Discouraged after Seminar last night

[JessPearl 9]

So, I took the first step and attended the surgery seminar at the hospital last night. All went well until she handed me the Self Pay form.....their price is $18,500 . I went in thinking it was quite a bit lower since I have a friend who went to the same hospital for the same surgery 3 years ago and she paid much less. Not sure what to do now...........thinking of getting insurance and going that route. Where to begin though? I have to first find a company that covers it and then most likely have to follow a 6 month diet? Can anyone tell me a great company that does not require that?

[LindafromFlorida 1,542]

Check online also by researching self pay in your area. If you have no insurance, self pay will be out of sight with your BMI and health problems down the road, so make some comparisons. We have a combination of HBP, diabetes, asthma, back problems, knee replacement, heart stent. Heart problems worsen as you age. God Bless and best wishes!<br />

[terri82much 80]

I got my surgery done in Mexico and with my travel and surgery it cost me $7,500. Surgery went well and the hospital was very clean and staff were great. Stayed 2 nights in hospital, staff picked me up from airport transported me to and from the resort to hospital and then for the drain removal. No issues and I am down 39 pounds as of this morning at 9.5 weeks out.

[MadB 26]

You need to watch a few things. Since you mention getting insurance, I'm assuming you don't have any right now. Once you locate a company that you feel comfortable purchasing a policy through, you need to make sure what they require for WLS. Some will cover only if there are comorbidities, others simply for being at a certain BMI regardless of any other existing conditions or not.

Also, you need to find out if they have an elimination/cool-off period for any procedures. Since you would be new to them, they could easily have a clause requiring you to wait x amount of time before they will consider it. (Similar to a pre-existing condition, where it would be covered, but only after you have been with them for x amount of time). They may also require more time and documentation than just what you can show them, especially if you don't already have a track record of regular Dr visits already.

If you can not locate an insurance plan that meets what you need, then you are only really left with self-pay. If you go this route, many places will offer payments plans after a large chunk down. You should also look around to other providers. Don't limit yourself to just your city or county. Check in the other major cities with a few hour drive to you. Even look at out of state places. If you still can't find a Dr you are comfortable with in a price matching your needs, you can consider Medical Tourism as well. It is a highly popular option, but is not right for everyone. While you can get a VSG in prices ranging from 4k to 10k, depending on time of year, surgeon, facility, and location. The 'good' doctors will be easy to find by word of mouth, on these boards and others.

I chose the Mexico route, (Monday is my procedure), as it's costing me only a third of what it would in the US, and that's including the airfare and extra nights I'm staying. Complications can happen to any person, with any doctor, at any facility, in any country. It's up to you to do your homework as always.

If you stay positive and keep at it, you will find the solution that works for you.

[Koofka 59]

Ended up doing self pay here in Colorado. Certainly wasn't cheap but upon talking to the insurance rep for my company ( small group insurance ) he indicated there are very few insurance options in the individual or small group marketplace that offer coverage for WLS. This may change in the future as the AMA has more recently labeled obesity a disease and insurance companies should eventually shift policies in response.

That said, in my opinion, 6 weeks out and a good bit of weight down, the money is an afterthought compared to the results so far.

[terri82much 80]

I went to Puerto Vallarta with Dr. Jose Casteneda. You can book him through Medical Tourism or contact him directly which will save you about $1,000.

Good Luck MadB

[SnohoGal98296 371]

The insurance coordinator at one of the centers I went to offered me a list of companies in the area that had insurance that covered WLS. I am happy in my career and place of work so I declined, but you might ask your center if they have a similar list. Just a thought. .. I am proceeding with selfpay, with a combo of my flexible health spending account and savings. Plus you can claim the cost on federal taxes (any amount over 10% of your annual income, but check that with a tax advisor, your state might have an allowance too).

[McButterpants 2,846]

If the insurance route doesn't work for you, there are lots of places that are much less than what they quoted you for self-pay.

I went thru Dr. Thomas Umbach in Las Vegas - I paid $11K.

Prices are much cheaper in Mexico by reputable doctors - I read somewhere earlier this week that someone one was getting it done for $5500. (I am NOT saying cheaper is better - do your own independent research on the doctor and get the best fit for you.)

Best of luck to you! Turn your energy towards finding another solution.

[Mrs.RRn 2,110]

I was a self pay and it was $9800 (Louisiana). Quite a bit of people go to Mexico as well. Some magical people have insurance to cover it-- mine said absolutely never.

[Catherine707 253]

As you know, there are many things to consider when evaluating bariatric surgery options. One thing that has been important to me is the follow up / after care post surgery. When you see a doctor that is local (or within a reasonable drive) you develop a relationship with that doctor and will continue to see them at regular intervals. My doctor is a 2.5 hour drive from my home (not exactly an easy appointment) but the information and support I receive at each follow up visit is worth the 5 hour round trip drive and over night stay at a hotel. I go in with a list of questions each visit and come away with information, and validation that are extremely valuable to me. Not everyone needs that kind of support but I think it has really helped me lose almost 100 pounds in 8 months!

Keep in mind that while $18,000 is a lot of money, your health and well being are priceless. This surgery changes your life in ways you can't imagine until you are well down the road to recovery. Feel free to ask lots of questions in these forums and of any doctors / hospitals that you are considering. This is not a "fast" and "easy" way to lose weight, take your time, consider all of your options and make the decisions that are right for you!

[SnohoGal98296 371]

LOL, magical people!, I love it, I have felt the same way! There is a local large company that gives WLS "out like candy" according to my HR manager. I tried to get my company to add WLS coverage with our 2014 enrollment, but apparently only companies that are self insured (read big corporate) cover WLS in this area. Not sure how true that is, might have been the run around because the company didn't want to add it. I am happy at this company so I made the choice to proceed as self pay.

[vdub_tx 92]

I would look around and find out what different surgeons charge. I'm in Houston and the self-pay pricing varies by thousands of dollars depending on which doctor you use for the procedure. In addition to the surgeon, differnet hospitals have varied self pay pricing. I was lucky because my hospital is a Bariatric Center of Excellence and also had an excellent "cash" price. Also, in my case, I have a hiatal hernia so my insurance is subsidizing the procedure, making my out of pocket costs about $4,000 less than they would be with no hernia. My surgeon suggested that I do an EGD and take a look since he suspected it anyway and it would reduct my overall costs. Don't get too discouraged. It may take a little more work than you thought but you will find a solution that works for you.

[LindafromFlorida 1,542]

I am curious as to what you do for follow up if you have problems, if you have surgery in Mexico. I was told by someone in my town that local bariatric surgeons will not take these patients. Is there any truth in this? Important to know when making a decision.

[MadB 26]

I am curious as to what you do for follow up if you have problems, if you have surgery in Mexico. I was told by someone in my town that local bariatric surgeons will not take these patients. Is there any truth in this? Important to know when making a decision.

To clarify, many surgeons will refuse to see a post-op patient if they had their procedure ANYWHERE other than with their practice. That means another state, or another city, or even another practice in your own city. Others only care if it was outside the US. And most, if they will see a patient that they didn't operate on, will charge a 'retainer fee', ranging anywhere from 500-2k. So it's not just a concern for medical tourists, but for anyone who wishes to go elsewhere.

It is definitely something to think about. For me personally..... My gastroenterologist will be looking after me for any issues. This will be the simple things, like incision checkups, labwork, etc. Should there be an emergency, I will be going to one of two ERs. Both of those ERs happen to use general surgeons that do bariatric procedures on their oncall rotations. Any general surgeon can fix you up should something happen. You don't need to specialize in bariatrics to go in after a leak is found, etc. (I wouldn't want a 'routine' general surgeon to DO the VSG, obviously, but post-op complications don't require more than that).

It is also important to note - if you are a self-pay patient, your insurance will most likely not cover emergency surgery once it's all said and done if the issue is directly related to the surgery. (A long time down the road is a different matter, but I'm referring to leaks, etc). It doesn't matter if it was in the US or in Mexico or somewhere else. You can frequently get 'coverage' through your original surgeon where he and his practice will go back in and fix things if something occurs. BUT, you're still playing the odds that if something happens, it'll be in your town, and you end up at their hospital where he has privileges.

TLDR version - These are ALL things that should be considered when you do your research. But be careful about rumor mills and how some local surgeons may phrase things. It's a business, and they want you to go through them. They tend to conveniently avoid some of the facts at times.

[Ariella 73]

In Jacksonville florida, my self pay will be about 13,500.... Just to through it out there, if traveling is at all an option