So, I have been denied twice and my appeal was just denied by UHC! My BMI is about 38 and I was diagnosed with high blood pressure in 2011. Insurance is stating that I would have to have the co-morbidity for 5 years in addition to the 5 years of weight history since I am below a BMI of 40. I have struggled with weight my entire life. I am 49 years old and I don't see this changing. I've lost weight several times over the years just to regain it, plus more! My parents both died in their mid 60's. both had high blood pressure and were overweight probably about the same as me as far as BMI. So, my question is..... Looking back at what you achieved, would you have gone through this having to pay yourself? I am not comfortable at this point going to Mexico so I will be checking with my doctor to see what he will charge me with no assistance from insurance. I am guessing around $20k. Thanks in advance for your feedback!

Without insurance, it would have been impossible for me to have this surgery. I am single and work in the non-profit world. While I can cover my rent and other bills, I don't have a lot of extra cash. I certainly don't have the kinds of funds it would take to get a procedure like this done, even traveling outside the country to do so. As it was, coming up with the program fees and paying for my part of the insurance was a financial struggle. I'm still paying off portions of it, but I don't regret it at all.

What is the actual cost for this surgery in the us?

The bill I saw (before insurance) was in the neighborhood of $30,000. I don't remember the exact price.

Although I have spent at least some part of every day reading on this site, it is the first time I have replied. I could have got insurance coverage for surgery, but being Canadian it would have meant a couple years of hoop jumping. I lost my brother and sister to weight related issues he was 42 and she was 45yrs old. My only choice was going to Mexico which my family still doesn't know about (they think I had it done in San Diago) It meant 4 airports and 3 plane rides in each direction, and a trip across the Mexican boarder, and being by my self for the whole journey/surgery. It was the first time I had ever been by myself for more then a night in my own home. After all that and the self pay I would still have to answer with ABSOLUTELY YES!!!! I got home and 2 weeks later I was told I was going to be Grandma for the first time and and at the end of May I will be taking a solo trip around Ireland, England and Wales (a gift from my husband). These are things I can only enjoy now that I am healthier, so don't wait if you have any choice, because time is passing:)

If my insurance doesn't pay I won't be having surgery. I would need to hit lotto in order to pay for this surgery.

My insurance wouldn't cover the actual surgery (i had the sleeve) I had a Hiatal hernia as well so my insurance ended up covering part of it so my total out of pocket was $7200! I am from TX as well! If you have heartburn or reflux a lot then you prob have a hernia!

I didn't know that heartburn and reflux indicated a hernia! I've recently been put on Nexium to get the heartburn under control.

I'm still waiting to hear from the insurance company, but if they don't cover it, I will probably put it off awhile. We've got two teenagers, and an aging house - all of our money is going to saving for college and fixing things around the house that break.

Bariatric Center of Kansas City is offering a special for self pay gastric sleeve of 12k. I'm going to Mexico, though. $4700 for Dr. Garcia on march 29.

Deborah

Houston17, that might be an option! If you do have a hernia...insurance will pay to have that repaired...then you may be able to just pay the extra for the sleeve! The hospital, anesthesia & actual main surgery should be covered

I have no idea what the cash price would have been. My hospital stay (overnight) was $42k alone. Didn't include the surgeon or the ana. So I don't know. If I could have gotten out the door under $15k I probably would have done it. Otherwise, probably not. My insurance did negotiate what they paid, which I guess they all do that. My out of pocket was less than $3500 for everything, so that was cool.

I paid for it myself. It was about $23,000. I'm one week post op and in the midst of post-op depression, but in a few weeks I'm sure I'll say I'm happy I did it.

I paid $12,000 myself. Best money I ever spent.

Thank you all for your comments and suggestions! I can't wait to call my doctor's office tomorrow to start researching the costs! I really want to do this! My husband has been so supportive! He doesn't struggle with weight and he can see how much this is hurting me! He told that if I wanted to do it that badly' date=' then do it! He assured me not to worry about the costs! [/quote']

I will end up scaring you but it has to be said....twenty grand will cover you. I paid that for the surgery and after care for two years (which I won't be getting). And the half a million for the complications. This is typically NOT covered by insurance because it's an elective or denied procedure. And then it will be three or four grand for after care from another doctor. For me, this isn't going to bankrupt us, but if it would you, you'll want to be sure you have contingency insurance in place if you have any issues. For this surgery complications may be a low percentage...but when they happen they are life threatening and very very expensive.

here's a question that I haven't seen addressed on the boards yet... My husband was laid off in Jan. 2013. We took Cobra so I could be sleeved on3.25.13' date=' Everything went fine, we are going to cancel our Cobra coverage now because we can't afford 1667.00 for Cobra, plus pay the mortgage, buy food, utilities.... My doctor's admin. assistant told me that everything after the surgery is covered for 90 days. Fellow sleevers, didi you have many blood tests, nutritional visits etc...

Thanks,

Carol[/quote']

Four nuts a year and the same for blood. Total would be less than two months of your cobra though...

No, wouldn't have. My hospital billed my insurance 35,000. I hAve to pay 3600. My anesthesia bill was 4000 I have to pay 448. Random drs were another few hundred and none of that includes my surgeon.

Yes! If I had been denied I would have paid out of pocket for my sleeve surgery. I had a plan B in case my insurance denied me. I am so happy that I had it done:)

The bill I saw (before insurance) was in the neighborhood of 30' date='000. I don't remember the exact price.[/quote']

Wow