Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Self Pay Surgery Requirements



Recommended Posts

Unfortunately, my insurance won't cover the surgery, so I have to pay out-of-pocket. I have made an initial consultation appointment to see Dr. Beltre in Altamonte, Springs, Florida. How does this work? Meaning, I know insurance companies make you wait anywhere from 3-6 months. Do you still have to go through the waiting period? Ideally, I would like to have the surgery as soon as I can so I won't miss out on summer fun with my boys (ages 11-17). Plus honestly, I'm afraid the longer I wait, the more apt I am to chicken out.

Share this post


Link to post
Share on other sites

I don't know if surgeons in the US have any set waiting period. I think it varies on the requirements. Some might want you to lose a certain amount of weight and have medical test for clearance for surgery. Most will want you to do a two -4 week pre-op diet.

I am going to Mexico and did not have any specific requirements other than the preop diet. My BMI is lower than most though at 31 and this maybe part of the reason. I scheduled my surgery 2 months out so I would have time to research and prepare myself mentally.

Good luck and I hope everything goes well for you.

Share this post


Link to post
Share on other sites

I was self pay & I had to attend the seminars & do my blood work, Bur the process was so fast & being that I was self pay, I picked the date I wanted to have procedure done.

Share this post


Link to post
Share on other sites

Hello. I plan on self paying and having surgery in TJ, Mexico. They have emailed me instructions (in booklet form) and have great communication. I have had consultations in the US also and using all info from those doctors to make the best decision regarding my pre and post op diet. Different doctors have different requirements so I'm doing what I feel is best for me. Also, I was able to set my own date for the surgery (especially since I'm self paying).

Share this post


Link to post
Share on other sites

I was self-pay in the states. I went in for a consultation on Feb. 1 and had surgery 2 weeks later. I had to have a psych examine, meet with a nutritionist, get scoped (because I have esophageal issues) and then I was ready. Did though have a hiatal hernia repaired at the same time and insurance approved that in a week.

Share this post


Link to post
Share on other sites

On 5/1/2017 at 10:27 AM, YeaMe said:

I was self-pay in the states. I went in for a consultation on Feb. 1 and had surgery 2 weeks later. I had to have a psych examine, meet with a nutritionist, get scoped (because I have esophageal issues) and then I was ready. Did though have a hiatal hernia repaired at the same time and insurance approved that in a week.

So you only paid for the WLS part of the surgery because of the HH repair? How did that work?

Share this post


Link to post
Share on other sites

I have no idea how the insurance company decided what they would pay and what I would pay. The hospital bill alone was around $35,000, then of course they discounted it to about $9,000 and then paid $6,500 and I paid $2,500. I also paid a portion of the anesthesiologist and the surgeon. All together I paid $6,200. My surgeon said it depended on what tools he needed to do each procedure and how long each procedure took.

Share this post


Link to post
Share on other sites

I went through all the insurance requirements just to get denied. However, I think my surgeon would have still required a psych consult, nutrition consult, and upper endoscopy prior to surgery.

Share this post


Link to post
Share on other sites

I had to jump through all those hoops too - $250 for psych consult, $125 for nutrition consult, insurance paid for endoscopy due to history of Barrett's.

Share this post


Link to post
Share on other sites

My mom was self pay and did not have to any of the requirements that insurance usually makes you do.'we had the same surgeon and I used my insurance and had to jump through hoops for six months. She was self pay and just meet with surgeon and picked what day she wanted to get her surgery done. She did opt to go to a nutritional consult and had a one week liquid diet. She paid $17,000.


Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×