Insurance coverage vs. self pay

I looked at my Regence BC/BS benefit for obesity surgery and it is listed as an exclusion, including follow up visits. I'm bummed. I wonder, since so many say their BC/BS now covers it, if mine might as well. I am in the PPP plan through OSCPA. Anyone here have the LRNY who self paid in Portland? If so, how much did it cost?

Kim, just recently found out that my Cigna insurance dosent cover any obesity services ( what a crock) I did alot of research on line before I made the decision and the thing I found is that Cigna was not that bad to get it covered, I just didnt know that mY husbands employeer chose to not have obesity services written in, So its not the insurance at all its my husbands employeer, I to am searching for self pay information, I really felt the bypass was the way for me to go but now Im looking at the band just becouse of how much cheaper it is,, any way lets keep in touch and share information,,

I have some links to finance companies that you might try. If you send me an email tomorrow at [email protected] I'd be glad to send them too you. These are companies that do medical procedure financing. I'd post them, but they're on my other computer lol. You might check out the WISH center in WA State. I 'hear' they start around 10 grand...but don't quote me on that Best of luck!

Kelly, Good luck in finding a way to make this happen. My boyfriend has CIGNA and I wonder if he would be covered. I know he has alot of weight to lose. Way more than me, but I don't know if he would be interested in looking into it.

I have some links to finance companies that you might try. If you send me an email tomorrow at [email protected] I'd be glad to send them too you. These are companies that do medical procedure financing. I'd post them, but they're on my other computer lol. Best of luck!

Thanks for the info. I do have an alternate source of funding already.

What is the OSCPA? I know for state employees they started paying for bariatric surgery this year. HTH. Dina

OSCPA stands for Oregon Society of CPA's. We get our group medical benefits through their contracted plan with Regence Blue Cross.

I just self payed for LRNY. My surgery was 09-07-06. Once I decided that I wanted to have the gastric bypass I was shocked to learn that our PPP Blue Cross/Blue Shield Plan did not cover it. I made lots and lots of phone calls. The state program did add this surgery as a benefit in January 06, as well as Medicare added it. The Public Employees, my husband works for a school district has not added it. I was told every October they review benefits and asked if they thought this would be added. I couldn't get a clear answer but was inclined to think not. Dr. Hong my physician thought that in the next 2 to 3 years we will see alot more companies comming on board. I had another little lift when my employeer started offering benefits last June but then found they also did not cover Gastric Bypass Surgery. My husband and I have an equity line of credit that we added the cost of this procedure to. I haven't got my final hospital bill yet but anticiapate the entire amount to be around $30,000.00. My insurance did pay for all my blood tests, 2 sleep studies, cardiac stress test and ultrasound and colonoscopy that my physcian wanted me to have. I included the $1,500 in co-pays to the final bill. Other thoughts that I had about possibly lowering the costs of the procedure are: on next years taxes I will be able to write off medical costs. With the amount I've paid in we should receive at least $5,000 back in taxes that we otherwise wouldn't have gotten, so I figure that is a savings. Also, since we borrowed on an equity line of credit all the interest we pay into will be tax deductible and that is a savings. I will be checking with my accountant to see if there are any other tax benefits. Good Samaritan Hospital financial staff said that if I pay my Hospital Bill in Full within 30 days of surgery I will get a 10% discount. If I didn't have any insurance (even though mine didn't pay for it) I would have been eligble for a 15% discount. I am going to argue this point a bit. I know insurances disallow alot and I won't be happy about paying more than my insurance company would have. Also, as another little savings, while calling Brian the financial advisor at Good Samaritan to pay my deposit before surgery he suggested that I put all my payments on a miles Credit Card and then pay the card off with the loan I received. I didn't have a miles credit card but promptly switched the one I had to airline miles. So when everything is said and done I will possibly have a trip or two to celebrate the new me. The last time I was on an airplane I had to ask for an extender belt in which the stewardess went down the aisle asking people to check and see if they had one in their seat pockets. (Very embarassing) Believe it or not this was one of the turning points in my decision to have this surgery.