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Cold Feet... Self Pay And Worries



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I could use some advice...

I am set for my VSG with Dr. Kelly in TJ on Feb 2nd. My insurance plan does not cover WLS and even if it did (the insurance company has guidlines if it's allowed on your plan), the hoops to jump through will cost us more out of pocket than if we go with the self pay option.

So, innocently cruising this site, I've come across the complication stories and other threads in the other forums which list "insurance not covering complications" as a big reason they won't consider this option which feels like a miracle to me. I thought I'd done my homework, but now I'm waffling... I touched base with my PCP and they're cool to monitor me, I even read my insurance company's Medical Policy, all 30 odd pages of it, and see nothing noted about denying coverage for complications arising from elective and/or overseas procedures. But now... I'm feeling scared and unsure.

My faith and personality want me to be Little Miss Sunshine and trust that this is a God-led solution to a 300lb problem. I feel confident that it's the right procedure for me, that the doctor I've selected is right for me and my needs... etc.

But then I wonder if I'm not sticking my head in the sand. I read the Medical Policy rather than call them because they're notorious for giving you different answers and I'm very afraid to put myself on their radar (maybe I need a tin foil hat?) by asking questions.

How did YOU handle these questions? Maybe you're still living them out and working through them? In the quiet moments of the day, I think it's this specific insecurity... will I be taken care of if something goes wrong... which is giving me cold feet.

ugh.

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i wouldn't worry i would never say a thing to ins company again so they won't say it was because of surgery they won't know u have half a stomach less they tell someone to to xray u... go to www.gastricsleeve.com and check out that site seems to be alot better than here.. just got back sun at midnight and i feel great......glad i did it.. try that site and i think u will fell better.. good luck.. karensuue@yahoo.com

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Thank you for the encouragement karensuue!

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My surgeon had an extended insurance plan For cash pay people Underwritten from an insurance company. I think it costs about $600 to cover me for an entire year post-op. I would ask someone in your surgeons office if they have anything like this available, makes me feel a lot better at night when I go to sleep. I know if I ever have a leak I'm covered it's Good peace of mind and worth every penny.

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I just asked my doctor if they had a insurance policy to add and they said no. :(

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Well, I had the same thoughts as you and went back and forth. In the end, my desire for a change and knowing this was the only way I was going to get it. So, I went for it. I'm currently almost 2 weeks out Thursday and feel great. I've been sticking to the plan and have lost over 10 pounds already. hope it continues. it's all a personal decision, just do your homework and know what your getting into...

best wishes,

Traci

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I could use some advice...

I am set for my VSG with Dr. Kelly in TJ on Feb 2nd. My insurance plan does not cover WLS and even if it did (the insurance company has guidlines if it's allowed on your plan)' date=' the hoops to jump through will cost us more out of pocket than if we go with the self pay option.

So, innocently cruising this site, I've come across the complication stories and other threads in the other forums which list "insurance not covering complications" as a big reason they won't consider this option which feels like a miracle to me. I thought I'd done my homework, but now I'm waffling... I touched base with my PCP and they're cool to monitor me, I even read my insurance company's Medical Policy, all 30 odd pages of it, and see nothing noted about denying coverage for complications arising from elective and/or overseas procedures. But now... I'm feeling scared and unsure.

My faith and personality want me to be Little Miss Sunshine and trust that this is a God-led solution to a 300lb problem. I feel confident that it's the right procedure for me, that the doctor I've selected is right for me and my needs... etc.

But then I wonder if I'm not sticking my head in the sand. I read the Medical Policy rather than call them because they're notorious for giving you different answers and I'm very afraid to put myself on their radar (maybe I need a tin foil hat?) by asking questions.

How did YOU handle these questions? Maybe you're still living them out and working through them? In the quiet moments of the day, I think it's this specific insecurity... will I be taken care of if something goes wrong... which is giving me cold feet.

ugh.[/quote']

Rather than asking WLS specific questions just contact your insurance you a comprehensive detailed coverage policy from them.

Amanda Rae

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