If self-pay... What about complications?

[Jen40 12]

My husband's employer has excluded WLS, so we will be going self-pay. (Mexico actually)

What about complications down the road, if there are any? Dehydration, ulcer, stricture, leak?? If (God forbid) anything were to happen requiring ER or hospitalization, what are the chances of insurance covering anything related?

[Sue Magoo 71]

Hello:

I was curious about this too, but from a different viewpoint. I have medical insurance that doesn't have any exclusions for WLS. However, I was curious if I would have coverage if I had complications and had to go on short term or long term disability. I sent an email to our benefits folks for work and got it in writing that if I did have a disability caused from complications of this elective surgery I will be covered.

You should probably call the phone number that's on the back of your insurance card. Or, if possible, email them. If the answer is yes, make sure you get it acknowledged in writing.

Good luck!

[JeanZ_RN 378]

My employer's insurance also has an exclusion for WLS, so I was self pay. Any complications will also be self pay. I had my surgery done in Dallas, TX, so I have follow-up care available from my surgeon and his staff. That's comforting, no matter who is paying.

[gohelpyourself 377]

I do not think you will have a problem with short term DBL... long term only kicks in after you exhaust short term but some ppl carry supplemental short term DBL coverage and each policy differs and you must call and check prior to avoid disappointment later. Sadly, if you are one of the few ppl who experience complications immediately post of ie. leak... that will be your responsibility to pay if you are paying out of pocket and that can add up quickly. Even one additional night can end up costing you. Best thing to do is talk with your surgeon. Are you having your surgery in the U.S?

[Kindle 8,667]

My insurance excludes WLS. It also excludes any WLS complications unless it is for a "life saving emergency". I guess you just have to decide to take your chances. If it is a direct surgical complication (leak, stricture, etc.,) I would be stuck with the costs. I actually did end up at urgent care for severe dehydration from diarrhea. Turns out I have a Clostridial infection and as long as they don't enter the billing codes under WLS, insurance should cover my visit, fluids, and lab work since I technically presented with diarrhea and dehydration. My OB/Gyn said she would run my followup labs as routine annual checks so insurance should cover that, too. I figure I pay them $3600 in premiums every year...it's the least they can do.

For me, it didn't really matter as far as complication costs whether I did it in Mexico or US. Insurance wouldn't cover in either case. I researched surgeons within. 200 miles of me as well asMexican surgeons and went with the one I felt was the most qualified.

[Sassy Pants1 186]

My company also has an exclusion for WLS so I was a self-pay. My insurance would not cover any complications. Luckily, I was a textbook case - no complications at all.

[sbarbiegirl 109]

Maybe you can ask the surgeon in Mexico what will happen if you have complications. I was sleeved in Mexico. I asked my dr and he told me I would stay at his hospital in Mexico and he would take care if it. I did not have to purchase any extra insurance. The drawback is I would have to get to Mexico (I'm Only a six hour drive). Since my insurance covered EKG and bloodwork before surgery as long as it was not coded to wls I was sure they would cover dehydration . I decided to take my chance and thank GOD everything went fine.

[dadayako 0]

I am also a self-pay patient because my plan excludes bariatric surgery.

My surgeon suggested that I get BLIS supplemental insurance. Here's the link: http://www.bliscompany.com/#BariatricSurgery

I haven't signed up yet, but from what I can see the coverage is about $2200. I'm waiting for them to call me back to explain all that is entailed. I'll write a follow up post when they do.

[Shortcake 6]

I am also a self-pay patient because my plan excludes bariatric surgery. My surgeon suggested that I get BLIS supplemental insurance. Here's the link: http://www.bliscompany.com/#BariatricSurgery I haven't signed up yet, but from what I can see the coverage is about $2200. I'm waiting for them to call me back to explain all that is entailed. I'll write a follow up post when they do.

I had surgery 2-11-14, I also purchased the blis insurance, cost me about 1600, covered 90 days leak/perforation/bleeding, and 30 months stricture/stenosis. There are other various packages too. I did not elect the package for embolism/ dehydration, as I feel it would be difficult for insurance to deny that as you can't say for definite it is surgery related. Blis would cover all selected complications in my package so long as the surgeon diagnosed the problem, even if it was over the phone and he referred me to local er or something. Have had no complications and I hope I never have to use it.

[Nevermind 117]

My insurance also had an exclusion. After much research and all of my thoughts saying "What if something goes wrong?" I have decided to stay in the US.

For many people, going to Mexico is the best decision for them. But after much research and prayer with my family, I've decided to go to Texas.

At the end of the day, you have to do what is best for you and your situation.

Best wishes to you.