Has anyone had any luck going through their PCP to determine if they had a hernia before seeing the bariatric dr? I have the symptoms, but what are they chances they'll send me for a barium swallow or EGD to see if I have a hiatal hernia?

My BMI is on the fence. 3 lbs and half an inch makes the difference between > 35 BMI and < 35 BMI. Also, just because my home scale says I weigh enough (barely) their fancy bio metric scale might say something else. that instant decides the self pay or insurance track. all of the other requirements are no problem, it's just not a 100% sure thing i will be 35 BMI that exact moment.

If I go to the bariatric dr and I am 35 BMI, insurance covers it all. copay for the appts, $25 copay for hospital stay, no deductible, etc. Excellent coverage.
If I go and I am not at 35 BMI - it's $710 right then and there. that's a lot to pay for being 3 lbs underweight. self pay cost for VSG is $18,500 (not going to happen).

the scheduler was very clear that their scale will have a different result than my home scale. that's a HUGE risk for me and I'm not sure if I want to take it.

Thoughts/Tips/Advice?

See if PCP will send me for hernia testing (so I can try to do insurance for hernia repair + cash for VSG?)?
Find another dr who doesn't use the biometric scale?
pig out on Hardees burgers topped with boneless ribs to make sure I weigh more than enough?
Use one of the dr's such as blossom bariatrics, Dr Borton, etc, or one of the ones in MX the US that cost less than $10k?
buy my own biometric scale to practice weighing?
Go to the local weight loss clinic for $90 a month who uses a biometric scale, but struggle to follow the program? (could also count as medically supervised diet), then go to the bariatric dr?

I'm so frustrated and sick of being obese for the past 20 years. just not quite obese enough. ~sigh~

That's a hard call. You are the only one that can decide whether surgery is right for you. If you feel it is the right call, they will have you do a gastroscopy (scope your esophagus) to see if you have a hiatal hernia. Just because you do, surgery might not be recommended. Also, if it is big enough to have surgery, you will probably still have to pay some out-of-pocket as your insurance company will only pay a portion of the hospital/surgeon fees. Of course, it depends on the insurance, but my insurance paid about 70% of all the bills. I find that doctor's scales always put me 5-8 lbs heavier than any of my home scales ever had. I hate to say this, but I would put on the few pounds and make a late afternoon appointment! I

Gain 10 pounds and call it a day. I had to gain 15 to reach 40 BMI. Seems silly to gain 15 for weight loss surgery but I lost 100 in 6 months so well worth it

Hi I'm new at this just finished with my nutritionist but I have been gaining weight I do have thyroid problems and it's very hard to loose any kind of weight , my nutritionist did advised me that I can't be gaining because my insurance can deny my procedure?

When my mother had he band done 20 years ago... I think she had to gain 20lbs to qualify... she ultimately did

Put some rolls of quarters in your pockets. Add some extra weight.

I am post-op Gastric Sleeve by 1 week tomorrow. I went the self pay with hiatal hernia repair route. My insurance would not pay for bariatric surgery but would pay for hernia repair. By having the hernia repaired, I saved a little under $10,000 out of pocket for my gastric sleeve. Gastric sleeve price was $16,500 out without hernia repair..... $6,700 with hernia repair and insurance coverage. I feel great and am looking forward to a healthier future not only due to the weight loss but to the hernia being repaired. By the way, I live in MT but had surgery in Henderson, NV. It was totally worth the trip!!

On 11/1/2017 at 9:05 PM, Baseballfan said:

I am post-op Gastric Sleeve by 1 week tomorrow. I went the self pay with hiatal hernia repair route. My insurance would not pay for bariatric surgery but would pay for hernia repair. By having the hernia repaired, I saved a little under $10,000 out of pocket for my gastric sleeve. Gastric sleeve price was $16,500 out without hernia repair..... $6,700 with hernia repair and insurance coverage. I feel great and am looking forward to a healthier future not only due to the weight loss but to the hernia being repaired. By the way, I live in MT but had surgery in Henderson, NV. It was totally worth the trip!!

AWESOME! I was self pay... Same boat. My total cost was about $10000. Before hernia - 16000.