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Sigh....unsure..

So, although I am insured by Aetna, I dont think they are going to approve my surgery. My bmi is only 36 an although I have 1 comorbidity (high blood pressure) I am only on 1 medication and the insurance requirements are that I am supposed to be on 3 concurrent meds. So yes I have high bp but not high enough and yes I am at an unhealthy weight but not unhealthy enough! I really tried not to just ball in front of my doc.... So now I am contemplating Mexico and I am honestly terrified and unsure of where to start! Ive been reading thru the posts and am glad to read all of the positive results..but what happens when u get back home? Who do you go to for check ups or additional leak testing? Im just wondering if and how does the aftercare work or if there even is any? Ugh I am so scared to make the wrong or deadly decision.

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i don't have insurance at all, so i can relate to how you're feeling. i noticed that a lot of people from my area (oklahoma) have gone to mexico to get their surgery... so.. i'm looking into that, too... and i was wondering the same things as you.. looking forward to the responses. :)

I, too am in a similar situation. I have United Health Care and they also cover bariatric surgery. But my BMI is at about 34, and I also have High Blood Pressure - but this is not enough to warrant their coverage. Stupid. So, I didn't even go down that road -

I am looking at Dr. Aceves at the moment. I have considered the other doctors in Mexico that cost about half as much as his surgery costs, and although I'm quite sure they are adequate surgeons, I just think I would feel better with a doctor who allows you to stay in the hospital for 3 nights, who checks on you 3 times per day, every day you are there. I found out today that he performs surgery 6 days per week! The only day he doesn't do surgery is Sunday, but he still checks on his patients 3 times per day on Sunday, too. That's comforting to me to know that he is that dedicated.

You also book the surgery with his coordinator, Nina. She will answer ANY question you have via email (or phone, I guess - haven't called her yet) but she answers within 24 hours of receipt of the message. I talked with one of those agents about another surgeon, and she gets a commission from which ever doctor she arranges your surgery with, but I wasn't comfortable with the whole idea. They are sales people, and they are not a part of the doctor's true staff. Kind of like buying a house from a realtor instead of dealing with the person that owns the house. I'd rather talk to the person that owns the house because they know it better than anyone else.

Those are just my thoughts at this point. I will definitely have the surgery because after becoming increasingly more and more overweight as the years go by, I see that it's only going to get worse if I don't have the surgery. And yes, I realize that the sleeve is a tool and not a "cure all". At first I didn't quite understand why everyone emphasizes that point, but now I think I get it. From what I have read, having the sleeve stops the hunger and cravings, and it physically prevents you from eating like a pig. I have always failed at diets because I get so hungry that I give in to the temptation. Also, even if I WERE able to stick with a diet, I know the weight would come right back after I stop. With the sleeve, you will never be able to eat like a pig again, and the beauty of it is that you won't have the desire to do so! No serious hunger pangs to fight. I can deal with that!

So, that's where I'm at right now. I figure I will try to go through with it in October, probably. We'll see! But I do understand your hesitation. BTW, I'm 5'6", I weigh about 207 and I'm 56 years old. I want to get down to 130, if that's possible. This website is awesome for getting all of the details that you may not have heard about otherwise. I'll keep you posted, and you let us know where you're at, too!!!!

Well make that four of us....I was super excited because with uhc i thought it was bmi of 35 and 1 comorbidity. Well at the consult ins coordinator told me bmi of 35 and 2 comorbidities. UGH!!! I was happy because my bmi came in at 35.2 but only high blood pressure. Right away i looked into mexico but today i realized that i should continue to follow up with the evalutions with the three doctors required by surgeon...maybe i have sleep apnea and wasnt aware. Anyhow, im having the surgery regardless if ins pays or i travel to mexico. I was impressed with Dr. Aceves as well. So im currently deciding between him or Dr. Ortiz.

My insurance covers bariatrics. I have a lower BMI and knew that I would have to gain weight to have insurance cover surgery, go through the 6 month supervised diet, etc, etc. I would save alot of money going with insurance but I no guarantee I would qualify. I am having surgery on 9/10 with Ortiz. I will keep you posted on my experience.

I found a surgeon close to home that agreed to do my follow up care/ leak tests etc... More surgeons are doing this as alot of people are going to mexico. I went to Dr. Almanza and had a great experience and save ALOT of money...If you have any questions about him/his staff i'll be glad to help. I am an RN and was impressed with the care and felt totally safe the entire trip...

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Thanks everyone for the responses!

So I just got off the phone with the bariatric consulting coordinator and she said that I do not have to neccessarily be on 3 medications at the same time as long as I have tried 3 different types of medication. I explained to her that my blood pressure rises with my weight. The minute I lose weight my blood pressure seems to go down. Medication has never really helped. I have been yo-yo dieting for about ten years and each time I re-gain the weight a few extra pounds tend to join the party raising my bp all over again. She said that I could have my primary doctor write a strong letter on my behalf explaining that the weightloss is a necessity due to fact that my blood pressure goes hand in hand MIGHT do the trick....MIGHT.. so I will now try to beg my doctor for a strong letter and pray that it will help. I will start my Mexico research in the meantime because insurance or not this tool is truly a necessity for me.

Good for you! I will keep my fingers crossed. I would have loved to have my surgery closer to home -

  • Author
Good for you! I will keep my fingers crossed. I would have loved to have my surgery closer to home -

Thanks girl!! I will have u in my thoughts come Monday! It must be so exciting to know you are going to start a new life in a couple of days! Please keep me posted. Best of luck to you! :)

(1) So, although I am insured by Aetna, I dont think they are going to approve my surgery. * * * (2) So now I am contemplating Mexico and I am honestly terrified and unsure of where to start! * * * (3) what happens when u get back home? Who do you go to for check ups or additional leak testing?

(1) Some doctors might be able to convince Aetna to pay. Check with their patient liaison people.

(2) The doctors who advertise on the Internet invest heavily in reassuring potential patients. Make use of their 800 numbers -- you'll be talking to intelligent, English-speaking sales agents. Also, our blog has put up several items under the "medical tourism" and "culture" tags that should help reassure you that things are on the up-and-up around here.

(3) Every surgeon should answer this question for you. Some have reciprocal arrangements with doctors in the U.S. for follow-ups, others prefer being present for the recovery period. There's some nice scenery around here.

I will be going to Tijuana on Friday to have surgery with Dr. Ponce. I had my mind set on having surgery at the hospital I work for (we have a bariatric surgery program in our off campus facility) when I found out our insurance won't cover it and it would've been $19,000.. WITH my "employee discount"! (I am an operating room RN in a busy Level 1 trauma center) Anywho, that's what got me started looking into self pay threads on forums and I stumbled into the Mexico threads. You woulda never convinced me I'd be going to TJ for major surgery this week LOL I feel very confident in this decision and am going to take lots of pics and will be posting them on a shutterfly site I started just for this adventure. I'll be putting up the link next week after I've got back home.

I will be using my primary care doctor here after I get home if I need any follow up care. Honestly I'm not worried about getting care after getting home.

  • Author
I will be going to Tijuana on Friday to have surgery with Dr. Ponce. I had my mind set on having surgery at the hospital I work for (we have a bariatric surgery program in our off campus facility) when I found out our insurance won't cover it and it would've been 19' date='000.. WITH my "employee discount"! (I am an operating room RN in a busy Level 1 trauma center) Anywho, that's what got me started looking into self pay threads on forums and I stumbled into the Mexico threads. You woulda never convinced me I'd be going to TJ for major surgery this week LOL I feel very confident in this decision and am going to take lots of pics and will be posting them on a shutterfly site I started just for this adventure. I'll be putting up the link next week after I've got back home.

I will be using my primary care doctor here after I get home if I need any follow up care. Honestly I'm not worried about getting care after getting home.[/quote']

Friday?!! How exciting!

I was quoted 18k down here (Florida) and as a mother of two, I felt to guilty putting that much debt on our family. I am also a full time student, trying to be an Radiographic tech so will be hopefully joining the medical field as well...ok Im rambling...lol

Thanks for responding...I am actually really considering Dr. Ponce...(do you happen to have Trish's contact info?)

Have you started your pre-op diet? Hows that going?

I am sooo excited for you and your journey! I can't wait to see your pics! :)

  • Author
sorry to butt in' date=' this is Trish's facebook page https://www.facebook.com/#!/TrishyLupz I will be going with Dr Ponce and Trish as soon as I can get the money together.

Ha, Thanks for butting in! :)

  • Author

I am going to reach out to her tmrw. I am really looking forward to speaking with her.

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