are fully funding or self funding our insurance plan.

I work for an insurance company. If your workplace offers health insurance that has a bariatric surgery exclusion clause, it will not be covered under any circumstances, regardless of how skillfully you plead your case.

Your best (and speediest) option is paying $2999 all-inclusive to be sleeved in Mexico by a bariatric surgery practice called Long Term VSG: http://longtermvsg.com/gastric-sleeve-surgery-in-tijuana-mexico