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insurance changes new doctor fees!

I am one month from completing my original 3 month pre-op requirements only to learn that BCBS has changed their requirements to 6 month minimum. Due to my job that moves my surgery from July to November or December. On top of that there is a new $5000 surgeon copay, new deductible and 20% which will be around $7000. Am I crazy to now consider having the surgery in Mexico for affordability?

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I am one month from completing my original 3 month pre-op requirements only to learn that BCBS has changed their requirements to 6 month minimum. Due to my job that moves my surgery from July to November or December. On top of that there is a new $5000 surgeon copay, new deductible and 20% which will be around $7000. Am I crazy to now consider having the surgery in Mexico for affordability?

OUCH! sounds like Mexico is a definite possibility...

It is pretty unfortunate you had to put up with this, but this 'co-pay' has been something that they have wanted to implement for a while. Expect those fees to stick around or even rise. Until there is some reform by the government, insurance companies will make you jump through so many hurdles to have a procedure that can give you a better quality of life, and that can even save it.

Take things calmly, maybe you can find some loop-hole to go through. This may just be a minor set-back. Stay focused and you will eventually have your surgery.

Nope..you're not crazy. That's what I am doing. Tired of fighting w/BCBS and am headed to Mexico in 9 days :) My Mexican surgeon has done far more sleeves than most US surgeons...so, as crazy as it sounds to go to Mexico to have most of your stomach removed..I am doing it!!!

Best wishes to you!!

Wow, that insane. What has insurance come to?

I feel your pain. I ended up paying about $3k out of pocket. My $1200 surgeon and $500 asst. surgeon costs went up to $1700 for the main surgeon and $750 for the asst. by the time they finalized me for surgery. It was major sticker shock but I found out about the increases the day I was given my pre-diet to start. This is their flat charge they charge regardless of what insurance pays them. Above and beyond. I came home and had to do some long hard thinking about going to Mexico and would have it not for the additional delay. I'd endured too many of them and decided that paying it and getting it over and done was the way to go. But if you are further out, I'd really consider the option.

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i am a teacher so we have BCBS TRS active care. According to others I have spoken to almost every insurance provider will be joining the bariatric surgeon copay next year or shortly after. June 2 is my "last" wt mgt meeting so I will wait to see if I am approved or not. My decision will be made from there.

thanks for all the posts and support.

chelle

I have BCBS Tennessee and though the sleeve is excluded, my surgeon thought we could get it paid for on appeal. Of course, insurance only paid 50% of the allowable charges which was about the same amount of $$ as it was going to cost in Mexico. I'm an impatient person and didn't want to waste any more time so I cancelled all further appointments and scheduled surgery with Dr. Aceves. Best money I've ever spent and I got a much more experienced surgeon to boot.

Not insane....but keep in mind....there are complications with this surgery. IF you do develop one after having surgery in Mexico your insurance likely WILL NOT cover anything related to it once you are back.

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