Self pay question

Hello everyone, some of you may remember me from last year, I was jumping thru all the hoops for my husbands insurance company.  I had letters from 10 different Dr's that have seen me. Also had the total bill that they paid out in my monthly meds, knee surgery, foot surgery, etc.  And after fighting for over 6 months, they still turned me down "weight loss surgery exclusion ' in their policy!!   So now I am back again to plan to get a loan for a RNY with Dr. Jones. She was the one that did the siminar within  a year and 1/2 ago, also had the shrink evail, spent another 4 months seeing a co-therapist as he recommended, and attended support meetings, also paid for the appt. with her at the same time also. My question is this?  Has anyone out there had to 'self-pay".  I was told the surgery hospital bill would be $20,000 and Dr. Jones bill would be around $5600 I believe. These were discounted (for cash) self pay pt's.  Do all Dr's at St. Vincents charge the same?  Have many of you had to go this route to have the surgery after you were turned down by your insurance company?  So much money, talked to the bank today and maybe able to get a loan (by way of a credit card).  Payments would be around $600 a month, which is alot to add to our budget.  Does anyone know of any Bank, etc. that specializes in Bar. Surgery Loans?  Also I had heard that some hospitals are offering a small medical insurance policy for 'post problems', anyone else heard this?  I am very miserable right now, I am hovering around 300,  I have to stand all day at my job, and my legs and ankles are so huge by the time I get off work, and I am on 3 BP drugs, not to mention others, and  after a sleep test in Feb, I must now sleep with a CPAP!  I know this is so much money, but I am only 57 and have alot of working years ahead of me!  Has anyone who have self paid ever regreted spending that much money?  Seems so selfish of me, but I feel my life will be shortened conciderably if I don't take action soon!      Spike

Hi Spike. So glad to hear from you. I am so sorry that you can't get your insurance to cover your surgery. I think it is a shame that insurance policies refuse to cover wls. Yes, it may be a lot of money to cover but over the course of years a person who is obese (especially morbidly so) will cost them a lot more in the end. I would think that they would figure that one out. The insurance companies can be so stupid. I remember the last time that I was at my wls doctor's office they had a card on the desk about a Capitol One credit card. It said something about surgery. You might want to check into them. Not sure how you would do that but they do have commercials on television.  I hope that I helped you some. Just remember that if God brings you to He will get you through it. Keep on keeping on and tudging the road. Notice I said trudging~it sure isn't skipping and hopping that is for sure! Please feel free to post more often. That way we can get to know you and you us. We love to see new faces!

Sadly, when there's an exclusion for WLS, it's a decision usually made by your employer and not the insurance company.  Every employer gets to decide what they will and will not cover when they enroll their employees ... by excluding WLS, they may get a slightly lower rate.  And it's not just WLS that gets excluded ... treatment for TMJ (a common jaw joint arthritis), addictions, even preventive exams/well child checks can be excluded!  The best you can do is keep yelling at your employer that you're willing to pay a little more for insurance to get more services covered.

You could try Care Credit. They financed my lasik surgery. It was alot less, but I guess it would depend on your credit scores and all.

You can make calls to the Different Drs. but if you liked the one you saw and trusted them well enough to start the process... Shopping around for a cheaper price may get you what you pay for...Think of it this way the grocery bill will go WAY down... you will become a cheap date going out to eat and nibbling off your partners plate.. I am 3 years out and can only eat a full childs plate..I take home an adult plate in leftovers. Your Dr copays will be less...the meds will be reduced or eliminated so little to no copays for those. You will find great clothes at the clothing exchanges 4 times a year and will become sooo satisfied with goodwill when you see the new size you fit into... I think y ou will be amazed at how much paying for it yourself willfit into the budget... If it is what you want.. I am 52 and soooo glad I did it..I ruined my kids life by being fat and having a bad look on food.. I will have so much better time with the grandkids.. Good luck!! Linda Kay

Spike, I had surgery 4 years ago.  I self paid.  I have never been sorry.  It is now paid off.  I was 57 when I had surgery. It was hard financially but I decided I needed to do it to live longer.  Keep researching for loans I would shop around for the best loan deal rather than the best Dr. deal. I was very lucky and didn't have any complications so I didn't have any more expenses for extra procedures.  I knew ahead of time of that possibility but also knew we would figure it out some how. I wish you the best and let me know if you have further questions.  Carolyn

Try www.carecredit.com for a line of credit.  Also, check with your regular bank if they would consider extending you a line of credit or loan for something like this. 

Spike,

Sorry, I don't have any advise on self pay except to shop around for the best loan.

I do have questions about your post though. You said it was your husband's insurance that had the exclusion. If I read the post right, you also work? What about the insurance that your company offers. If you work enough hours to have your company's insurance & they don't have an exclusion, you might want to go that route. I'd check into that because monthly/weekly insurance contributions from your check would be less than a loan payment. You might have to wait until the next open enrollment but it would save you some money in the long run. Just food for thought, calorie free.

Good luck to you on your journey.

Health & Happiness-
Jill

I was a self pay too.  And that quote was exactly what I paid for Dr. Gupta.  St V's is $20,000  and included everything to do with the hospital and the overnight stay (I only stayed 1 night, but it pays for 2 nights and 3 days).  Dr. Gupta was $5,625.  That included everything from the first consultation, the pre op testing, the surgery, and the check ups for a year.  It is financially difficult to pay the monthly bill but it was so worth it!  I would recommend, even though I will end up paying about $125 for every pound I loose!      I would say if it is at all possible to come up with the mony and if your insurance won't pay for it, it is worth it!  My view was I could buy a new car or I could buy a new me.  I opted for the new me and now, only being 5 months out, I already know it was definitely the right choice!  Good luck with whatever you choose! Nikki

Thanks everyone for your input on my  "Self Pay" question.  Gave me some hope and helps me believe I CAN DO THIS!  I will check out the couple credit options that were mentioned.  The retail company I work for doesn't cover Bar. Surgery either, so that was not an option for me.  When I talked to St. Vincent's Doctor Rep she did mention that some of the Dr.'s may have a payment plan for their part, will ck this out further.  I totally agree about this surgery saving money from our budget each month, just my copay on my prescriptions is $100 a month!  This week  I will be checking with another bank we have had loans with in the past . I have practiced  "The Secret" this past year, ask the Universe and it will be given.  Don't know if many of you are Oprah watchers, but I followed this and made my "Dream Board", and it's unbelievable, 4 things that I had pictured on my board have came true this year!  So I am putting my fate in the Universe and God's hands and I know it will happen.  Oh, and one more thing, I love this sight, but I really do need to get a new picture taken, the one I have on now is from a Freaky Marde Gras Party a couple years ago, and everytime I see I scare myself!!!!   LOL