DS Approval w/ Private Pay Insurance
Has anyone ever gotten the DS with private pay insurance? PPI is something the Hubs and I are looking into since he was laid off and we discovered our COBRA costs are over $1300 a month. Ridiculous. We will ensure that any PPI we get will cover bariatric surgery. I'm sure any PPI we get will fight us tooth & nail over approving my DS surgery, though. $600 or around that a month for a couple of months to approve a $22k surgery almost seems like robbery. :\
That's why I come here to all of you experienced ladies & gentlemen. If you were a PPI DSer, please tell me your experience. :)
That's why I come here to all of you experienced ladies & gentlemen. If you were a PPI DSer, please tell me your experience. :)
I don't think you will find a private pay insurance that will cover any bariatric procedure. I am like 98% certain of this. Cobra is expensive, but if you want the DS and you KNOW it will cover it you might want to try to hang onto it until you are through surgery without any complications, because if you switch I am assuming a complication from the surgery could be considered a pre existing condition and then you would be stuck. You may want to wait until your DH has another job lined up and hope his new jobs insurance covers WLS. Good Luck.
I wish COBRA were an option for us, but with my husband not having a job and us having a small baby, there is no way we can afford $1300 a month. I figure it doesn't hurt to look into private pay insurance. And, if not, then I guess I'm screwed - for a while. I feel like this entire journey thus far has been one step forward & two steps back. Discouraging. I'm hanging in there, though. I really have no other choice at this point.
Ms. Cal Culator
on 8/29/11 2:22 pm - Tuvalu
on 8/29/11 2:22 pm - Tuvalu
On August 29, 2011 at 9:14 PM Pacific Time, Erika T. wrote:
I wish COBRA were an option for us, but with my husband not having a job and us having a small baby, there is no way we can afford $1300 a month. I figure it doesn't hurt to look into private pay insurance. And, if not, then I guess I'm screwed - for a while. I feel like this entire journey thus far has been one step forward & two steps back. Discouraging. I'm hanging in there, though. I really have no other choice at this point.No insurance company is going to allow you to sign up for a $600/month insurance that will allow you to spend tens of thousands of their dollars on surgery.
Can you find a way to borrow enough money to keep your COBRA going until after surgery? That wll be your cheapest solution.
Ms. Cal Culator
on 8/29/11 9:56 am - Tuvalu
on 8/29/11 9:56 am - Tuvalu
PPI DSer?
Are you saying that it seems like robbery for you to pay $1300/month (or even $600 in your dream scenario) to pay for a $22,000 surgery is robbery on YOUR part or on the part of the insurance company?
Because if you get the DS--and all your other health stuff covered--for $1300/month for a few months, YOU have gotten away with murder. Don't blow it.
What I meant was, should I find an insurance plan for $600 or $700 a month that covers bariatric surgery, it would almost seem like robbery for me to pay, say, $700 a month in insurance for 6 months at the most, and then the insurance company pay for a $22k surgery.
With Hubs not having a job, there is no way we can afford $1300 a month, like at all - at least not now. I don't know how much a self-pay visit with Dr. Stewart is, but I imagine that it isn't cheap. My pcp (who is on board with me having the DS) offered to help me with "weight management" *aka* the 6 months pre-op diet most insurance companies require before approving surgery. A visit to his office is less than $180. I'm thinking that if we aren't able to afford COBRA or find a PPI plan that is affordable and offers bariatric surgery coverage that I'll take him up on the offer and go to him for the 6 months diet plan and have everything transferred to Dr. Stewart's office when we get our healthcare coverage back. And, of course, I'd discuss this Dr. S. It's sort of my plan C since plan A failed and B is still in the works. Think it'll work?
With Hubs not having a job, there is no way we can afford $1300 a month, like at all - at least not now. I don't know how much a self-pay visit with Dr. Stewart is, but I imagine that it isn't cheap. My pcp (who is on board with me having the DS) offered to help me with "weight management" *aka* the 6 months pre-op diet most insurance companies require before approving surgery. A visit to his office is less than $180. I'm thinking that if we aren't able to afford COBRA or find a PPI plan that is affordable and offers bariatric surgery coverage that I'll take him up on the offer and go to him for the 6 months diet plan and have everything transferred to Dr. Stewart's office when we get our healthcare coverage back. And, of course, I'd discuss this Dr. S. It's sort of my plan C since plan A failed and B is still in the works. Think it'll work?
Ms. Cal Culator
on 8/29/11 2:33 pm - Tuvalu
on 8/29/11 2:33 pm - Tuvalu
"...should I find an insurance plan for $600 or $700 a month that covers bariatric surgery, it would almost seem like robbery for me to pay, say, $700 a month in insurance for 6 months at the most, and then the insurance company pay for a $22k surgery."
Yeah...they've already thought this through. IF there were a policy that covered bariatric surgery, YOU would be excluded based on your current weight. Sorry.
Love/hate relationship with insurance. I'm new to the wonderfully bittersweet world of health insurance. Can't ya tell? Oh well. I'll guess I just do the pcp visits to keep doing the weight management and then transfer records. And, if Dr. S's office has an issue with that, then I think I'll just plop down and sob.
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