Can I hear from the self pays please?

[pschmolle 0]

My ins. co. does the physician monitored weight loss. My problem being if I lose any weight I won't be morbidly obese & I won't fit in the insurance guidelines for surgery. I would then have to be self pay. So, I'm kind of scared about spending the money. Can you please advise?

[soontoBthin 0]

I had to self pay for the Dr. ($10,350-he was out of network) and it will be the best money spent if it improves my health issues. I made the statement to my DH that it was like making a car payment. He responded "no, a car depreciates, you will only appreciate". That put a new spin on it.

[pschmolle 0]

That's a good one! Where did you get yours done? I'm in Illinois.

[Oregondaisy 2,021]

My daughter did a one year physician monitored diet to be approved for gastric bypass. One week she would lose 2 lbs the next week she gained it back, and this went on the entire year. She was approved after a year. All she did was go to the dr. and get weighed.

[betttybboop 1]

To gain a little perspective, have a read through the Canadian discussions... we ALL are self pay (our healthcare system & insurance will not cover it, ever) and I think you'll find that an overwhelming number of Canadians agree it's money well spent. Compare the cost to the amount you've spent on dieting (programs, special foods, gym memberships, etc.) and larger amounts of food over the last couple of years... you might find this isn't that big of an investment afterall!

[HeatherO 7]

Check with your surgeons office and the insurance company. I was originally going through insurance and my surgeons office verified that as long as I qualified with the right BMI during the start of the process, it did not matter if I lost weight and had a lower BMI at the end. I remember being scared about it because I just barely qualified. I think this is how if works, but definitely verify it first.

[texgirl 0]

I tried for 3 years to get approved. I finally just gave up and self-paid. I originally had Aetna. I had all the requirements they asked for and they still denied me. My insurance changed to United Healthcare and our policy has an exclusion. Everything went so quickly after I decided to self-pay that a wish I had made that decision 3 years ago!

[ssdown 0]

My insurance did not cover any WLS, so I coughed up the $16,000 and went through the pre-band process, which took a few months. I was beginning to get high blood pressure and my heart was starting to speed up (now taking Rx's), in huge part due to my increasing weight. The peace of mind of not constantly thinking about food is wonderful! I have not regretted my decision for one minute. SS

Edited April 18, 2008 by ssdown

[SB0233 0]

You might want to see if you qualify for a tax break next year if you self-pay. It will depend how much the surgery is in relation to your total income. Not as good as having insurance pay, but still something is gained in the process.

I was self-pay and I have no regrets. Process was much faster and on my terms.

[dab 0]

I paid $18.5k for my surgery. I was fortunate to have an upfront retirement fund to draw it from, so no monthly payment....but it was the best money ever spent.

In seven months I have lost 155 pounds, basically the halfway point. I am gaining control of my life and that is worth more than any monetary value. I figure it will realistically take me another 14 to 16 months to get the second half off and it will take some regimented physical activity as well.

I had my 7 month checkup yesterday and talked to them about financing for my wife to have the procedure.

It is a tool and you have to have a desire to succeed, but it is a great tool!

dab

[pschmolle 0]

Thank you all for the inspiration!

[MacMadame 81]

oops. didn't see someone post this exact same info.

[HeatherO 7]

I jumped through hoops for most of a year with testing, evaluations, six months supervised physician diet, etc . . . . and my insurance plan changed the month that the everything was done and the final packet was being submitted. Now I had a lovely exclusion.

I was so disheartened it was unbelievable. So I decided to try it again on my own (traditional methods to lose weight with diet and exercise). I lost 50 pounds over about 8 months. I never had a problem losing weight, it was just keeping it off that killed me. I am just hungry if you know what I mean. I slowly gained it back and two years later I was at the same point. Then I figured, what the heck. I want this too bad to let anything stop me. Why let a technicality force me to waste any more time???

My husband and I made the decision to move forward. Did research, made a selection and two weeks later it was done. It was so easy and painless, I regret the wasted time so much more. If only I could go back five years and say . . . just do it!!!! I am sure things would be different today.

[mommy4 0]

i also had to to self pay. my aetna is aetna and they would not cover. i just had to do what i had to do for my health

[ReadySteadyGo 8]

I am self pay. It took me almost as long to raise the money to pay for it as it does for some to go through insurance. With all the test and everything I spent 14,000. I haven't been banded that long, but I want to lose 150 lbs (super goal) So the way I figure it it is like 80 dollars a lb...Which seems so pricey...but when you look at my health it seems like nothing.