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Cost

please tell me what insurance will pay for the gastric sleeve. I have bluecross but they want pay please help I am self employeed.

and have had blue cross since 2003. I feel like I am screwed!!!!

trustme it is not like the man on the porch comercial I got BLUE CROSS AND I AM COVERED @..$ 660.00 A MONTH. I HAVE PAID FOR IT IN THE PREM. OVER A COUPLE OF 2 OR 3 YEARS

akweldon@windstream.net

251-600-9466

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pretty much any policy where you are self-insured isn't going to pay. Group health plans typically pay. Sorry.

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!!

Allen I feel the same way you do. Simple math. 12 months @$500/month=$6000 bucks

Sleeve in mexico=$4500

Sleeve in US=$12000

If my companies health insurance has been getting paid for the last 4 years and I rarely have anything go wrong why not pay for me to better my long term health. I guess corporate greed is better than helping the ones who pay for their ferraris and multi million dollar homes

(null)

Just becasue it says BCBS doesn't mean it's the SAME insurance coverage. BCBS is a manager for MANY insurance plans for MANY companies. In my case my manufacturer COMPANY is the actual insurer and BCBS is the manager. WHAT they pay on a particular plan and HOW MUCH they pay is negotiated between the company and BCBS when they agree on a plan.

My particular BCBS WOULD of paid if I would of taken the time - typically 6 to 9 months - to jump through their hoops. The cost to me out of pocket WOULD of been ABOUT the same on my high deductable plan, that is about $5000 so I elected to go right away and pay my own way in Mexico.

So you'll have to check with YOUR plan provider.

  • 2 months later...

Yes, insurance companies underwrite policies specifically to meet the employers needs. Most self insured plans do not cover bariatric. In my case my employer has an exclusion on my plan and there is no way around it so off to Mexico I go!!!

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