Insurance to Cash

[lindsaybrumfield 2]

Hey everyone....

I have tricare (through the army) and I know they will pay 100% for the surgery but my nurse is worried we won't have approval back by my scheduled surgery date of 2/28.

I am considering paying cash. But roughly what does the sleeve cost out of pocket and would insurance refund me?

I plan on making calls to both the dr and insurance tomorrow but this is driving me crazy. Surgery is supposed to be in 9 days.

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[nurse247 74]

Look on the Tricare website to see what their referral turn around time is and then ask your surgeon when they submitted. If it's beyond that time Tricare is out of compliance and must approve the referral by default.

[mbuczkowski 272]

Cash depends on your area. I found 10,500 and 14,254 in Orlando. I ended up with Dr. Illan in Tijuana, MX for 4,400. I do NOT regret Mexico, it was awesome!

Insurance would not likely reimbursement you. They get billed differently when going through insurance.

[Berry78 4,259]

If you are that close, be willing to delay the surgery if necessary. It is a ton of money that will be better spent buying Protein or new clothes

I also have tricare and decided to do self pay in MX because there was no proof of dieting with my pcp. I would have had to start from scratch and surgery would be a year or two out.

You are so close.. a week or two should be no biggie.

[AK_Bookworm 116]

Also another thing to note is if you don't get preauthorization with some insurances they will not reimburse you after so that's something to look into and consider when making your decision

[lisamn 15]

Tricare is notorious for slow auth process. You should definitely wait and postpone if necessary. You are so close, don't pay for it yourself.

[BigUtahMan 207]

Do not pay out of pocket, insurance will never reimburse you unless you are approved BEFORE the procedure


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[MissouriMama 18]

My insurance covered mine 100% but I paid close attention to what it actually cost. Mine was close to $30,000 for everything. I would have never been able to pay out of pocket. That's why some folks go abroad if they are paying cash. Hopefully everything goes through for you. My insurance only took about 3 days.

[JOTP 1]

Try Dr. Dirk Rodriguez in Dallas or Houston TX. Dr. Dirk performed my hiatal hernia repair, that was covered through my insurance, and he only charged me $2000 for the sleeve. The hospital was $1700 and allowed me to do a payment plan. Dr. Dirk is a WONDERFUL Dr. And he truly cares about your health.

[SweetPeaGracie 30]

I paid 4300 out of pocket and had it done in Mexico 3 weeks ago. I am down 20 lbs so far and I feel great!