Insurance Hoops? or just finance the thing and go to Mexico

[Photo925 100]

I'm just curious if I'm the only one who has considered this. We all know what the insurance companies make you go through to get this surgery, and not that I don't think it is necessary because I do think that the insurance companies have every right to qualify people for this surgery. But my thought is that why wait to get through the 6-12 months of insurance hoops when theoretically you could go to Mexico and finance the surgery and get your life started in a quicker fashion. I'm in no way swimming in cash, but I am anxious to get to the next level and when you are waiting 2-4 weeks at a time just for the next appointment, I kind of feel like I'm just waiting to live. Maybe this seems somewhat logical to me because I wouldn't have to fly anywhere to get to Mexico because I'm in San Diego....maybe I'm crazy?? Just curious if anyone thought the same way I do??

[Bufflehead 6,358]

I considered going self-pay in Mexico rather than jumping through all the insurance hoops. I had a six month doctor supervised diet I had to do and did NOT want to wait. In the end, I decided to go with my insurance, and I'm glad I did. I think Mexico is a great option, don't get me wrong. But I'm glad I have the local aftercare and I'm glad I didn't raid my house emergency fund to go to Mexico and self-pay.

Just from a financial standpoint, I think if you have to go into debt to do it, it's not a good choice unless you have no other option. I would wait wait to get an insurance determination. If you have the cash on hand and no other looming expenses, I think either way is a good choice.

I will say that waiting those extra six months also ended up being good just because I did learn a lot in the supervised diet classes, plus going to nutrition and weigh management classes with my surgeon's staff. Going to support groups prior to surgery is also great. So having to wait six months is not the end of the world . . . I totally understand your frustration though! Best wishes to you.

[Blondiee 278]

My insurance (Kaiser CA) required a 3 month program called Options. I didn't want to go... I also didn't want to pay for this surgery if I didn't have to. What requirements does your insurance have?

I wish you the best in whatever decision you make!

[Cupcake 801]

I do understand your point, but we me since my insurance pays 100 percent , I am willing to go through the 6 months, I can honestly say its been 3 months so far and I have learned so much about my self, as well as eating, and why I am eating. I now make wise food choices and really look at what I am eating, am I eating because I had a stressful day at work, or even ask myself am I hungry , or just eating because this is something that I have aways done. When I am stress now I go for a walk, I journal, I even go sit in my car or my office with the lights out to regroup. I would have love to have my surgery early but to be honest I just can not afford the debt. But kudos to those of you who can.

[Photo925 100]

My insurance (Kaiser CA) required a 3 month program called Options. I didn't want to go... I also didn't want to pay for this surgery if I didn't have to. What requirements does your insurance have?

I wish you the best in whatever decision you make!

I have Kaiser also, but in San Diego it is six months of classes as opposed to three. The classes don't bother me so much (except that it seems that for Kaiser, EVERYWHERE except San Diego is only 3 months of classes) I think that you learn a lot and the classes help you be successful, but I feel like I've been going at this for two months now and am still just trying to get to the classes!! In reading through different threads on here it seems people with different insurance also have to go through a lot of hoops and they don't even know if they will get approved. I guess with that part I'm glad I have Kaiser cause at least I'm doing labs and meeting the doctor before I go through the program....I would hate to go through the program and then be denied

[Photo925 100]

I guess what Im really afraid of is getting through the whole program and getting denied...does anyone know if that happens a lot?

[unbesleevable1 420]

I think this is not a process you should rush into. My insurance approved me really fast and I was almost not ready for it. Things start happening really fast after that. Kaiser has pretty straightforward guidelines. you either meet the requirements or you don't. I would just do what they recommend, and learn the information. It's a huge, life-changing decision, and I think the time required is important.

[No game 14,436]

I tend to agree with the poster above.. Besides being a major surgery it is a major lifestyle change, one that should not be necessarily rushed into. The classes really help people prepare for those changes and gives you the opportunity to start implementing small changes as you go. Instant gratification is not always what it seems.. not to mention it is part of the reason a lot of us ended up here... Mexico is a last choice for a lot of people that do not have insurance coverage, so why put yourself behind the eight ball by financing something that your insurance offers already? .

Edited October 17, 2013 by laura-ven

[gamergirl 4,609]

So I got my surgery in Mexico as did my husband. We were very, very happy with the experience and the education we received.

But if my insurance had paid for it? I would have done it here.

I probably wouldn't have qualified, (BMI 37 and no co-morbidities) but my husband would have. The reason I would have done it here? Well several.

1. Cost. We're not a young couple just starting out, so we could have afforded to have it here for both, but it's still a lot of money that I could use for clothes, home improvements, vacations to build memories with my children etc. Free is hard to beat.

2. Continued nutritional support. I have a great book my doc wrote and I have this forum. But I don't have a NUT guiding me that I can just call regularly.

3. Counseling. I would probably have hated having to go but it would have clarified for me whether or not I had a food addiction, what I would struggle with, etc. And just to be clear, I have a PH.D. In psychology so I'm not completely clueless about it. But book knowledge and self-awareness are sometimes different.

4. After surgery support and peace of mind. My doctor is amazing about responding. Much better than what I see about docs here. His coordinator responds within the HOUR. But I did worry about what I would do if I had complications. What if one of us developed a leak? Who would take on our care? Etc. If your insurance covers the surgery, it's all accounted for.

5. Convenience. It was hours of driving or flying. Wish we'd only had to drive for an hour to get home.

So honestly, think hard about going into debt just to avoid a few hoops. Because those hoops come with some mighty fine advantages too.

[CaliGirlSlimmingDown 6]

I actually saw two different doctors in two different physician groups. The firs

[CaliGirlSlimmingDown 6]

st physician I saw told me that my insurance REQUIRED me to participate in a 6-month weight loss program prior to surgery. I was working with this physician and staff until it was taking them weeks to schedule every step and I feared it would end up being more like a year or two by the time all was said and done. I ended up seeing a different surgeon, one who performed my friend's gastric bypass 3 years prior, and this office actually showed me my benefit in writing. There was NOTHING that said I had to participate in a 6-month weight-loss program. This physician got me approved almost immediately. So my point in explaining all of this is that you need to read your policy yourself and find out for sure what your benefit is.

[caligirl3 73]

I'm just curious if I'm the only one who has considered this. We all know what the insurance companies make you go through to get this surgery' date=' and not that I don't think it is necessary because I do think that the insurance companies have every right to qualify people for this surgery. But my thought is that why wait to get through the 6-12 months of insurance hoops when theoretically you could go to Mexico and finance the surgery and get your life started in a quicker fashion. I'm in no way swimming in cash, but I am anxious to get to the next level and when you are waiting 2-4 weeks at a time just for the next appointment, I kind of feel like I'm just waiting to live. Maybe this seems somewhat logical to me because I wouldn't have to fly anywhere to get to Mexico because I'm in San Diego....maybe I'm crazy?? Just curious if anyone thought the same way I do??[/quote']

Consider checking out Smart Dimensions in Fountain Valley, OC. I started the process this week and they're sending off my letter to insurance next week. They move you through super quick!!! And they're great at the processing! My insurance still may require a 6 month wait, but I'd rather have it paid for and save up for my Tummy Tuck afterward that I will have to pay for!!! Haha!

http://www.smartdimensions.com/

Feel free to message me if you have questions. I did the info session, nutrition appt on the same day. Then Friday I have the dr visit and psych eval, so they'll get the letter off real quick. No waiting between spots, cuz they're set up as group classes with teams to help everyone. You have a dedicated coordinator assigned to your case, they're very professional, and renowned.

[Photo925 100]

Thank you to everyone who supplied constructive feedback...I appreciate it.

[Blondiee 278]

I guess what Im really afraid of is getting through the whole program and getting denied...does anyone know if that happens a lot?

Photo925-

If you were accepted into the Options program you qualify for the surgery and are not going to be denied. I hope that helps to put your mind at ease.

My journey through the Kaiser process has been pretty straight forward ( see my signature). You should maybe call the Health Education department about upcoming Options classes. Please feel free to message me if you have any other questions.

[Amie 90]

I used my insurance in the US, but if I had to doing over I would have just went to Mexico. It ended up taking a year to get my surgery and with the $1200 I had to pay for my out of pocket requirements and all the copays and the days I had to take off work to make all my pre-op appointments, 2 physic tests, 6 weigh-ins, 1 dietitian, 1 learn to exercise, 2 surgeon, all before I had surgery, I think the money part of it would have been the same, but I would have lost this 88lbs one year sooner. This is just my oppinon of course. I totally understand were you are coming from. My mom had it done in Mexico 3 weeks after she decided to do it. Which doesn't mean she hadn't been thinking about it for years.