Self-pay vs. Insurance

[Sprinkles1 358]

I'd like some opinions on this because maybe I'm just being too rash. I want to have wls ASAP, however, I already know my insurance is going to make me jump through hoops to get it and it can take 6+ months and there isn't even a guarantee that I'll get approved afterwards. Part of me just really wants to lose some weight on my own, learn more about the post op diet of gastric bypass, gather more info then head down to Mexico to get the procedure. I've honestly paid more in personal trainers and fad diets then the costs I've seen to have the procedure done out of the states.

Just want opinions but would you... A.) Go through insurance and hope for the best or B.) Do self pay?

I'm such an impatient person and the thought of waiting 6+ months is torture.

[Creekimp13 5,841]

Absolutely go through insurance and try to have your surgery locally.

Why? Because follow ups are a huge key to success. Also, when you have problems, it's nice to have someone local who has your back, who will see you, who knows your history and can look at your records.

i'm not saying Mexico is horrible. I know a lot of people have had good experiences. Some have also had horrible experiences and fallen victim to scams. Still others have come home having terrible problems (because some folks do have a harder time) and had no support and no one to call except the emergency room.

I think the best, safest way to have this surgery....is to have it with someone board certified, someone within an hour or two drive (if possible) who has a good reputation and who preferably offers a 24 hour hotline to their clients and lots and lots of client education.

Keep in mind that you're talking about a procedure that will significantly change your anatomy forever. You will have to take Vitamins forever. You'll have to give up certain things...forever. You should plan to be rechecked and continue to see your nutritionist and doctor yearly. This isn't a minor thing. This is a LIFETIME decision. Six months...is a drop in the bucket.

Also, keep in mind....this surgery isn't a cure. Eating right and exercise are going to be huge parts of your success. Practicing those skills for six months isn't unreasonable....and it will help you get into the best shape you can before surgery for your safety and recovery.

I would do a LOT of research before making this decision. And I would definitely try to go through your insurance.

[BigAussieGirl 162]

I don't really understand the health insurance system in the US. (It confuses me to know end that you could have insurance but get denied a procedure). Regardless, I would be apprehensive not having the surgery done locally. I'm 4 months post op and the post op support I've had from my team has been invaluable.

[Introversion 1,876]

I'd rather jump through the hoops to get insurance to pay for the surgery. If six months of hoop-jumping ensures that $5,000 remains in my pocket, I'll take that chance.

Mexico was my back-up plan in case my health insurance didn't grant approval.

[PrayingForWeightLoss 340]

6 months sorry of hoops is not bad. Time will move fast once you go through your prgramme.

[Overcomer2food 3]

I totally agree with what everyone says, but several clinics/hospitals in Mexico follow up with you and have nutritionists on staff to follow you. They are not just doing the surgery and cutting you lose. My top 4 clinics/doctors I researched have great follow up plus they have Facebook communities for support even one gives a lifetime guarantee on the sleeve procedure and work with you if your weight stalls. (Thyroid and other blood work)

My insurance takes 9 months to 1 year to approve you for the procedure. I’ve asked for a referral for over 5 years and because I have no other medical issues I was denied. But now my BMI is over 50 and I’m finally being referred. But I have to take classes at weird times and jump through all these hoops which my husband has to take time off from work to watch our kids or we have to pay a babysitter which Is expensive and hard to find for 2 or 3 hours a couple times a week. Including drive over an hour for classes. So we’ve decided to go to Mexico for the sleeve surgery. I’ll update you when I return next week.

Good luck with your decision!

Edited December 26, 2017 by Mom2twins2016