where, when and how much?

[Hiccup 32]

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.

[vikingbeast 985]

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.

[Elidh 238]

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.

[Dave In Houston 199]

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.

[ColieCallwell 128]

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.

Sent from my SM-N976V using BariatricPal mobile app

[ShoppGirl 3,451]

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 September 9, 2021 by ShoppGirl

[Anj0399 61]

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.

[Luna Girl 307]

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 September 9, 2021 by Luna Girl

[Queen ApisM 426]

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.

[Tomo 1,157]

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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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.

Sent from my Nexus 5X using BariatricPal mobile app

[Sleeve_Me_Alone 654]

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.

[njlimmer 338]

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.

[nursesunshine 9]

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

[jenny8791 11]

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