Moving to another state for insurance coverage

[imagine 3]

I live in a state that is not required to cover bariatric surgery. I had Lap Band surgery 10 years ago and now have to have the band removed. I want to convert to a Duodenum Switch, but my current insurance will only cover the removal of the band. I would have to self pay for the DS surgery, which will run $50k -60k. I don't have that lying around so I will have to go in to considerable debt, which could take a very long time to pay off. It will probably ruin my credit and might lead to filing for bankruptcy.

23 states require insurance companies to cover bariatric surgery. I am thinking about renting my house and moving across the boarder to one of those 23 states. I will rent an apartment get a state drivers license and buy health insurance. I work from home so I can be anywhere as long as I have phone and Internet. Including the move I think that my out of pocket expense will be $5k, maybe $7k. I can swing that.

Has anyone moved to get coverage? If so is my plan sound or am I missing something?

[Inner Surfer Girl 12,015]

I know people who have moved for good schools but no one I have known up to now has moved for insurance coverage. I would bet it has happened though.

Before taking such a big step, you will want to explore all of your options and weigh the pros and cons.

I do know there are many people on BariatricPal who have travelled to Mexico from the US, Canada, and even Japan for their surgery. People in Europe and the Middle East also sometimes travel to another country for surgery.

[Djmohr 6,965]

I would do it if I had to. Unfortunately I moved from a state that did to a state that didn't and now getting anything like annual blood work is not covered.

That needs to change. Obesity is a metabolic disease, that causes so many other comorbitities. It doesn't make sense that it is not covered in all 50 states.

Imagine how insurance costs would go down for them vs up. I simply don't get it at all. It is ludicrous!

I hope you are able to figure it out and get it done. It is the best thing I ever did for myself.

[Clementine Sky 707]

There are reputable bariatric surgeons outside of the US who have done excellent work at a fraction of the cost. My insurance was't going to the VSG because my BMI was under 35 and they didn't view my PCOS as a grounds for coverage, and the local surgeons I consulted with charged between $29,000 to $35,000. I had the surgery at a sparkling clean and comfortable clinic with a fantastic surgeon in Tijuana (Dr. Fernando Garcia) last August for $4200, which included my hotel stay at the Marriott. I've had zero complications, met my goal weight, and my blood work is fantastic. I know there are also quality surgeons in Europe and Asia. From what I understand the DS is more complicated and fewer surgeons perform it, but there are still many who do. When I was going through YouTube videos last year before surgery to learn more about people's experiences with it, I saw one from a woman who had the DS with dr. Ponce de leon in Mexico. She was very pleased with her results.

[Clementine Sky 707]

This is the channel for the woman I mentioned above whose videos I watched last year:

https://www.youtube.com/channel/UC_NOWDnanmOTEwRAkghYNjQ

[James Marusek 5,244]

From the time that I began the process for bariatric surgery until I had the surgery, it took around 9 or 10 months. So you may want to factor that into your decision process. Maybe you should have the band removed in your current state and then start the process of moving. Some insurances will cover one type of bariatric surgery but not another. So you may want to research this also.

[northcountyr1 199]

I've NEVER heard of ANY states pasting for surgery? I'd double check that if I were you.

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[northcountyr1 199]

Sent from my SAMSUNG-SM-G920A using the BariatricPal App

Sent from my SAMSUNG-SM-G920A using the BariatricPal App

[OutsideMatchInside 10,166]

A lot of plans don't cover DS. You would be better off just going to Mexico, but I'm not sure I would have the DS in Mexico because it is a complicated surgery. Not because the surgeons aren't good but it requires a lot of follow up care and not many people get the DS and it would be hard to find care in the US.

Why not the sleeve?

Also you have to consider if you are going to buy a plan on the Healthcare exchange, the plans change every year. So whatever plan you get you need to have surgery in that plan year.

[OutsideMatchInside 10,166]

@@northcountyr1 what OP means is some states consider bariatric surgery and essential service, so insurance plans on the exchange are required to provide coverage. There is a sticky on it in the insurance forum.

[imagine 3]

I don't think Mexico is an option for me. For every success story I hear I also hear a nightmare story. Also a conversion from Lap Band to DS is as I understand it the most complicated surgery. It might end up being 2 surgeries with an endoscopy in the middle.

In 23 states health insurance companies are legally required to cover bariatric surgery. Yes the insurance company could turn me down based on my specific case, but at least in I would have an appeal process. When you get turned down in states that does not required coverage it there is no appeal, they simply say no.

I have a health insurance broker that sells insurance in my state and the state I would move to. He along with my Dr's office can help me chose a plan that is most likely to cover it.

At the moment I planing to move for 1 year. I'll rent a place over the boarder and will rent out my house to cover my mortgage. I figure the entire move and surgery will cost me $5-10k. That's much more manageable than $60k

http://www.ncsl.org/research/health/aca-and-health-mandates-for-obesity.aspx

[Brenda Sherwood 64]

I dont think moving would be worth it at all. These insurance companies really dont want to approve people. My state requires it, I meet all the criteria, yet Ive been denied several times. Imagine if you moved, went through a bunch of BS and still got denied. Tons of people turn to Mexico after their insurance denies them or simply because the deductible through insurance will be the same as going to mexico. Im in the process of booking with Dr Garcia now after extensive research. Could keep going round and round with insurance begging for them to pay but Ive been doing that for 9 months now. I wish I went to mexico in december when I started this journey, id be down 80 to 100 lbs by now. Ive only found 1 "horror story" and that was a death. If you read the fine print from your surgeon, it says that happens in every 200 to 500 people. Just saying, you may want to research a bit. I think Im into the thousands now on success stories ive read

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