Anyone pay for their own insurance plan out of pocket and qualify for lapband?

[🅺🅸🅼🅼🅸🅴🅺 296]

Hey guys....

I'll make this as short as I can because I'm so ADD, LOL!

Do any of you pay for your own insurance plan out of pocket? If so, did being obese cause you any problemswhen you bought your plan or attempted to buy your plan? Did any of you have it easy when buying your own policy being obese or overweight and also have an easy time getting approved for your band surgery? What companies did you attempt to get coverage under and failed/suceeded? What company did you choose?

If you're in Texas, your input is even more valuable because I'm sure the differences in coverage varies by state. However, everyone's input is greatly appreciated!

[ACajunAnna 1]

I feel your pain, Kimmie. I also work for a huge company (AT&T) and am insured with UHC with an exclusion for any type of weight loss surgery.

I have researched getting a supplemental hospitalization policy and spoke to several companies. The bottom line is that self pay will be the best way to go. But here is the breakdown....

All of the semi-affordable policies that I found have a 12 month waiting period (about $300/month x 12 = $3600) The policy will only pay for 75% of the surgery (average cost for insurance pay at my surgery center for lapband is $40,000. 25% of 40,000 = $10,000) That is a total of $13,600, plus fees for aftercare and fills, and I would have to wait a year to have the surgery.

Self pay is $13,365 which includes fills and after care for 1 year. That is the way that I am going to go as soon as I can round up the funds, I can charge $6500 on Care Credit and pay monthly on that, so I just need to find the other half. If you have decent credit, you can probably get a loan for the entire amount (my credit sux)

Congrats on quitting smoking. I quit 7 years ago and it was the best thing that I could have ever done. If only getting this weight off were so easy.

Good luck.

[🅺🅸🅼🅼🅸🅴🅺 296]

Thanks for the info Anna :sneaky: We're the plans you were looking at just supplemental or did you look into full insurance plans?

[ACajunAnna 1]

They were full insurance plans, but since I already have insurance through my employer, the policy would have been secondary, or supplement what mine did not pay. They were also hospitalization policies only. The policies for full coverage which include doctor visits and prescriptons were very very expensive and still covered only 75% of the surgery after a 12 month waiting period.

You live in the Dallas area, have you looked into that doctor in Dallas that was offering the $9000 special? I read that thread a couple of months ago somewhere on this site. Not sure of his name.

[Guest BikiniBeachy]

Kimmie---so I'm in the EXACT same boat as you, trying to do this individually. I am not help to you at this point, but if you have any pointers, let me know. So far Humana and Aetna have been a nightmare...looking at BCBS now

[honeyroast 0]

hi anna

i agree that self pay is the way to go if your insurance wont cover you!

mine denied me because i dont have any co-morbidities. i decided to get financing through my doctors office. they had some good deals with low interest rates- i got 4% -not too bad. i am so glad i decided to just get it done on my own- i have no regrets absolute! oh and dont forget that what you pay out of your pocket is a tax deduction!

thats something to think about.

tiff

[ACajunAnna 1]

"oh and dont forget that what you pay out of your pocket is a tax deduction!

thats something to think about."

Yes, that is also something to take into consideration. Before filing my taxes this year, I itemized my deductions and added $15,000 of medical expenses to see the difference in my refund. I would have gotten about $2000 more refunded.

[honeyroast 0]

heres another thought to consider if you are a home owner-

i worked out the details and got a second mortgage loan and paid off my surgery with this-now my interest is a tax deduction where before it wasnt. but you have to get some financial advice to decide what will work out for you best where your$ is concerned. this option also gave me a much lower payment. BONUS!

interest rates are really low right now so its a good time to consider these options.

tiff