Scared to take the plunge!

[Fluffy_Gurl 3]

So after fighting and arguing with the insurance company i have finally come to the conclusion that i am going to have to self pay for my surgery. sooo... i am scared that if have the surgery through self-pay that i will not be able to get insurance or treatment etc after the surgery. Can having a surgery through self pay methods affect your other insurance coverage? Has anyone who did self pay have any trouble getting treatment after their surgery. i know many of you have had no other option but to self pay im also worried that if their are complications or whatever that i wont have money to pay for them etc..has anyone had this problem?

id appreciate feedback from those who may have had good or bad experiences with self pay! I am looking at Dr. Kirschenbaum in aurora co. thanks!

[RestlessMonkey 7]

I am not sure (check with your insurance) but using an example....people smoke (it is something they "do" to themselves) and insurance covers related illnesses like emphysema etc. OR...if you have plastic surgery (self pay) and then have an issue your medical coverage will cover the issue (like an infection etc)...

I think once it's done, if you have problems they have to cover it. They may not cover maintenance like fills etc (in fact I bet they won't) but if you have trouble like GERD, or the rare slip, etc they will cover that.

Just call and find out!

[spud.mama 7]

HEY! Nice to talk to someone in Colorado!! I live in Fort Collins and I'm going to Dr Johnell in Greeley. I have Aetna which I've heard is somewhat hard to get them to cover. I tried another place and they were no help to me at all, but the insurance lady in Greeley is wonderful!

I don't know what all you have done, but I've heard some insurance places will hold out for a long time just to make sure you are serious. I am so happy with my lady I'd suggest calling her, I'm sure she would help.

Dr. Johnell is at North Colorado Medical Center Bariatric Center, Vanessa is the insurance lady. 1-866-569-5926 You can tell her "Ada Potada" suggested you to call. She really is knowledgeable.

Hope you don't have to self pay. Good luck at whatever you end up doing.

Spud Mama :cursing:

[Fluffy_Gurl 3]

Thanks for the replies!

I was looking at dr. johnell but i really dont want to waste my time or money when my ins wont pay so ive been trying to get more ins info before the consultation. I am told that it is my employer that has said no to covering wls not the ins company, who would have covered it pending manual approval had my employer not discluded that from our policy. nice huh? i work in healthcare so this astounds me a little that they would deny something that could prevent diseases like diabetes etc especially whent hey specificaly care for ppl who end up having to be in our facilities due to these diseases that in the long run cost them more money but anyway... ill have to wait another year for the surgery to even be added to our policy and then who knows if they will approve it?

im at a point in my life where i need to do something before its too late and i have some of these diseases that being fat like me causes. i want to be here for my daughter and want to be able to see her get married blah blah blah ..so instead of waiting and gaining ive decided to do somethign about it now! so yet again i findmyself asking what about after the procedure?

[Nevergoback 0]

I had my band covered by United Health care, then our company got bought out and now we have Aetna. I had to go self pay on my fills, but when I had to have my band removed due to staph infection in my gut, Aetna covered everything to do with the removal without question. I was in the hospital 13 days had multiple tests and was only a couple of hundred dollars out of pocket. My doctor told me Aetna (and most insurance companies) will pay for any treatment which is medically necessary. Now I am self pay planning to have VSG and I pray all goes well during procedure. I'm hoping that if I have any problems, they surface after I get out of the hospital and we can go through Aetna to pay (i.e. infection or leaks). With band surgery, if you have any problems like infections, go back to your surgeon, if he will help you get well. Most likely your insurance will cover it. If it is a problem with the band, then your surgeon will most likely fix it at a reasonable rate, or as a part of your original payment. I heard that my original doctor actually replaced a band for someone without charge.

Good Luck and try not to worry. I have found that if something is going to happen, it's going to happen whether you worry or not. At this point in my journey, I am still not mad that I had the band, many of my coworkers who had it done at the same time are still doing great.