BrandNewMe11

I was self pay too. Had surgery Jan. 23, 2012 and have had no complications. Anthem was my insurance at the time and WLS is a policy exclusion. But they did pay for my EGD, labs, sleep study, etc. HOWEVER.....the hospital billed my insurance (by accident) for the surgery three months AFTER the procedure and my paying for it. Anthem sent a letter stating they had terminated my coverage. After speaking with their underwriters, she said they will not reinstate me until 3 YEARS after surgery!!!!! This is ridiculous that they will drop a person for having to pay out of pocket for a procedure they don't cover to begin with!! So now I have United Healthcare Insurance. Under no circumstances should your insurance find out you had weight loss surgery,or you may find yourself in the same boat I was. Good Luck!!!

My favorite is "Unjury". They have protein powder in flavors such as chocolate, vanilla, strawberry sorbet, chicken soup, etc. It tastes really good too! To get in protein when you're in the clear liquid phase I recommend Isopure plus zero carb protein drink. They come in 12 oz. bottles, have 40mg protein, and come in flavors such as Alpine Punch, blue raspberry, green melon, etc. You can get Unjury at "unjury.com" and the isopure at GNC.com. My surgery is scheduled for Jan. 23rd. Good Luck!!

My husband and I are both self-employed (we are specialty physicians) and we have Anthem BCBS. We also pay high monthly premiums for what I thought was great coverage. I was denied for gastric sleeve surgery from BCBS. We are in the state of Kentucky and bariatric surgery is an exclusion with BCBS. There are only two major employers in the state of KY who pay extra to have bariatric surgery included in their employee plans. No one else can get it. We also checked on switching to other plans, but the only other two available do not have bariatric surgery as an option. Self-pay is the only option available to me. I did look into having surgery in Mexico with Dr. Guillermo Alvarez, but ultimately decided to have it done at my local hospital. The cost is $12000. My surgery is scheduled for Monday, Jan. 23rd. In your case, I'm afraid you'll also have to look into the self-pay option. I know it doesn't sound fair considering you pay so much in premiums only to have weight loss surgery be denied. In my state there's even insult to injury because KY State Medicaid pays for the gastric sleeve!! So someone on medicaid gets it for free, and those of us who pay for our own insurance can't get it!! GOOD LUCK!!

Yes, spending $22500 is a lot of money out of pocket, but it is an investment in my health and future. A future with my husband and 7 year old daughter. Mexico is out of the question for me, I have no one to travel with me and/or help. The funny thing is...I gained 10 lbs. just to get into the qualification range. I am not a diabetic or have HTN...but the other co-morbidities qualitied me. Switching to another insurance in the state of Kentucky, when you pay for you own health insurance, leaves me with only one other option which is Humana. And this coverage is worse than Anthem's. The only reason I know this is that my husband and I are both specialty doctors (and no we are not hospital employees). We deal with insurances all the time!!! And no, being a doctor does not get you special privileges from the insurance company...as my ANTHEM denial clearly indicates. But when I get to the office tomorrow, I'm calling Anthem's pre-cert department (again) and let 'em have it!!

Hi, everyone. I'm completely brand new to the forum but have been reading the posts for months. Got the courage to see the surgeon after decades of weight loss struggle. My first appointment was in October, went to the seminar, saw the dietician, had the labs, EKG, EGD, sleep study and got all my medical records detailing my multiple attempts at weight loss in the past. This was all submitted to my insurance company on Nov. 22. My surgery was scheduled for Dec. 12th. But then the insurance decided to give me a big, fat, denial (no pun intended!). My husband and I pay for our own family plan. We do not have a workplace insurance. I thought Anthem was supposed to be so great and has offered great coverage in the past, but not this time. I called the finance officer at the hospital and the cost is $22500!! Now, I do have a wonderful husband who said he would pay for it as a Christmas/birthday gift (and also because I've been wanting this for so long). So I'm going to schedule the surgery for the last part of January 2012. But I feel so guilty spending this money. I feel this is why I pay for insurance. What upsets me the most, and sorry if this offends anyone, is that in the state of Kentucky the gastric sleeve procedure is a covered service under state Medicaid. And yet I pay thousands of dollars a year for Anthem and get denied. They say it is a "policy exclusion", but when I called them prior to my first doctor's appt. they said it only needed to be pre-certed. Oh, well, I guess this is one of life's lessons. Whether I pay for it out of pocket or not...the end result will be the same.....A BRAND NEW ME!!