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Caribou ME
on 11/1/07 1:10 pm - Caribou, ME

Okay guys and gals.  Here's my problem....I'm sure most of you have had similar experiences and I could really use some help. In 2003 I began looking into WLS.  My doctor was completely against it. At work one day I overheard someone telling someone else that her childhood friend (the daughter of a dr) had the surgery.  Well just as soon as I got home from work I made an appointment to see that doctor.  I thought if he allowed his daughter to have the surgery why wouldn't he allow me to also?  The doctor was very supportive and he even told me he would have his nurse check my insurance coverage.  I remember him coming back into the room with a smile and said...I'm going to make an appointment with a local surgeon for you.  Do you want a morning or afternoon appointment?  It only took a week and I was sitting in Dr. Jimenez's office.  We discussed my weight and he asked me to work really hard loosing the weight on my own.  I went back to see him a month later and at that time he advised me his nurse would set up appointments with a psychiatrist and nutritionist.  Everything was going well...so I thought.  At this time (2004) his nurse checked my insurance and discovered my employer had a no weight loss surgery clause in the plan.  Well it's 2007 now and I'm still paying for those expensive doctor appointments.  boo hoo. January 1, 2007 I began a new job.  About a month ago I looked in the mirror and realized I didn't like what I saw.  I also realized I avoid those stupid mirrors because of my weight.  So I contacted my new insurance company myself to see it this surgery is covered under my plan.  I was told yes.  Yippie!...Sorta.  My plan has a $5,000 deductible then I pay 30% and I have a $10,000 maximum oop.  Now I don't know how much this surgery costs but I do know it's going to cost me more than $10,000 once I pay those specialist copays, travel, etc. How do you all pay for your surgeries?  Remember I'm still struggling to pay those medical bills from 2004.  3 insurance plans and 3 years later I'm finally covered but it's the crappiest coverage I've ever had. Does anyone have any suggestions for me?  What am I to do?  I've looked at ads for medical loans and they all talk about how low their monthly payments are.  Then I discover what they call low is actually $300-$500 monthly.  Gee if I had that much extra cash every month I wouldn't still be paying all those other bills...not to mention I'd go to a bank to get a personal loan with lower interest rates. So what direction should I go now?  Has anyone ever negotiated costs with their surgeons?  What about payment plans with their surgeons?  I owe both Cary and TAMC money already so I don't expect any help there. help! Help! HELP!   

 

 

 

Cinderella83
on 11/1/07 5:05 pm - Anson, ME

Wow, you've definitely had time to put some thought into all this.  It's sad that the insurance companies dictate our health care more than our doctors do these days. I believe my RNY surgery bill was about $32,000. Ouch!   I started my wls journey with one insurance company that denied me twice and ended with a new insurance company that approved me in 1 day.  The differences in insurance companies and plans is crazy.   Some surgeons and hospitals will work with you on a payment plan, so that's definitely worth checking into.  Be cautious with medical loans....the interest rate could cause you a heart attack!   Any possiblity that you can upgrade your insurance plan to one with better coverage?  Most company's have several different plans and your employer is the one who chooses which one to go with.  But occassionally, you can upgrade individually, so you might want to ask your insurance company if that's a possibility.  Another option, depending on how serious you are about having the surgery, is possibly refinancing your home or taking out a home-equity loan.  There are other costs involved, but you can have up to 30 years to pay it back.    Also, check with the surgeon or hospital to see if there is a "cash" price.  Sometimes there may be a discounted price if you pay cash.  This is helpful especially if you are taking out a loan.   If all else fails and you can be patient......hold lots of garage sales, do odd jobs for cash,  for Birthday & Christmas - ask for $ towards your surgery, work an extra part-time job with all the money going towards your surgery fund, etc.  Creativity can help in this area.   No matter what, NEVER GIVE UP!!!  There is an answer out there.  Keep looking!   I'll keep you in my prayers.  Blessings, Yvonne  

 
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