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Self pay

Hi all. New here! I've been lurking for a few days. I attended 2 different seminars recently to compare each Dr. Our insurance does have an exclusion on WLS so we are self pay. We have to have some up front and the rest the hospital will do a 5 year payment plan(which we will use some of our HSA to help cover cost). We are looking at 25-28k. The thought of spending that much money makes me cringe BUT it is my life, health, and I want to do it now while my kids are little! DH is on board with me but our only concern really is if 6 months after surgery something medical comes up and our insurance won't cover it because I had this surgery. Anyone have this issue?

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I am self-pay and my surgeon has an insurance policy that he requires all self-pay folks to buy (its basically a warranty) to cover any complications that would not be covered by insurance. I wouldn't even consider the surgery without it. Your surgeon probably has info about it but I did find the company's website here http://www.bliscompany.com

Where are you? You can find self pay for way less than $25k without going to Mexico. I paid for mine, it was $10.5k in Florida. Mexico is even less, I think around $8k. I think there are some lower-cost self pay options in Texas and Arizona as well. Sorry, I know this wasn't really the purpose of your posting, but you should try and shop around before you pay that much out of pocket.

As far as insurance paying for complications (fingers crossed that you won't have any anyway), it isn't a "pre-existing" condition, it's just something they wouldn't pay for, so I don't think it will be a problem.

  • Author

I am in Ohio. Mexico is definitely not an option. I'm not against possible other places but really for the extra 10k it's worth it to me to have someone local who I can visit within an hour if I am having issues of some sort. :)

Have you contacted your insurance company to ask about follow-up care if necessary. My insurance company said they WOULD cover any infection or complication down the road and my regular doctor agreed to do my post-op blood work.

I had my surgery in Mexico and paid FAR less than you are looking at. I haven't had any issues and I received EXCELLENT care while I was in Mexico. Let me know if you want more information.

I am in Ohio. Mexico is definitely not an option. I'm not against possible other places but really for the extra 10k it's worth it to me to have someone local who I can visit within an hour if I am having issues of some sort. :)

I'm not sure what part of Ohio you're in, but I had the sleeve done by Dr Trace Curry in Cincinnati and it was $14,700 in June.

  • Author

Butterfly effect- how far of a travel was it for you to go to FL? How did the pre-op testing work? Did you do that local? Did you have to make more then just the surgery visit to FL?

I live in Florida, but it's a three hour drive to get to where my surgeon is. I have made the drive a total of five times, including an initial consultation, pre-op testing, the surgery itself, and two post-op visits. I know he has had people come from as far away as NY to have him operate on them though, so he must have a plan in place for that, where you would do your initial consult via Skype, or something, and then have your pre and post-op care via someone local for you.

My self pay story: My insurance company does not cover bariatric surgery. Surprisingly, 70-80% of people with weight related issues have HIATAL HERNIAS. Most, if not all insurance companies pay for laparoscopic Hiatal Hernia repairs. My Doctor spoke to the Hospital's CFO and both he and the Hospital offered me a 30% discount. Total out of pocket expense $6,930 here in Texas.

  • 4 weeks later...

Where did you go in Florida? I am looking for a surgeon

@@trulyamazingtoo

My surgeon is in Boca. Google his name, you'll come up with most of what you need to know. Feel free to ask me anything, though. I've been very happy with my experience.

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