Self-Pay Guidance

[TexanGal 12]

Hello,

I will soon be scheduled for the gastric sleeve (done all the prep work). However, my insurance won't cover me because my BMI is "only" 34 (5 feet 8, 225 pounds). So, I'm going to self-pay (total about $13,000).

But I"m scared that something will go wrong in the surgery and since it's not insured, I could be facing mountains of hospital bills.

Has anyone done self-pay and had something go wrong so they were charged a lot more?

I really appreciate any advice since I've found this forum to be a godsend on my WLS journey!

[MIZ60 1,291]

My former coworker had RNY back in 2004 and was self pay since insurance at the time was not covering it. Several years later she was hospitalized for severe gastritis and bleeding from an ulcer. The insurance denied coverage for that hospitalization stating the problems were a result of her previous elective surgery. She could not pay the almost $25000 hospital bill and was forced to declare bankruptcy. Good luck in getting it sorted out...insurance decisions are ridiculous.

[aNYCdb 310]

Obviously insurance only wants to pay for surgery if you are morbidly obese, there is not getting around that. That said gastric sleeve is pretty low on the long term side effects scale so the chances of needing additional surgery and being denied are similarly low, its a question of personal risk vs reward.