Denied by Premera Blue Cross, could use some advise regarding financing/ self-pay

[light_lady 27]

Hi Everyone,

This is my first time posting! I have been visiting the site for a few years and finally decided that it was time to ask this hugely supportive and inspirational group of people for some advice regarding my situation....

I am 24, live in San Francisco, and am desperately trying to find a way to pay for my surgery. I have numerous weight related health problems but, because my BMI is 34.5 (not 35) I have been denied coverage by Premera Blue Cross. I have appealed their decision twice, with no luck, and am instead taking the self-pay route. I have been saving for 6 months because I know what a difference the band will make in my life, but Dr. Cirangle has quoted me $17,000 for the surgery (all inclusive) and I have no where near that much saved..... So, this brings me to my question!

I'm looking for advice regarding financing, specifically Care Credit as I believe that is the only company Dr. Ciranlge works with.

Which companies have you worked with? Would you recommend them?

Do any of you have experience financing your surgery with a low credit score? Any idea what the score requirements are for various companies? Most sites use descriptors like "excellent, good, fair, poor, bad", which doesn't really tell me much. My fiancee has a score of 700 and is willing to apply for a loan for my surgery, he knows I've wanted this for a long time, but we are worried about being denied and having his score take a hit from applying for too many lines of credit. It would be wonderful to hear your stories and get as much information as possible!

My 2nd consultation appointment is on April 2nd and I am very much hoping to have my surgery before May......

Thanks, in advance, for any information you have! I am so inspired by all of your stories

<3 light_lady

[cindya 54]

I'm using True-results and they finance half. but I'm in texas it runs about 10,000.

[light_lady 27]

Thanks for the info, cindya!

[2muchfun 8,928]

You live in a beautiful part of the U.S. but also one of the most expensive. There are several docs here(Denver) that will do that surgery for $10K. But aftercare is as important as surgery so I'm not suggesting you fly out for surgery but if you can look for other docs nearby? Mabye Sacramento? Stockton? Cost of living is less outside the bay area and you might find a doc who is more reasonable?

Regarding financing, do you have any assets at all? Car? House? Boat? Anything with a title? You can use those as collateral for a loan? Good luck to you.

tmf

[2012 359]

I used my car and refinanced it and got lucky and had enough value to finance enough to pay for the surgery at only a 3.5% interest rate.

[jessicawinston 58]

I live in Florida and I'm having my surgery done in Tampa. Mine is only 10,900. I am going thru care credit. My insurance had an exclusion so it didn't pay.

[light_lady 27]

Thanks 2much fun and 2012! jessicawinston, did Care Credit require a very high credit score?

[forensic6 89]

I hate to ask because I'll bet someone rips me for this but...why not gain the extra weight if that is the ONLY reason why you're being denied? Shouldn't take many lbs to get over that hump. Just sayin'.

[lilmispcl 298]

I was planning to have surgery locally and it was $18k. I was not able to get financing for the whole thing. I was approved through care credit for $11,700 and decided to travel to Dallas to have my surgery with True Results for $9,980. It is a 30 minute drive then an hour flight. Definitely worth the savings. Even if I have to pay for the first year of aftercare locally ($250 per visit) I will still spend WAY less than the $18k I thought I was going to pay.

[KAATNS 1,473]

Does your employer offer a flexible spending plan?

[light_lady 27]

No flex spending, sadly, and my insurance company requires that you have had a BMI of 35-40 for more than a year..... if they didn't, yeah I would totally just gain the 10lbs it would take for me to be approved.

[jessicawinston 58]

Thanks 2much fun and 2012! jessicawinston' date=' did Care Credit require a very high credit score?[/quote']

My score is like 695 not sure if that is good or not.

[light_lady 27]

Thanks everyone, for the advice! Looks like my fiancé and I will have the best luck by taking out a loan against one of our cars... We are going to start the process tomorrow, I'll let you know how it goes!

[2muchfun 8,928]

I hate to ask because I'll bet someone rips me for this but...why not gain the extra weight if that is the ONLY reason why you're being denied? Shouldn't take many lbs to get over that hump. Just sayin'.

I like the way you think! We sometimes hang onto every fraction of an inch in height out of pure vanity. Why not be 1/2" shorter? Could make the diff between 34.5 and 35.5 BMI. I have one daughter who takes after my Mom and my daughter claims to be 5' 0" tall but I'll betcha she's 4' 11.5".

Or, pig out and gain weight if you've already taken the height to it's extreme?

tmf

[light_lady 27]

forensic6, I actually completely agree with your logic; what is 5 extra lbs, when your health and your future are on the line? Then again, I firmly believe that insurance companies should look at bariatric patients holistically. Just because you don't quite have a BMI of 35, doesn't mean you won't benefit immensely from the surgery... Its a shame that so many people who need the band aren't given the chance because they fall just a little bit short.