Hey everyone. This is my first post on VST.

So in short I am in my mid-twenties and have bounced between a BMI of above 40 and below 40 the past few years. Now I am at almost 42. Because of this and lack of "serious" co-morbidities my insurance (Aetna) won't pay for the surgery. I do have what my insurance company considers less serious conditions because of my weight - chronic back pain, hypoglycemia, chronic fungal infections, mild sleep apnea (yet no diabetes yet, I know). My ultrasound was also negative for gallstones so I won't be getting any help whatsoever.

The money for the initial surgery (I will have it in the US I think because I prefer the laparoscopic approach) isn't a huge issue. I have money saved and my parents are helping me. But my biggest concern is what happens if I have serious complications? If my insurance company considered the surgery elective and wouldn't cover it, they won't pay for the costs of medical crises that occurred due to said surgery, right? I feel very powerless because I truly believe this surgery is the tool I really need to succeed in permanent weight loss. But I couldn't live with bankrupting my parents with emergency room or secondary surgery bills. What I am wondering is - what have your experiences been as self-payers? Have any of you had complications? What have the bills been like and has your insurance company been of any help? Does anyone know of any good studies out on the rates of complications with the gastric sleeve? I know that sometimes they are preventable but other times it is totally out of one's control.

Just looking for others' experiences. I know that going for surgery is always taking a chance, but I'd feel better doing as much research as possible and hearing from people who have been through it before me before I head down that road.

Thanks!!

Hi iggychic,

I have my own insurance policy independent of my parents, so any debt incurred would be mine alone. They are willing to loan me money in the event that the surgery isn't covered by my carrier so that I can self pay. But there still may be hope - I am having another sleep study next week after my fiance informed me that I wake up at night gasping for air (which I never remember) so my sleep apnea may have gotten worse. Not that obstructive sleep apnea is something to be happy about >_< But it's considered a serious enough comorbidity to approve surgery for those with a BMI of 35+.

Also, sorry to hear you had such serious complications. Hope you have recovered fully from them. It's definitely something that should weigh heavily on anyone's mind considering WLS and I am no exception. Though I guess at the end of the day everyone tries to figure out what is right for them. I am fortunate in that I see a fairly accurate picture of my future (if I don't take control of my life) in my relatives, especially my dad. I love him dearly but it's not a pretty sight. And I know he wants a different life for me.

So I did read the policy and limitations booklets through my employer and found for the most part that complications of elective surgery are well covered with some small random exceptions. But they won't pay for things like plastic surgery to remove excess skin after an elective WLS. Hopefully being still fairly young I won't need it

Thank you all for your suggestions!

Honey can I adopt you? LOL I want a child that grows up as smart as you

My complications were rare and you shouldn't expect them, but the fact that you're looking to answer the "what if's" impresses me. I think given you are your own insured, you'll be ok and your parents won't be on the hook legally (morally...if my child died during a surgery would I cover it?????? probably) but again that's a conversation for your family to have. I just like reading your thought process. It's responsible and tells me you'll do well with this.

You are a 40 plus bmi with one comorbidity...you should be covered hun. I was 35ish with none and while I'd like to make it not legal for people like me to have the surgery, (and no one in my company will because we set the policy) I highly feel that the standards (40 + or 35+2 ) are fair. I hope to hear you find you're covered.

If you do end up going MX please think through the process and co insurance because (for instance) my insurance specifically would not allow coverage for anyone who had a non - US elective surgery with complications. We pride ourselves on very high level coverage...so we are very lenient, but that's not something I'd add to our policy if I had the option. You want to differentiate carefully.

Anyhoo....are you available for adoption? LOL Ok maybe not, but I wish you the best darling. You sound like your parents have done a lovely job raising a smart young lady I mean that as a compliment

I am glad my story could be an inspiration to you. Just be sure to do your homework. I researched the surgery and my doc for over a year before making a move. Good luck to you.

I too denied me 6 x I am scheduled to have a vertical sleeve in Mexico on February 27 went Dr Fernando Garcia