DENIED - HELP with Self Pay Options??? New Surgeon????

[attitudz 0]

So I found out today that after going through the whole pre-op procedures for the past 6 months that my insurance won't even consider my app. due to the fact that I don't have "comorbidities". I feel my surgeons office has wasted my time for the past 6 months having me go through all this and then telling me I'm not even a candidate. My BMI is over 60 but since I don't have any major heart issues I'm not a candidate. I am completely focused on having this done, and need to find somewhere and a way to pay for it. My surgeon at the U of MN wants $19,000.00 and 350.00 for each fill. HELP - I'm in WI and need to find somewhere to go and someway to pay. Any suggestions are welcome! I've cried all day, now it's time to get to work!

[123crod 170]

I was self pay in Houston $12,900 for Surgery and fills for a year. Dr. H. Spivak and I love him. A plane ticket to Houston might not be that much. Good luck

[health4life 0]

I was a self pay in Cincinatti Ohio for $12,999 with 2 years of fills. I think Capital One has financing for healthcare. I forget who I got financing through. Help is out there. Good luck to you.

[Enchanted 2]

I'm sorry this is happening with you.

Are you sure you have no comorbidities? With a BMI so high, it seems that being heavy wouldn't be the only issue.

Here's a detailed list of what I found online. It's long.

Commonly Observed Comorbidity of Obesity

Orthopaedic

Slipped Capital Femoral Epiphysis

Blount’s Disease

Early Osteoarthritis

Painful Flat Feet

Carpal Tunnel Syndrome

Avascular Necrosis of Femoral Head

Genu valgus

Neurology

Pseudotumor cerebri

Increased Neural Tube Defects with Maternal Obesity

Pulmonary

sleep Apnea or Obesity Hypoventilation Syndrome

Asthma

Daytime Somnolence

Gastrointestinal

Steatohepatitis

Gallbladder Disease

Acute Pancreatitis

Gynecology

Polycystic Ovarian Disease

Hyperandrogenism

Amenorrheal/Oligomenorrhea

Hirsutism

Fertility Problems

Endocrine

Diabetes Mellitus

Hyperinsulinemia/Insulin Resistance

Metabolic Syndrome (Dysmetabolic Syndrome, Syndrome X)

Prediabetes (Impaired Glucose Tolerance)

Hypertension

Gynecomastia

Hypogonadism

Cardiovascular

Post-Exercise Tolerance

Easy Fatigueability

Dyslipidemia (Early Cardiovascular Disease)

Deep Vein Thrombosis or Hypercoaguability

Increased Risk of CVD (Increased Fibrinogen, increased CRP, increased PAI-1 [Phasminogen Activator Inhibitor-1])

Psychology

Other Eating Disorders

Depression or Poor Self-Esteem

Ostracism

Oncology

Increased Risk of Cancer—Breast, Colorectal, Endometral, Esophageal, Renal, Pancreatic

Metabolic

Gout

Infectious

Yeast Infections

Skin

Acanthosis, Nigricans, Skin Tags

Striae

Necrosis Lipoidica Diabeticorum

Acne

Maceration with Skin Folds

Falliculitis

[attitudz 0]

thank you for the help, I do have alot of those problems but the ones they have listed only have to do with the heart and diabetes...... the insurance company is a total roadblock they wont tell me anything, they ONLY deal with the doctor, I feel my surgeon is dropping the ball on this, my regular doctor is VERY supportive, I'm thinking I should go back to him and see what he thinks

[Enchanted 2]

You might get the HR department (or whomever is in charge of your insurance at your company) involved in this if the insurance company will only deal with the doctor. The doctor isn't the customer.

I'm so mad about this for you. CrAzy!

[happy2lose 0]

This is crazy! My insurance didn't require comorbidities with a BMI over 45. They just flat out refused to do lap band.

I went to a great surgeon in Mexico and self-paid $7,000 which included the hotel stay, pre-op testing and lifetime fills. I believe due to the poor economy that my surgeon has since dropped his price.

Best of luck to you and don't give up!

Donna

[Humming Bird 275]

I used Dr. Kirshenbaum in Denver. it was $9950 for everything. This includes free fills for 3 months and the fills after that are only $15. You could get a cheap flight to Denver for a fill for less money than some of these docs charge per fill. There is a hotel about a block away from the surgery center. He will do a phone consult and does not require you to do all that pre-op stuff you just went through. It has all worked out well for me s far. He has many patients that come from other states. his web site is Lap Band Surgery in Denver Colorado | Lap Band Surgeon in Denver | Gastric Band Surgery Denver | Bariatric Surgery

[attitudz 0]

Thank you all for your help, I heard from my Doctors office today and they are livid! He says I DO have the comorbities listed and that they will try and fight, I do NOT however want to spend the next 2 years fighting. Also - my insurance will only pay for a bypass with my high BMI and I don't want that. I talked to Dr. Kirshenbaums coordinator today. I am trying to find some financing and once that comes through i think I'm going to Denver! Anyone have suggestions on medical financing?

[Humming Bird 275]

I used Health One 1-800-558-3424 (there is a link on Dr. K.'s web site too)

It works like a credit card. They approve you for a max dollar amount and send you a card. You charge it on the card at Dr. K's office.

I have a very high credit score and the best rate they would give is 10%. (because it is an unsecured loan) There is no interest for the first 6 months, so I am going to try to pay as much of it off as I can in the first 6 months. I might transfer the balance over to my Capital One card after that because my rate on that one is under 5%. My minimum monthly payment on my first bill from Health One was $100. It has gone down since then because I have been making large payments.

[Enchanted 2]

Sounds like you have a plan and are putting it into action. Good for you!