Need advice on insurance

Aloha everyone. :help: Im going to say Im having surgery,not wanting I AM having it,I just need to get insurance to pay for it.I have been to both Castle and Queens seminars but they dont give much information about insurance. So Im ready to start insurance shopping,Im self employed so I dont have medical insurance thru an employer. I have no idea what companies here in Hawaii pay for surgery and after care cost. I have no idea even how to research this,so if anyone out there has any information I would be greatful to get it. Mahalo, Tracy

Tracy - I had HMSA-HMO HPH and my insurance approved the VSG (which I absolutely love) within a few days. They approved the surgery for out of state because no one here performs it. I had mine done by Dr. Cirangle in CA. LAPsf handled all the paperwork. I did have to pay $4000 out of pocket for non-covered expenses for after-care. But it was so worth it for me. HMSA-HMO HPH covered 100%. I asked Dr. Cirangle to recommend someone who he worked with here for my primary PCP and he recommended Dr. Robert Schiff. Who I am very happy with. He was very thorough and he is very WLS friendly. If you want more info on Dr. Cirangle (he has a seminar here every month - the first saturday of the month at Pali Momi) and the VSG check out the VSG forum. Best of luck.

I also have HMSA HMO and I had my surgery done by Dr. Cirangle in San Fransico. My insurance paid for everything except the $4000 fee that Dr. Cirangle has. I had no problem with getting approval.

Hi Tracy... I have HMSA HMO (Health Plan Hawaii) and I'm having surgery though Dr. Murayama on Monday. I've been to all the seminars for everyone who performs surgery in Hawaii, and all recently (within the last 5 months). HMSA HMO covers a good deal of the surgery amount. I can give you the exact break down for Dr. Murayama and an estimate for Dr. Fowler (at Castle). For Dr. Murayama I came out of pocket for my nutritionist fees ($80 the first visit, $30 for the last two visits) and I will also have to come out of pocket for my surgery ($12.00 for Dr. Murayama and $12.00 for the anesthesiologist). Everything else is covered 100%, the hospital, the drugs, the surgery itself, the doctors visits. For Dr. Fowler the program fee is $400 or $600 upfront (I can't remember which one) and $40.00 a month after that for the next 12 months for follow up. It basically came out to a little over $1000.00. And like the other two ladies said earlier, Dr. Cirangle has a $4000.00 out of pocket fee. I just want to let you know that Queen's is awesome. The staff is great, the nutritionist is great (see Dr. Curtis) and Dr. Ramsdell and Dr. Murayama are both super super terrific. I started with the seminar in June and I was approved last month and have my surgery on Monday. It took a couple days over 5 months but HMSA HMO was a breeze to deal with and they are always willing to help you out and answer your questions. The only thing with HMO is you always have to go through your Primary Care Provider, which would be your regular doctor you see, to get refferals for anything. It does take a couple of weeks longer than if you had PPO but in my opinion it was well worth it. With PPO you will have to pay 20% of your hospital bills and a % of your doctors bills. That will also come out to probably around $4000.00 or more and you will probably have surgery in the same month just a few weeks longer. Good luck!!! If you have any other questions don't be afraid to ask. I haven't had surgery yet, but I can answer almost anything you want to ask about Dr. Murayama or HMSA and the approval process. =) Dana