Hey guys, I am new here! I recently found out that I have what is called a complete heart block, where by electric signals are working as they should in my heart. I am over weight with a BMI of 38.4, I have high blood pressure, i am pre-diabetic, high triglycerides and cholesterol (hereditary), fatty liver, acid reflux and I am getting a sleep study done for sleep apnea. My heart doctor said it is 100% nessesary for me to lose weight or I won't make it to see my kids grow up.

My insurance is United healthcare choice plus and my employer doesn't have weight loss surgery on our plan and my HR said they never have and won't add it to our plans, so it is obviously going to be denied.

My question is being that it willow sure be denied and I don't have coverage for it on my plan, if I appeal it and have my doctor write a letter stating that it is very medically nessesary for me to have this surgery would that change anything? Or is there zero chance of it getting approved because I don't have the coverage?

I'm working with Blossom Bariatrics in Las Vegas to hopefully have surgery in Sept/Oct of this year. Like you, my work insurance does not have bariatric coverage. They are able to use my out of network surgery coverage to cover some of the cost however. I still have to pay $10,500 out of pocket.

I was also considering going with Dr. Elias Ortiz (used to be with ALM) in Tiajuana. My aunt and 3 cousins have had sleeve surgery done by Dr. Ortiz and all had nothing but great things to say about him.

It's considerably cheaper than Blossom, but right now with Covid, the thought of traveling anywhere (especially internationally) is rather scary.

I've also spoken with the University of Kansas and they have a low cost option if you are in a surrounding state. I'm in Montana which excluded me from that option or I would've gone with them for sure. Good luck!

The cost of my surgery is $72, 948.40. I'm lucky that my insurance is paying for all but $4,500. I can't imagine what the cost would be without my insurance. No matter what it is I wouldn't be able to afford it.

I'm working with Blossom Bariatrics in Las Vegas to hopefully have surgery in Sept/Oct of this year. Like you, my work insurance does not have bariatric coverage. They are able to use my out of network surgery coverage to cover some of the cost however. [emoji4] I still have to pay $10,500 out of pocket.
I was also considering going with Dr. Elias Ortiz (used to be with ALM) in Tiajuana. My aunt and 3 cousins have had sleeve surgery done by Dr. Ortiz and all had nothing but great things to say about him.
It's considerably cheaper than Blossom, but right now with Covid, the thought of traveling anywhere (especially internationally) is rather scary.
I've also spoken with the University of Kansas and they have a low cost option if you are in a surrounding state. I'm in Montana which excluded me from that option or I would've gone with them for sure. Good luck!

I am actually having mine done this Friday. Nervous but, I am happy with my decision with this clinic. I am in Las Vegas, NV now as my fiance already had a project to do out here at the same time my surgery was scheduled anyways. But I took the option with the "out of network" benefit and paid $10,500 with my care credit card. So yea out of pocket but still I don't think it's that bad.

48 minutes ago, BostonRiley said:

The cost of my surgery is $72, 948.40. I'm lucky that my insurance is paying for all but $4,500. I can't imagine what the cost would be without my insurance. No matter what it is I wouldn't be able to afford it.

I think they often charge insurance companies a lot more than they do self-pay patients.

11 hours ago, STLoser said:

Yes, I understand. I wanted the surgery for many years and never had insurance that covered it, so I never planned to get it. When the surgeon who took my gallbladder out told me my liver was so bad he didn't think I'd make it to 60 if I didn't lose weight, I decided to get the money out of my 401k. It wasn't something I'd ever considered doing because I wanted to save that money for retirement, but hearing that surgeon's words made me realize I would never be able to use that money if I was dead anyway! There's no way I could have come up with that money if it weren't for the 401k, though.

The reason I decided to have my surgery when I was so young was because I was still on my parents insurance plan until I turned 26 and they always had phenomenal insurance so I figured it was now or never. I think having it young made the weight loss and recovery process much easier anyway so it worked out very well for me.