Use insurance for BYPASS or pay out of pocket for SLEEVE

[keneee 6]

I am considering having a Bariatric surgery.
My insurance company only covers Gastric Bypass surgery.
I was really leaning towards Gastric Sleeve operation.
My thought is Sleeve is less complex so it’s safer, fewer cuts and staples. It essentially costs about the price of a used car, which I can afford.
Should I pay out of pocket for Sleeve or use insurance for ByPass?
ByPass seem to have greater weight loss effect.
Any advice?

[The Greater Fool 1,951]

It really comes down to you. Is the cost difference more important than getting the surgery you want.

For me, getting the surgery I wanted was pretty important. For someone else money may be the more important factor.

Think about it all carefully.

Good luck,

Tek

[Aliana Wood 19]

If I were in your position, I would honestly go with what the insurance pays for. I wouldn't want to, but for me, cost would be very very important. But if you can afford it and you really don't want the bypass, then go ahead and self pay.

[GreenTealael 24,857]

I would lean towards letting Insurance cover WLS and save your money for your new wardrobe or even plastic surgery down the line if you need it

[Dave In Houston 199]

I needed the bypass because of reflux. If I had asked for anything else, the surgeon wouldn't have done it.

[The Greater Fool 1,951]

19 minutes ago, Dave In Houston said:

I needed the bypass because of reflux. If I had asked for anything else, the surgeon wouldn't have done it.

Good for your surgeon. I love me some Doc's that stick to their medical guns.

No one in this thread is wanting a surgery that is contraindicated.

It seems everyone here is on the ball. Gold stars all around!

Good luck,

Tek

[catwoman7 10,862]

sleeve has fewer potential complications, but honestly, they're both pretty safe surgeries these days. Many of us never had complications, and if complications do arise, the majority are minor and "fixable". Of course, you can get major complications with either surgery, but most people don't. Like someone else said, it comes down to whether the money or getting the surgery you want is more important to you.

[STLoser 1,085]

I know for me, I would have taken any surgery insurance would have covered. Unfortunately, our insurance covered none, so I had to pay out of pocket. Because I already paid that money for my wls, it's unlikely I'll be able to get surgery to remove all the loose skin I am left with. If I were in your position, I'd go with what surgery covers.
Also, I went into this wanting the sleeve myself, but after meeting with the first surgeon I changed my mind to gastric bypass. After that (it was beginning of covid), he was fired and I saw a different surgeon who recommended the Loop DS for me, which I had not heard of at the time, but after researching that's what I decided on because he said it was the one I would have the best chance of losing the most weight with.



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[blackcatsandbaddecisions 844]

I received the sleeve and that’s what I wanted, but you better believe it insurance had only covered bypass that’s what I would have gotten. For me it wasn’t the original cost that stopped me from getting surgery (I had to wait years to get on a plan that covered it at all) it was the unknown of potential complications increasing the cost. I could have afforded the out of pocket but if I’d had a leak or needed additional days in the hospital this could have been a huge issue.

I work in the medical industry and the out of pocket cost for uninsured medical complications is no joke. I would always recommend to someone if they can get insurance for it then go that route. It’s just safer from a financial perspective.

[keneee 6]

9 minutes ago, blackcatsandbaddecisions said:

I received the sleeve and that’s what I wanted, but you better believe it insurance had only covered bypass that’s what I would have gotten. For me it wasn’t the original cost that stopped me from getting surgery (I had to wait years to get on a plan that covered it at all) it was the unknown of potential complications increasing the cost. I could have afforded the out of pocket but if I’d had a leak or needed additional days in the hospital this could have been a huge issue.

I work in the medical industry and the out of pocket cost for uninsured medical complications is no joke. I would always recommend to someone if they can get insurance for it then go that route. It’s just safer from a financial perspective.

Thank you for answering.

This is exactly what I was telling my wife last night. We can afford to pay for the surgery out of pocket. But what if things don't go well and I have to be hospitalized for an extended period. That unknown financial risk is too great.

I am certain I will go with whatever insurance will cover.

I have spoken to my insurance company about adding Gastric Sleeve as a covered therapy. They told me to talk to my HR department from work. I submitted a nice letter to the HR department showing all of the benefits of GSV to them ( cost less, fewer nights at hospital, less invasive, etc.) They did not immediately say NO to covering GSV. They sent my letter to the Insurance Broker for consideration. I am hoping they will cover GSV. Otherwise I am likely to go with RNY.

[blackcatsandbaddecisions 844]

Smart move! Hopefully they can get it added, and if not you’ll still be getting an effective and safe surgery. I feel like it’s a good thing I saved the money on the surgery because I ended up spending it on new clothes, exercise equipment for my new home gym, and weekend trips around the state with my family now that I have energy and can actually hike and participate in activities.

[keneee 6]

Wohooo!

I just heard back from the HR department from my company. They will add GSV to insurance covered procedures list effective September 1st. My surgery date is November 12th. Now I got choices.

[blackcatsandbaddecisions 844]

Awesome news! And good on your company for listening and updating things in a timely fashion.

I personally love my sleeve- the restriction makes it so I’m “full” so quickly, even 9 months later. I always felt like before surgery my stomach was a black hole, I was always hungry.