Has anyone else had insurance deny you for years, so you just paid out of picket?

[wife4life 4]

After 2 insurances saying no repeatedly, I finally had to just do this myself. Anyone else?

[Jacqbult 112]

Why did you get denied? I think a lot of people have done it on their own...check different states b/c the price varies a lot.

[Jersrose43 837]

I think it matters why you got denied, were both your insurances provided by the same employer?

If so it was likely an employer restriction, which means you can get other insurance privately, switch employers or get it through a spouse and obtain coverage.

Just takes more research.

[BitterSweet* 835]

A lot of people are in your shoes and others can get approved but they just don't want to jump through hoops like a circus animal so they travel to Mexico or pay triple that amount in the States.

[Jersrose43 837]

A lot of people are in your shoes and others can get approved but they just don't want to jump through hoops like a circus animal so they travel to Mexico or pay triple that amount in the States.

I pay enough for my coverage evry week - it's called holding them accountable to pay for services

[BitterSweet* 835]

Not sure what you were trying to say @Jersrose43. Let me clarify. There are people with insurance who do qualify for surgery through their employment but choose to just pay out of pocket instead of waiting upwards of a year to finish all requirements. Some people just don't want to wait and jump through hoops.

Those who have the monetary means to pay for it in the States do so, and those who choose not to spend that much money (whether they have it or not), go to Mexico.

The insurance scheme in our country is a racket. It is treated no different than car insurance. Often times companies opt out of covering bariatric services because the sicker you are the more money they will make off of you. Sick people help balance the equation for young, healthy people that don't have to pay as much money for coverage.

[Jersrose43 837]

Opt out is one thing.

Choosing to not go thru "hoops" is something I will do considering my cost per year for premium is close to $2000 a year. So if it's covered I find out the guidelines and make sure I meet.

Then I pay my deductible and coinsurance

And yes it's more expensive than Mexico but I can go 10 miles and see my surgeon whenever I need to.

[BitterSweet* 835]

Uhm ok. I don't disagree with you whatsover @@Jersrose43, so I don't really get your response. That is your right and everyone is entitled to make decisions regarding staying the course with insurance or choosing another option for their own personal reasons.

The "hoops" may be a pain in the rear, but the length of time it takes to complete them gives someone time to research, plan, get therapy or whatever in preparation for this life altering decision. There are plenty of folks who choose to skip that part. My personal opinion is that it's not a good idea, but I don't have to deal with that decision; they do.

The OP clearly states she has been denied twice, so my response to her was to specifically answer the question she posed.

[Jersrose43 837]

I agree with you. The hoops can be a good thing. Especially in this life altering decisions

[wife4life 4]

Sorry I'm just seeing this. Back 4 years ago I tried with my insurance but they don't cover it at all. Once I became a stay at home mom I went on my husband's insurance. Come to find out, they won't cover any of it either because they just don't offer it. They wouldn't even cover the sleep study. After 2 years of fighting with them and lots of saving in the past few months, I'm getting it done anyway in a few weeks but I was just curious if anyone else had something similar happen.

[dashofsunshine 875]

I am paying out of pocket in the states. It is costing a FORTUNE and I am using all of my savings (my parents are helping out as well). I tried to get approved by my insurance and they said it wasn't happening. I had the option to switch to a different plan in hopes that maybe they would cover it on a more expensive insurance plan, but they required me to have been morbidly obese for at least 5 years before surgery (it has only been 3 for me being MORBIDLY obese...I've been overweight most of my life) and I decided that I would rather pay out of pocket than wait two more years and gain another 100 lbs and get diabetes. The worst part is that I turn 26 in 4 days and will be dropped from my secondary insurance which was my dad's. He works for the Post Office and has the federal employee program, and the entire surgery on his plan would have cost $350. Because of the law, however, I'll be dropped on my birthday. Horribly disappointing. But I'm coughing up the money because, what better to spend it on than a long, healthy, happy life?

[Kindle 8,667]

I pay $3600/year for my health insurance. Thanks to Obamacare that is a lot more than I used to pay, much less coverage and a higher deductible than before insurance became so "affordable". And unfortunately the state I live in opted out of WLS under the ACA, so despite my insane premium, I was on my own for this surgery. I took all the money I had been saving for two years for a down payment on a new truck, put about $1000 on a credit card, and headed to Mexico. 10 months later I happily drive my 15 year old truck to work everyday. Money WELL spent!