Mel1071

All I know is that after researching WLS like mad, and especially after spending endless hours here, I want to bop anybody who says having WLS is the "easy way out." I don't care if you're going the insurance route, the self-pay route - this is a hard process regardless of how you pay for stuff.

I don't doubt that for a second! I would love to see statistics of the success rate of people who have to do these multi-month programs. I think for everyone who hates to have to go through the insurance hoops there's someone else who wishes their insurance covered it so they had hoops to jump through too.

I suspect because they think some people won't make it through the six month period and then they wind up not having to pay. It's a gamble they are willing to take.

Thanks for that link!

You are going to be awesome! I can't even fathom how you feel knowing your surgery time. You are in the hands of a great surgeon and this time next week you'll be sharing your post-op recovery story. I look forward to that! Good luck!

Right now it looks like my forerunner may be Dr. Nicholson in Dallas - seems like he gets rave reviews. One of my concerns is I've heard he can do 11-13 surgeries in one day. Is that excessive? Part of me is like, well, he knows his stuff. And part of me is like, hmmm, not sure I'd want to be patient #11, And that's nothing against him per se, it's just my own ignorance.

Thank you all for all the responses! I did check out Dr. Umbach in Vegas - my only real issue was the fact everything is done outpatient. I don't know yet if I'd be comfortable with that. I've never had any kind of surgery so hospitals kinda freak me out, but then so does the thought of having the surgery as an outpatient. The unknown can be one heck of a beast in my mind!

Hello all - I am from TN, not TX but am looking into having Dr. Nick do my surgery. It seems like he does a great job from what I've read. Would any self payers be willing to share with me what their costs were? I talked to his office and they say the $12,200 covers pretty much everything - from his fee to 2 nights in the hospital to pre-op tests. Was this your experience?

Also, if anyone who traveled from out of state to have surgery from Dr. Nick, I would love to hear about your experiences as well.

Thanks in advance!

Melissa

I thought of the other insurance but no one wants to issue a policy to someone with a BMI of 47 taking meds for cholesterol, HBP, and depression.

I like the idea of working on my head - I've been doing that for awhile and I think that's why I am finally at the point I even started considering surgery. But a little more time can't hurt

I am spending way more time online checking out sleeve info lol I should be finishing up my business' website and gearing up for teaching my Fall classes, but, but, well, this is just so much more interesting right now!

Thanks for the kind words

Well, it's official - our insurance will not cover the surgery and I am looking at going to self-pay route. Time to start socking away every spare penny I can. I know financing is an option but we carry no debt other than our mortgage and I hate to add to that. I am kind of tempted to pay cash for half and finance the other half. The surgeon closest to me that does self-pay is a smidge over $18K. I am also looking at other doctors in surrounding states - saw one in TX whose rates including up to two nights in the hospital and all pre-op tests for $12K. I'm not thrilled with going out of state for the surgery as I like the idea of having my doc 20 minutes from me if, God forbid, there are any post-op complications. And Mexico is not an option either for various reasons - I know it worked for some folks, but it's not for me.

Obviously now that I've decided I want to have the surgery, I want it now I figure if I save for the 18K surgery, I would have at least a year to prep and get ready for surgery. But I think that year might kill me. Regardless if I have to wait a year or several months, what did you do to prep yourself for the surgery, physically and mentally?

Do you mind sharing who you are looking at? I am in TN and am looking at all of my options. So far the best self pay I have found price-wise is $12,200 - and that's in TX. Atlanta would be a much easier trip. Thanks!

I am looking at going self pay myself. I can't help you with the first question but will share what I know about the second.

The doctor I am looking at includes the pre-op tests in the fee (which looks like it will be around 18K). I've looked at a number of other websites and some specifically say pre-op tests aren't included.

If you're like me and like to gather up as much info as possible, give the doctor's office a call.

Good luck!

You go, girl! Keep up the great work!

Good luck!!

Thanks for the info! I have been researching like mad and am also going to the seminar at Centennial so I can meet Dr. Houston. I've heard good things about him too. Centennial's self pay is less than Baptist's too. I am hoping that by meeting various folks someone will help me find a way to get our insurance to cover it. If I have to wait for self pay, well. I may be waiting awhile

I have scheduled an appointment for a general informational seminar to meet with a surgical group in 2 weeks - Baptist with Dr. Spaw. As of right now it looks like insurance may not work out for me which stinks Has anyone done a self pay with Dr. Spaw for a VSG? If so, could you share how much it was ( I have left a message wi the medical group and haven't heard back plus I would just like some info from folks who have been there, done that.

Also, if not, do you have anyone else that you've done VSG self pay with in this area?

Thanks in advance!

Melissa

Thank you all so much for your advice! I feel like the hardest thing so far has been #1 telling myself I need this and #2 telling my husband. He is beyond wonderful with everything but it was just hard to admit I can't do this myself - that I felt weak admitting that, but he assured me it takes a lot of heart to say hey, I need help here and he will support me any way possible. I figure if I can get over that hump, I can get the payment part figured out too!

I will need to check into the college. An individual policy is out of the question - I tried to get one after I had moved here and bad not yet married my hubby. I was turned down because of my BMI and comorbidities.

My insurance is through my husband's policy and to my understanding it's the only one offered. I am a part time faculty member at a local college and also run my own business so I am dependent on his. The sad thing is - with this exception, his policy is great.

I figure it's taken me years to accept the fact I need the WLS - heck, it wasn't even until last week I felt brave enough to even mention it to my husband ( who has been great and aupports me 100%). I figure if there's a will, there's a way. I am nothing if not determined!

Oh, I guess I wasn't clear - I have no interest in the lap band. I've been doing lots of research and I'll be honest - I never thought I would ever be considering WLS. It wasn't until recently that I had even heard of VSG and what I've read about it makes me think it is a very viable option.

I guess it just bums me out to realize that even though it seems like I am a prime example of someone who could be greatly helped by VSG (BMI of 48.something with high blood pressure, high cholesterol, pre diabetic, depression, and a history of sudden cardiac death in my family) but my insurance doesn't care about all that and would rather take a reactive rather than proactive approach to my health.

Thanks for the info! I am already looking into self pay options - not really interested in going out of the country. I know the place I'm looking at offers lap-band self pay for 12K but I'm much more interested in VSG. Will contact them to see if they offer a VSG self pay.

..is it a hard fast no always? I called and asked my insurance about medical weight loss/WLS surgery and the agent basically read off a script and said it's not covered. So I asked well, what if I have a letter of medical necessity from my doctor? To which she simply re-read the script *sigh*

So does no really mean no or does this mean I have to look at jumping through a bunch of hoops? I'm hoping for jumping through hoops. :-)

Before I found this info out, I made an appointment for a seminar on 8/19 with my surgeon of choice and one of the things that was mentioned when I made the appt I that I need to bring my insurance card with me. Apparently their insurance coordinator will contact them as well. But if this no is a definite no, do I even need to bother with having them contact my insurance?

Thanks in advance!

Melissa