mmcclure

Just a question here - how do you know for sure that Dr. Aceves has never had a leak or complication? Is that something that you have heard or do you know this for sure? Not that I think Dr. Aceves is not telling the truth or anything, but people have told me that Mexican doctors "hide" patients with complications or deaths. I know someone who worked for a plastic surgeon here in the States and she said that they had to fix things that Mexican doctors did all the time. Granted - there are good and bad doctors everywhere, but I am a bit of a skeptic when I keep hearing that a certain doctor has never had a complication when he has supposedly done thousands of surgeries. Don't get me wrong - Dr. Aceves is my first choice if I need to go to Mexico for this surgery; I just want to make absolutely sure that things are not hidden and he is as good as everyone supposedly says he is. As a matter of fact - how do we know that his patients on here are actually patients? Just asking...

I have been haunting the Aetna website since Feb. 11th. I am using a limited insurance policy to cover the surgery through Aetna and have been going nuts trying to find out if they would cover this or not. Anyway, the surgeon's office finally spoke with the supervisor and she said that they don't require precertification so the surgeon is going to get us started (my daughter and I are having it done) and plan on doing the surgery after mid-April. We have to pay the lot amount to the surgeon, but should be able to get it reimbursed if Aetna does indeed cover the sleeve next month. I am sooooo excited. I have been afraid to get too excited because I wasn't sure how it was all going to turn out, but now that I know that there is a very good chance that it will be done, I can hardly contain myself!!! :confused1:

Thanks. I've already been in contact with Nina and Dr. Aceves will be my choice if the insurance company doesn't come through or the co-payment is too high. Both my daughter (21) and myself are doing this, so I really need to find the best doctor at the best price. I won't sacrifice care for cost, of course, but I want to look at all options as well.

For those of you that didn't go to Mexico, Is this what was billed to your insurance company or is this the self-pay amount? I'm trying to figure out what my costs will be for my 20% and deductible. Thanks!

Hi everyone, I am in the process of figuring out whether the SRC insurance I have will cover part of the cost for the sleeve and if they will, what my out-of-pocket expenses will be. The hospital doesn't seem to be able to give me any idea what they would bill the insurance company, so it is impossible for me to get an idea. Also, I would like to know so that if my cost is too high, I can make plans to go to Mexico and have it done. I know that every hospital is different and costs can vary widely. But - can anyone let me know what your hospital was billed? I don't care what your insurance paid because mine is different, but if I can get an approximate (maybe high and low?) of what amounts were billed, I might be able to at least get an idea. Thanks!

Ok, now I am totally confused. I called the member services number on my ID card and the person there told me that our coverage is actually NOT an Aetna plan, even though it says it is an Aetna company. Because it is a different type of plan/company, they don't follow the same guidelines and rules that Aetna does. She said that it doesn't matter what type of surgery we have done, it is covered up to a certain amount, with deductibles of course. I'm afraid to be too excited about this until my surgeon's insurance coordinator calls to confirm. But, I am optimistic because this woman told me the same thing several times and even gave me a direct phone number for the provider to call to confirm. I told her that the insurance coordinator called before and was told something different and she said that, according to our file, no one has called (they keep track of every call) and that the coordinator probably called Aetna, not them. Has anyone had this kind of insurance before and used it? Even though my ID card very clearly says, "Aetna" on it, it also says, "SRC an Aetna Company."

Yes, but haven't they been doing this procedure as the first step in a two-part surgery for people with high BMIs for a long time? Seems to me that that could be used as evidence that it is safe and effective, especially since I read that a lot of those people lost enough weight that they decided not to do the second part of the surgery. This is really bumming me out. My daughter and I really want and need this surgery but can't afford to pay out-of-pocket here in the States and she is adamant about NOT going to Mexico to have it done. And, it makes me nervous when I hear about people having complications and no one willing to touch them after they have had surgery in Mexico. So depressing...

It's my understanding (could be wrong) that Aetna is going to look their bariatric surgery policy over on February 11th. Say a prayer that they approve the sleeve at that time. My daughter and I both want that surgery, as well. I don't know why it is taking so long for the insurance companies to approve it (although some of them are now) - it is cheaper, generally has less complications, better long-term results, etc. Of course, we ARE talking about insurance companies here - they always make sense, right?

I'll make sure to find out after February 11th and post it here. I think they only look at changes once a year, but I could be wrong.

Question: If you feel comfortable answering this - why did you need to have the band unfilled due to your MS? I have MS and want the sleeve but, as of right now, Aetna doesn't cover it.

I, too, have Aetna and was told that they don't cover the sleeve. However, I did some research and discovered that their bariatric surgery guidelines are supposed to be reviewed on February 11, 2010. So, keep your fingers crossed that they will come to their senses and start covering it! Geez - less risk, better results, you would think it would be a no-brainer!

I have wonderful insurance through my company. However, they will not cover bariatric surgery. However, my husband's company insurance will so we decided to switch during open enrollment. At the last minute, he was switched to part-time and has to pick up Aetna/SRC which covers the surgery but has a limited max that they will pay for everything (including doctor visits). So, I kept my insurance and he is also getting this insurance (which considers itself primary no matter what). My concern is, if there happens to be a complication, would my other insurance company cover that if they won't cover the bariatric surgery? I have this fear that, if there is a complication, the hospital fees will quickly go over what the limited insurance will cover and I will end up owing thousands of dollars, even though I have great insurance that just happens to not cover bariatric surgery. Does anyone have any experience concerning something like this? Thanks!