Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Bummed....a big DENIED....



Recommended Posts

Well, I have a 12 month pre-existing clause on my insurance so they denied me because of this. In my fifth month of having this policy now. Also, at they also want a three-year BMI of over 40 and I have been 38-39 and over 41 for just the last year. No major comorbidities......So, I can go self-pay or wait 1-2years MORE. I have already waited almost a year for this......thinking I will head to Colorado....SO BUMMED because I am ready for this NOW....

Share this post


Link to post
Share on other sites

That sucks - but keep positive maybe something better is going to come from this

Share this post


Link to post
Share on other sites

Yeah.....it does suck. Insurances are starting to make it more and more difficult to get the surgery approved.

Share this post


Link to post
Share on other sites

I had my surgery in CO by Dr. Brown and could not be happier with him. I know he has a very affordable cash price for LBS, and they are very easy to work with. I couldn't recommend him more highly. There are also many other CO surgeons that are recommended highly in CO as well with similar cash pay options-Dr. Kirschenbaum (or something like that) I've heard positive comments on as well.

Best of luck whatever you decide!!

Share this post


Link to post
Share on other sites

I had my surgery in CO by Dr. Brown and could not be happier with him. I know he has a very affordable cash price for LBS, and they are very easy to work with. I couldn't recommend him more highly. There are also many other CO surgeons that are recommended highly in CO as well with similar cash pay options-Dr. Kirschenbaum (or something like that) I've heard positive comments on as well.

Best of luck whatever you decide!!

Dr. Brown is doing my surgery next week, $9900 for self-pay. They are very helpful with directing you to financing options, they accept credit cards as well. The only good thing about paying yourself is the speed of the whole process: less than one month from first phone call to surgery for me.

I have good, comprehensive group insurance but WLS is completely excluded, so it was never an option for me.

Good luck. If I were you I would do the self pay rather than waiting so long!

Share this post


Link to post
Share on other sites

Dr. Brown is doing my surgery next week, $9900 for self-pay. They are very helpful with directing you to financing options, they accept credit cards as well. The only good thing about paying yourself is the speed of the whole process: less than one month from first phone call to surgery for me.

I have good, comprehensive group insurance but WLS is completely excluded, so it was never an option for me.

Good luck. If I were you I would do the self pay rather than waiting so long!

So would I. In fact, I did self pay. I had my band placed in Mexico for $7,000. The price quoted above for self pay in Colorado seems really fair to me. I would definitely do :thumbup:some research on Dr. Brown.

Share this post


Link to post
Share on other sites

insurance is really going downhill theses days. i was lucky to get mine approved but i have to wait till january to have the surgery. Another really great Dr. in colorado is Dr. Micheal Johnell. he is amazing and they can also help you with self pay and do payments and finacing.

Share this post


Link to post
Share on other sites

My mom was self pay, my insurance covered mine. I would do self pay especially if I could find a place that did it for $9000....my mom's was quite a bit more than that! Plus say you wait 1-2 years, then they will most likely have another way around not having to pay...and then you start again ugh! Good luck to you!

Share this post


Link to post
Share on other sites

Well, I have a 12 month pre-existing clause on my insurance so they denied me because of this. In my fifth month of having this policy now. Also, at they also want a three-year BMI of over 40 and I have been 38-39 and over 41 for just the last year. No major comorbidities......So, I can go self-pay or wait 1-2years MORE. I have already waited almost a year for this......thinking I will head to Colorado....SO BUMMED because I am ready for this NOW....

I chose to self pay in my case because I wanted to have the surgery while I was still healthy. I didn't yet have diabetes, sleep apnea or high cholesteral. The only problem I had was high BP but it was under control. I was afraid of my knees and hips going bad and not being able to exercise. My insurance refused to do the lap band and was pushing me to gastric bypass which I wasn't mentally prepared for.

I am so glad I did it when "I" was ready because that in itself makes all the difference. Determination and motivation is 3/4 of the battle for me. The rest I can manage and I know that this time I will succeed.

If you can afford to bite the bullet and pay yourself, you will have the added motivation from having spent all that money and be able to do it now when you are ready.

Best of luck to you,

Donna

Share this post


Link to post
Share on other sites

It seems to me more people are getting denied. (Or they are the ones that post more about it) I can see that this little window we have here might be the last one we will have in a long time to get something like this paid for. The government and insurance companies. Whew!!!

This is not a political agrument for me one way or the other just in case someone thinks it is. Just one readers opinion. I know my BC/BS dropped the six month diet. I just can't imagine that is going to last.

Share this post


Link to post
Share on other sites

I am flying to Brussells and self paying at $6000. That is pre-consultation, transortation from/to airport and from/to hospital.

If you read the Dr. De Bruyne thread, you will see many, many people who have used him and have great things to say. My surgery is September 23. (And after care will be done at a Center of Excellence locally)

Share this post


Link to post
Share on other sites

Amlus, Where do you live? I am from Hattiesburg MS and there are no surgeons here that do this type of surgery, so I had to go to Houma, Louisiana. The total cost of my surgery 9/4/09 is $5,700. I was able to go through my insurance but if I could not get covered I would have self-paid. I hear it costs alot more in other cities and states. I don't know where you are from but I wanted to tell you not to give up and if you are near or in Louisiana the cost is not outrageous. Praying for you!!

Phoebe

Share this post


Link to post
Share on other sites

The total cost of my surgery 9/4/09 is $5,700.

What???? Was this the total self-pay cost? I am in Iowa. What Dr. and what facility?

Share this post


Link to post
Share on other sites

The physicians that did my surgery are three brothers named David, Eric, and Fritz Rau and there is another doctor with them named Donald Schwab. They are part of Physicians Medical Center in Houma, Louisiana. The phone# is 985-853-1390. but the first person I spoke with was Brandi. She does all the insurance work or if you self-pay and her # is 985-868-2206. she can answer any questions you may have. I had my surgery on 9/4/09 and I just went for my first adjustment. Oh, the adjustments are free for one year and you can get adjustments every two weeks. the total self-pay is $5,700. I hope this helps you.

Share this post


Link to post
Share on other sites

Oh, the adjustments are free for one year and you can get adjustments every two weeks. the total self-pay is $5,700.

???

What the heck? The going rate around here is $12,000 - $16,000! There are a few places around $9,950 around Denver I have looked into. That really seems to low....are they like real doctors? (: Do they have you go to Mexico for the surgery?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×