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Just curious to see who actually paid for their surgery and who had it covered by their insurance. How long ago they did it and where.

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Mine is being covered by my insurance. I owe my 20% co-insurance up to my out-of-pocket max, so this should cost me somewhere around $2,000.

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I had my surgery in July 2020, and I was self-pay due to a lower BMI. My surgeon said if I gained 18 lbs. I could qualify, but that was not going to happen as far as I was concerned. 3-4 lbs. maybe, but not 18. I went to Cleveland Clinic because they had done a heart valve replacement on me the year before and there was some degree of comfort having them do the sleeve surgery. $26,000 out of pocket. Ouch.

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I have Medicare with a type G supplement. My surgery was paid for entirely, except that I got a bill for $350 from some assistant that Medicare apparently thinks isn't necessary.

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I paid out of pocket because I didn't want to wait until the holidays to have the surgery done, and I wanted some control over my surgery date. Insurance takes about 6 months start to finish. I was also on the cusp with my BMI being too low, and was told if I lost even a couple of pounds, I would disqualify myself for insurance. Once I was self pay, I was scheduled for the surgery within a couple of weeks. Also, in total, $26,000.

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I was insurance paid. Took about 5 months start to surgery. I had office notes to satisfy one of my monthly supervised weight management appointments.

Edited by ShoppGirl

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My insurance paid and my out-of-pocket was $1900. I have BCBS of AZ. It was 7 1/2 months from my initial surgeons visit until surgery day. I had to do 6 months of supervised weigh-ins and a few evaluations. It flew by pretty quickly.

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Even though my BMI was on the lower side, insurance paid due to high blood pressure and pre-diabetic. Took a little over a month from 1st office visit, pre-op tests, ins approval to surgery. My insurance did not require several months of weigh in's, only letter from PCP and psych eval. Out of pocket was $1800. Anthem BCBS

P.S. I did slide into a cancellation spot, or it probably would have been longer for surgery date.

P.S.S. I also did not wait for my surgeon's office to schedule my pre-op tests. I was very pro-active and reached out to hospital to schedule tests.

Be your own advocate!

Edited by Luna Girl

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I was self pay for my sleeve - my employer-paid insurance plan had a specific exclusion against bariatric surgery. All in all, it was just under $20k. Had a stuck to my original practice, it would have been much closer to $30k (I'm in the Washington, DC area).

Timing from start to finish is hard to comment on in my case... I switched practices at the beginning of COVID so that slowed things down incredibly. And then I was a bit slow in getting some of the requirements done (like getting my endoscopy, etc) because life and work got crazy. If I had been more on top of that sort of thing, it would have been faster esp with no insurance involved.

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Insurance covered my VSG, and then my recent revision because of Gerd. After I jumped through all the hoops, of course. Cardiac clearance, 2 visits with dietician, psychological evaluation, blood test... Etc.

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text

I was self pay for my sleeve - my employer-paid insurance plan had a specific exclusion against bariatric surgery. All in all, it was just under $20k. Had a stuck to my original practice, it would have been much closer to $30k (I'm in the Washington, DC area).
Timing from start to finish is hard to comment on in my case... I switched practices at the beginning of COVID so that slowed things down incredibly. And then I was a bit slow in getting some of the requirements done (like getting my endoscopy, etc) because life and work got crazy. If I had been more on top of that sort of thing, it would have been faster esp with no insurance involved.



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I will be doing self-pay in Mexico, surgery on 9/21. All in (hotel, flights, surgery, meds, spending money, etc.) will be just about $5,500. I did the math and using insurance would have put my out of pocket at about $7,000 and take roughly 9 months, versus about 3 months with my current surgeon. I wasn't so much concerned about the cost, though it was a factor, but I did take issue with the timeline. I have consulted for bariatric surgery multiple times and always chickened out. I didn't want to give myself that option this time. Putting down a down payment and a date on the calendar made it non-negotiable to me. On top of that, going the self-pay route cuts WAY down on the red tape and pre-op crap that insurance requires.

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I have BCBS of TX and I paid my out of pocket of $2400 and the rest of covered. It's nice having my out of pocket met, and I'll be having some other things done next month to take advantage of it. My insurance only needed a month, but since I needed it around spring break and I started in the fall, I decided to stretch it out to 6 mos but that was my choice.

Every insurance is different even with the same company - I think it depends on what your employer included in the package so you should definitely call your insurance and just ask if it's covered and what they require.

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Insurance provider is Regence in WA state and my copay was $300 five weeks ago.

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My surgery was paid by insurance. I have a 20% co-insurance, but an out of pocket maximum of $5k a year. I ended up paying around $4000 because it was early in the year, but on the flip side I'm going to have hip surgery in a couple months and will pay nothing.

California / Cigna

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    • Meganator

      Just deleted all of my food delivery/ordering apps and unsubscribed from several restaurant emails. I start my pre-op diet next week- unsure what that will look like until I meet with my dietician on Monday, but I want to be prepared for success. Let's go!
      · 0 replies
      1. This update has no replies.
    • Kaguragetshealthy_87

      Just logged into my insurance and found out I'm approved! Yes!!!!!!
      · 3 replies
      1. Candace76

        Congrats!

      2. GreenTealael

        Congratulations!

      3. ymn

        Yay!

    • echubbythighs

      FYI. I'm going to discuss poop! I'm a Registered Nurse x16yrs.  It's possible this might be to much information for some but I'm not gonna sugar coat my info/experience. I hope some find this much detail helpful.
      Post op gastric sleeve 8 days out. The first day/night was AWFUL. I believe the majority of discomfort was from all the gas placed in the abdomen during surgery. Day 3 I started have less pain from the gas yet the spasm/pulling/tightness in right lower quadrant of abd. continues to this day (maybe a 4 on the pain scale w/ 10 being worst). I recommend WALK, splint your abdomen w/ a small pillow to cough/sneeze/laugh/try to have a bowel movement!
      Speaking of bowel movements, my Doctor did not have me do a liquid fast 2 wks prior to surgery, only 24 hrs prior to day of. I was unable to pass gas or have a bowel movement until day 6 and that was with the help of Miralax on day 5 ( note I did take the pain med's/Lortab the first 3 days). I have no problem taking in H2O as I'm a water snob so this wasn't the issue.  FYI. Narcotics can increase constipation. I recommend the Miralax, I purchased individual dose pkg's which make it simple to take on the road/convenient. Bowel movements should return to pre surgery consistency if not discuss w/ your MD. 
       It was difficult to urinate ( minimal volume/stream) the 1st 3 days as well, I assume due to gas and swelling in the abd. cavity, 8 days out and the all things back to normal in that department. 
      No appetite, only thirst first 3 days. I started the Protein shakes my local health food store offered NutraBio 100% whey protein iso. 25 grams protein in one scoop and it tastes clean no after taste/grit. I started to notice a desire to eat on day 3. I found heating up Lipton soup mix or ckn soup from a can and straining out the solid bits extremely fulfilling. Now day 8 I want to have something of substance in my belly. I'm not sure if it's hunger or habit. I am still cooking meals for my family. I bought some ice cream last night and that made a huge difference in my attitude/energy/outlook. I've noticed many different diet recommendations throughout my research in regards to the liquid phase of the diet. My surgeon wants everything low carb, low fat, calories 700-900. That is a bit extreme for me I beleive. I've already gone back to work (day 5/modified w/ no lifting over 15 pds) and couldn't make it through the day on that limited amt of calories. I've been blending canned soups to liquid consistency the last few days, loads of yogurt, popsicles and yes protein shakes. Tonight I needed something with richer consistency so I made myself a small bowl of mashed potatoes maybe 2oz. I felt so Satisfied and afterward, the idea of another week on a Liquid diet didn't seem so disappointing/unattainable. 
      The most dramatic changes I've noticed to my body since having the surgery is the overall inflammation/bloating in my face/abdomen is 70% resolved, my skin is 90% clearer and I don't feel the need to take my bra off the second I put it on ( strange I know). I am thrilled with my choice to have this procedure thus far. I feel much better when I listen to my body and not just blindly follow the strict eating regimen ordered by my MD. I'm not encouraging anyone to go against your MD's recommendations but for me, listening to my body and making small adjustments is making this journey more positive/manageable.  
      To date I've lost 13 pds and it's only day 8 post op. 
       
       
      · 0 replies
      1. This update has no replies.
    • JLynnWilson

      Surgery is set for 10/4/21. At this point I haven't had any coffee, alcohol, carbonated drinks, or caffeine in general for over a month. Too bad it just hit pumpkin spice season! I'm missing my coffee!
      · 2 replies
      1. hopeainsley

        I have been a regular coffee drinker for 20 years atleast. Transitioning to no coffee is going to be so difficult. How did you do it?

      2. JLynnWilson

        I've been drinking about two large cups of coffee at day minimum for about 15 years. I also drank probably one-two cups of soda a day, but i've always drank a ton of water through out the day. I think what helped me was telling myself "the end was coming" and i stopped soda/alcohol first. I gave myself one last weekend and stopped. During that week I had my "favorite" coffees and said the upcoming weekend was my last. That Sunday i had my husband put all my coffee on the top shelf in the cabinet and I haven't had any since. It took about a week or two to adjust, especially with the caffeine withdrawal. I think it just helped me to space things out instead of stopping everything at once. I also drink warm tea that doesn't have caffeine in the morning, helps to trick my mind I guess!

    • LindasBlu

      I bought a box (7 servings) of peaches and cream oatmeal (used one) and pumpkin spice pancake mix (none used).  I no longer want them.  The exp dates are 4/2023 and 10/2022, respectively.  I live in Manatee Co, FL.  Will take $10 for all.
      · 0 replies
      1. This update has no replies.
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