Question about payment?

Has anyone decided either by choice or not by choice paid for their surgery out of pocket? If so, can you give me an estimate of cost or what options you used other than insurance to pay for this surgery? The reason I ask is I am really concerned about my insurance. There is a pre-existing clause for some unknown reason on my insurance and I am sure since BCBS is not going to pay after 2005 when our contract runs out in July, they will come up with some reason not to pay because I have been obese all my life. I want to know what my options are before I go to the dr appt on the 17th. I am going to have it no matter what, but I need to know what I have to do to get it done from a money point. Thanks for all your in put. D'Lynn

I self paid for my surgery because my insurance company would not cover it. The cost was about $22,500. I've heard some doctors and hospitals will let you pay it over the course of time but all of mine was required at my pre-op visit. At least with self paying, I avoided a lot of the pre-op tests like the upper GI, sleep study, and psych eval. Good Luck denise

Who was your Dr. and how did you get out of doing the other tests? I do not have any real medical problems other than pretty bad reflux, and not sure if I have sleep apnea...I snore really really bad. Help. I really want to have this done and am trying to go ahead and work on saving the money I might need to put down if insurance wont pay.

Dr. Champion did my surgery and I was at Emory Dunwoody. Most of the pre-op testing is actually required by the insurance companies to see if you qualify for the surgery and have co-morbidities. All I had to have done was the lab work, ECG, and chest xray at the hospital before the surgery. I actually raided my 401K for the money since I decided without the surgery I wasn't going to live long enough to enjoy it when I retired. I also snored badly before surgery but stopped after losing about 20lbs. Good luck. denise

Thanks for the info Denise. I too snore really bad...according to my husband of course.

D'Lynn, I'm not trying to scare you, but PLEASE exhaust all options before you become a self-pay. I'm sure you are going to do this, but become a pain-in-the-arse of the people at your insurance company. Get to know them and push as hard as you can, to get your insurance to pay. If you cannot get them to pay for the surgery, find out what will happen if you need a few extra days in the hospital for some reason. Will they pay for that? I too thought about self-pay. I was ready, willing and able to do it, but found my insurance was actually going to pay. Thank goodness. I had some complications, to the tune of almost a million dollars. Had I been a self-pay, I don't know what would have happened. Like I said, I am not trying to scare you, but you need to be aware, and find out about the "what-ifs". Good Luck to you! Debbie J Duncan patient 01-14-02 lap-rny 01-15-02 leak repair surgery (non smoker, non steroid taker) 01-29-02 surgery to see if I had another leak, NO thank goodness SEVERE COMPLICATIONS! 45 days in ICU, 33 days kept alive via ventilator 30 days in a rehab hospital, had to learn to walk again Now, one happy girl.........LUCKY to be alive

Well that has scared the heck out of me...makes me not want to have it now..just kidding. I am sorry about your complications, and I see your point about the self-paid. But I dont know what else to do except do the self pay if my insurance denies me. I was out of town the last two days, and BCBS called while I was gone, but they did not leave a message on my machine so I dont know what it was about. I have not even been to the dr yet, but I did call about the surgery being covered so maybe they are calling to give me an answer before I pursue this.

D'Lynn, I agree with Debbie J. PLEASE don't give up on your insurance paying for your surgery! I think all of us have had fears about our insurers coming up with some reason not to pay for surgery. Anything from your thoughts (being obese all your life), to one of mine (I haven't been obese all my life, or I'm not obese enough), or others (I can't remember all the diets I've been on), (I don't have time to get all the tests done), (they will delay too long and then it will be past the deadline and they won't cover it). We have all had those worries. There's a saying I have in my kitchen: Who says worry doesn't work? Most of the things mothers worry about never happen. And in truth, most of the things we all worry about (above) never happen. So give yourself a break, just take one step at a time, send things in to your insurance company and see what happens. Do the best you can do with your part, put it in God's hands, and watch what he does. After all, if BCBS (also my insurance co.) doesn't cover the surgery, there will be time to plan your other options. Don't give up yet! Blessings to you on your journey, Cheryl

D'Lynn, one more thought. Go ahead and start saving anyway... even if you don't use it for surgery, you can buy yourself one fantastic new wardrobe a year from now!!! Cheryl

I am really worried about the insurance not covering this BCBS states they are not covering this surgery this year. I am not worried about being approved medically, but I have the pre-existing clause for some unknown reason on my insurance and I feel like that is what is going to get me not covered. I am going to find out all the areas I can to keep from having to self-pay. The other thing that has helped was the two sites put on about Ga requiring the insurance companies to cover the surgery for morbidly obese. I fall into that category I believe. My BMI is 41.2.