Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Bummed....a big DENIED....



Recommended Posts

Well, I have a 12 month pre-existing clause on my insurance so they denied me because of this. In my fifth month of having this policy now. Also, at they also want a three-year BMI of over 40 and I have been 38-39 and over 41 for just the last year. No major comorbidities......So, I can go self-pay or wait 1-2years MORE. I have already waited almost a year for this......thinking I will head to Colorado....SO BUMMED because I am ready for this NOW....

Share this post


Link to post
Share on other sites

That sucks - but keep positive maybe something better is going to come from this

Share this post


Link to post
Share on other sites

Yeah.....it does suck. Insurances are starting to make it more and more difficult to get the surgery approved.

Share this post


Link to post
Share on other sites

I had my surgery in CO by Dr. Brown and could not be happier with him. I know he has a very affordable cash price for LBS, and they are very easy to work with. I couldn't recommend him more highly. There are also many other CO surgeons that are recommended highly in CO as well with similar cash pay options-Dr. Kirschenbaum (or something like that) I've heard positive comments on as well.

Best of luck whatever you decide!!

Share this post


Link to post
Share on other sites

I had my surgery in CO by Dr. Brown and could not be happier with him. I know he has a very affordable cash price for LBS, and they are very easy to work with. I couldn't recommend him more highly. There are also many other CO surgeons that are recommended highly in CO as well with similar cash pay options-Dr. Kirschenbaum (or something like that) I've heard positive comments on as well.

Best of luck whatever you decide!!

Dr. Brown is doing my surgery next week, $9900 for self-pay. They are very helpful with directing you to financing options, they accept credit cards as well. The only good thing about paying yourself is the speed of the whole process: less than one month from first phone call to surgery for me.

I have good, comprehensive group insurance but WLS is completely excluded, so it was never an option for me.

Good luck. If I were you I would do the self pay rather than waiting so long!

Share this post


Link to post
Share on other sites

Dr. Brown is doing my surgery next week, $9900 for self-pay. They are very helpful with directing you to financing options, they accept credit cards as well. The only good thing about paying yourself is the speed of the whole process: less than one month from first phone call to surgery for me.

I have good, comprehensive group insurance but WLS is completely excluded, so it was never an option for me.

Good luck. If I were you I would do the self pay rather than waiting so long!

So would I. In fact, I did self pay. I had my band placed in Mexico for $7,000. The price quoted above for self pay in Colorado seems really fair to me. I would definitely do :thumbup:some research on Dr. Brown.

Share this post


Link to post
Share on other sites

insurance is really going downhill theses days. i was lucky to get mine approved but i have to wait till january to have the surgery. Another really great Dr. in colorado is Dr. Micheal Johnell. he is amazing and they can also help you with self pay and do payments and finacing.

Share this post


Link to post
Share on other sites

My mom was self pay, my insurance covered mine. I would do self pay especially if I could find a place that did it for $9000....my mom's was quite a bit more than that! Plus say you wait 1-2 years, then they will most likely have another way around not having to pay...and then you start again ugh! Good luck to you!

Share this post


Link to post
Share on other sites

Well, I have a 12 month pre-existing clause on my insurance so they denied me because of this. In my fifth month of having this policy now. Also, at they also want a three-year BMI of over 40 and I have been 38-39 and over 41 for just the last year. No major comorbidities......So, I can go self-pay or wait 1-2years MORE. I have already waited almost a year for this......thinking I will head to Colorado....SO BUMMED because I am ready for this NOW....

I chose to self pay in my case because I wanted to have the surgery while I was still healthy. I didn't yet have diabetes, sleep apnea or high cholesteral. The only problem I had was high BP but it was under control. I was afraid of my knees and hips going bad and not being able to exercise. My insurance refused to do the lap band and was pushing me to gastric bypass which I wasn't mentally prepared for.

I am so glad I did it when "I" was ready because that in itself makes all the difference. Determination and motivation is 3/4 of the battle for me. The rest I can manage and I know that this time I will succeed.

If you can afford to bite the bullet and pay yourself, you will have the added motivation from having spent all that money and be able to do it now when you are ready.

Best of luck to you,

Donna

Share this post


Link to post
Share on other sites

It seems to me more people are getting denied. (Or they are the ones that post more about it) I can see that this little window we have here might be the last one we will have in a long time to get something like this paid for. The government and insurance companies. Whew!!!

This is not a political agrument for me one way or the other just in case someone thinks it is. Just one readers opinion. I know my BC/BS dropped the six month diet. I just can't imagine that is going to last.

Share this post


Link to post
Share on other sites

I am flying to Brussells and self paying at $6000. That is pre-consultation, transortation from/to airport and from/to hospital.

If you read the Dr. De Bruyne thread, you will see many, many people who have used him and have great things to say. My surgery is September 23. (And after care will be done at a Center of Excellence locally)

Share this post


Link to post
Share on other sites

Amlus, Where do you live? I am from Hattiesburg MS and there are no surgeons here that do this type of surgery, so I had to go to Houma, Louisiana. The total cost of my surgery 9/4/09 is $5,700. I was able to go through my insurance but if I could not get covered I would have self-paid. I hear it costs alot more in other cities and states. I don't know where you are from but I wanted to tell you not to give up and if you are near or in Louisiana the cost is not outrageous. Praying for you!!

Phoebe

Share this post


Link to post
Share on other sites

The total cost of my surgery 9/4/09 is $5,700.

What???? Was this the total self-pay cost? I am in Iowa. What Dr. and what facility?

Share this post


Link to post
Share on other sites

The physicians that did my surgery are three brothers named David, Eric, and Fritz Rau and there is another doctor with them named Donald Schwab. They are part of Physicians Medical Center in Houma, Louisiana. The phone# is 985-853-1390. but the first person I spoke with was Brandi. She does all the insurance work or if you self-pay and her # is 985-868-2206. she can answer any questions you may have. I had my surgery on 9/4/09 and I just went for my first adjustment. Oh, the adjustments are free for one year and you can get adjustments every two weeks. the total self-pay is $5,700. I hope this helps you.

Share this post


Link to post
Share on other sites

Oh, the adjustments are free for one year and you can get adjustments every two weeks. the total self-pay is $5,700.

???

What the heck? The going rate around here is $12,000 - $16,000! There are a few places around $9,950 around Denver I have looked into. That really seems to low....are they like real doctors? (: Do they have you go to Mexico for the surgery?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×