Self pay- positives?

[Positive44 103]

I am going to be self pay. Surgeon is requiring 6 nutrition classes and 6 psych classes anyway. He said it will be at least 3 months before a surgery date, insurance or not.

Take it from me, it's all worth the weight... I mean wait:).

[StephanieS13 2]

My insurance doesnt cover any WLS. How do I know how much this even costs? I was approved for $10k in Care Credit. Would that even cover it? And I wonder if all Drs take it? I dont even know where to start.

[Positive44 103]

My insurance doesnt cover any WLS. How do I know how much this even costs? I was approved for $10k in Care Credit. Would that even cover it? And I wonder if all Drs take it? I dont even know where to start.

Start with a surgeon and set up a consultation. Once you decide on a doctor, their team with help you with insurance or explain fees and discuss if they accept CareCredit.

[Clementine Sky 707]

I felt I had more liberties and control over the surgery by paying for it myself. I didn't have to jump through months of hoops to get approval, and I didn't have to get tangled up in the red tape of insurance. I was able to schedule my surgery within the exact time frame that worked best for me. I didn't have to wait for months. I paid for the surgery up front, and then was done. No need to dread opening the mailbox and finding another bill. I had the surgery with Dr. Fernando Garcia in Tijuana, and the total cost including ground transportation and two nights at the Marriott was $4200. The medical facilities were actually much more modern and nicer than ones I've been to in LA, and I was well cared for. I paid a deposit up front and the balance by cashier's check after I had the blood work and EKG and was cleared for surgery. I've had follow up care through my local endocrinologist. It was a simple, straightforward, and effective process for me.

The other significant benefit of self-pay through Mexico was the savings. Even if I could have gotten approved by my insurance, which was incredibly doubtful since my BMI was just under 35 and they don't consider my PCOS as a comorbidity, my out-of-pocket expenses would have come to around $5000. I live in Los Angeles, and the surgeons I consulted with charged between $29,000 and $35,000 for the VSG. They also required a plethora of tests, consultations, logs, and the like, and couldn't have booked me at a time that was convenient.

[FreeTheSkinny66 9]

@@Clementine Sky Hopefully, you have not had any complications at all. But I am curious - if you had, going back to Mexico would not really have been an option so I assume you checked into getting any complications taken care of locally. Did you find out beforehand if your insurance would cover medical expenses from a complication if if you didn't qualify with them for the original surgery?

This is one of the main reasons why I have ruled out Mexico if I get denied, even though it is so much more affordable. Concerned about the potential for complications and the costs. Would love to hear what you know.

Thanks!

[Clementine Sky 707]

@@Clementine Sky Hopefully, you have not had any complications at all. But I am curious - if you had, going back to Mexico would not really have been an option so I assume you checked into getting any complications taken care of locally. Did you find out beforehand if your insurance would cover medical expenses from a complication if if you didn't qualify with them for the original surgery?

This is one of the main reasons why I have ruled out Mexico if I get denied, even though it is so much more affordable. Concerned about the potential for complications and the costs. Would love to hear what you know.

Thanks!

The concern about potential complications is definitely a valid one, and I took it into serious consideration. I actually could return to Mexico if there are any complications, and I got that assurance in writing in advance. Since I live in Los Angeles, it's just a couple of hours drive to Tijuana. I have been going to another Mexican city near the border at least once a month for the past five years to volunteer, so it's a really simple trip for me. My endocrinologist was the one who first suggested VSG to me because other women who've struggled with fertility due to PCOS have benefited from it. Several of her patients have gone to Tijuana and none have experienced complications. Neither have I in the 7 months since my surgery. I did first consult surgeons in SoCal, though, because it was still a worry. The local surgeons were willing to perform the surgery, but since my BMI was under 35 it was going to be virtually impossible to get my insurance (or any other insurance) to improve it. I was quoted $29,000 to $35,000 for self-pay through them. Though anyone can have complications, I was at a lower risk due to my age (early 30s) and lack of other health problems besides PCOS and mild obesity.

You can purchase Medical Tourism insurance to cover complications. My surgeon offers it directly through his office. You can also purchase it independently. Obviously you need to research the reputation of the provider and carefully read through the fine print.

http://www.prweb.com/releases/2015/09/prweb12936324.htm

Edit to add: there are several threads on here about insurance for self-pay Medical Tourism that I read through last summer before my surgery. Here is one: http://www.bariatricpal.com/topic/344567-medical-tourism-insurance-policy/

I'm not that knowledgable about the ins and outs of insurance, but I know an increasing number of Americans are going abroad for surgeries and treatments, and there's now a market for that coverage. A friend's father has been undergoing treatment for cancer In Mexico for the past year because even with quality insurance the costs became overwhelming. I know they have a special insurance policy because she's mentioned it, but of course I've never asked for details about it.

Edited March 25, 2016 by Clementine Sky

[FreeTheSkinny66 9]

@@Clementine Sky Thanks for all the info - it is helpful. I am still hoping that I will get approved through my insurance and not have to even consider self-pay, but you never know, so it is good to have info.

I've heard great things about peoples' experiences getting the surgery in Mexico. If I still lived in San Diego, it might seem more doable (as long as the complication coverage thing was sorted out). But I now live in the Northeast, and HATE the cross country plane trip. So the idea of doing that right after surgery is not attractive at all! lol

[Tammy Sherman Ratajczyk 0]

If i go threw with this, I would be self pay also, my worries are what if i have complications???? I don't want to put my family in finical ruin. I heard insurance wont cover complications! Is this true?