Needing Some Advice

[daluvoflife 41]

Hi all im new here. I been lurking for a while and finally had the courage to type up whats been going on. So i was recently fired from my job and when i say recently i mean last week wed, im happy im not there any more because my job was beyond stressful, but it has happen at a very bad time. I was just in the process of my first consult with the doctor which is going to be nov 30th my insurance ends nov 16. I do have the option of Cobra and everything will continue like i didnt even lose my insurance. So whats the problem you ask? the cost... for me alone with medical is 537 a month, now with a one income home i'm just feeling so guilty. Do i feel that we can make the payments? Yes its doable but its such a stretch. So i wanted to get some honest feedback, especially from people who had the surgery.

Should i do go ahead and take the chance and pay from the insurance, keep in mind i don't know if i will get approved from aetna(cobra coverage) running the risk of paying the premium and might not even get approved...

But i could get approved which makes the cost of the payments each month worth it. Either way my husband supports me but i know he would be stretched out. I'm also looking into medicaid in VA because i heard they might cover it also but then again thats a might.

Help me with your honest opinions, if you had to pay that amount for insurance to get your sleeve would you do it? Is it worth it?

[icon23 273]

I personally would do the math and figure out how much I would wind up spending on COBRA to be covered throughout the entire process (including follow-ups) and also how much I would spend if I kept COBRA for as long as it can last. Then, I would compare that to how much it would cost to do self-pay either in Mexico (as low as ~$4500) or in the U.S. (the lowest I've seen is ~$11,000) and see which one makes most sense financially. I know a lot of people don't feel comfortable with the Mexico option, but there are lots of people on here who've done it and I will be one of them, come March. You can read lots of reviews and such in the Self-Pay/Mexico forum. There are also a lot of people who have done self-pay in the U.S. and you can read about their experiences also--it just depends on your comfort level and finances. I would also find out if it's possible to get on hubby's insurance (and if they would cover it) and keep my fingers crossed about Medicaid. Best of luck to you!

[sramos89 260]

How far are you from being approved? I was able to go from 1st consult to surgery in two months. If you can do it that fast I say COBRA and do it. Call your doctor and tell them waht is up and that you need to push this through ASAP. If you are on a 6 month supervied diet than I would do the math and see if it is cheaper to self pay or pay COBRA. If the doc knows you are in a time crunch they can push it through. Good Luck!

[CowgirlJane 14,261]

That is a tough one. Regardless of if you are self pay or not, realize that if you have any complications, it would be good to have a plan of how that might be paid for too.

Good luck - how stressful to have all this happen right now!

[Ruffus 66]

We provide our own insurance. We have anthem. Our payments were and are 697 a month. I had started looking into this surgery last year in Feb. When we had Kaiser... my husbands boss decided he didn't like Kaiser for his family anymore there for all employees were told to get their own insurance. We chose a PPO. I had to wait 6 months I order to even see if I could be approved. Because of the pr-exsiting that new insured had a waiting period.

First time around I was denied. The dr. and his nurse worked with me I order to get approved. Told me what was required and how to deal with it all. It took an additional 3 months for approval., but I got approved.

In the process I found that having the insurance was worth it! I know now if I were to self pay and something happen insurance wouldn't cover the extra hospital stay, I would! If I went to Mexico the Dr. And his staff that I fell in love wouldn't even see me afterwards to follow up. (Even though he said he knew great surgeons there)

This is a personal decision that you have to think about. What is best for you and your family.

Talk to your husband tell him your concerns he will in the end be your biggest cheerleader!

[daluvoflife 41]

I thank you all so much for your wonderful insight. I def dont want to do Mexico because like you said if anything were to happen after who would i have to turn to. The way im looking at things i think its best for me to get the insurance and continue on my journey. Unfortunately my insurance requires 90days of diet so the most i can rush it wld still require atleast 90days plus the time it takes to get visits and test done. So i'm thinking 6months including any post op things.

I really really thank you all for your opinions they have helped much in my decision