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Anyone do the hiatal hernia insurance route?

If insurance doesn't cover my surgery, I want to do the option of having my hiatal hernia repaired and billed to insurance and I'll self pay for my sleeve. If you did this, how was your experience? How long did it take for approval, and who did you use?

I appreciate anyone taking the time to give me advice

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Insurance covered my sleeve and hiatal hernia repair. After I achieved and met the requirements it only took a few days for insurance to approve. Mine was BCBS.

I wanted to do this, but none of the surgeons in my town ever heard of doing it this way. I gave up and did self pay in another state.

Sent from my XT1254 using BariatricPal mobile app

  • 4 weeks later...

My surgeon doesn't do this, but I wish they did! It's a self pay package for sleeve only or sleeve with hiatal hernia repair that costs more. Good luck with everything!

I posted this in another topic, but it applies here as well.

I just has my procedure this week. Health insurance in Texas is not required to cover weight loss surgeries... So the only people that get it covered are on large corporate plans that have demanded it. I'm not one of them since I own a company with 3 employees.

When looking into, the cost was about $15,000 for a sleeve. If I have a hernia, the insurance will pickup about $5000 worth of expenses. So my cost goes down to about $10,000.

$5,800 to the doctor which covers everything through the first year or so on his side. Part of this is an insurance policy that covers complications. About $4800 to the hospital.

My psyc eval insurance covered. The blood work for a nutritional baseline insurance covered. As a cash pay, I told everyone to bill my insurance and I'd make up the difference.

I has secured a $15,000 loan from my credit union at 7%-ish... That's a personal loan for medical reasons. The monthly payment for 5 years was about $300/month.

The endoscopy to diagnose the hernia my insurance picked up. At that point I was down to a $10,000 expense. That's my threshold of acceptable. If I went to Mexico, I'd be looking at about $7500 plus travel... So at $10,000, I decided it makes sense to stay in the states.

The doctors office took payment by credit card and provided me an explanation of what that payment was good for. The hospital was more complicated and didn't want to give a price before the procedure. When I finally got a price they had forgot the hernia and insurance coverage of it. I was floored that the price doubled. After having a mental breakdown, making a scene, and crying like a baby, they got it figured out. I put the hospital put on my credit card.

After each CC transaction cleared, I payed it off.

When I was in the hospital, the staff was VERY nice. I was HORRIBLY nervous before the surgery. Thy gave me a shot in my IV to calm me down. That hit like a freight train. I told them I was getting light headed and dissy... They told me that if I didn't like that, their other stuff will make me hallucinate... I told them disy is fine, I don't want to relive my 20's with hallucinogens.

When I woke in the hospital bed... I hardly remember it. My mom, dad, and partner was there. I remember my mom commenting how nice the room it and taking pictures to show the hospital where she works. My parents keep telling me the first comment when I woke and realized I was in pain was "what the f**k did I just do to myself?"

Anyways, it's 4 days out and things are getting much better. I'm happy with my decision so far. I haven't experienced hunger yet.

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