RNY without insurance coverage

I am so frustrated. I have been going back and forth with my insurance company being told numerous times that Gastric Bypass would be covered but my provider felt we needed it in writing. Last Friday my provider called said they received what they needed and it was covered and we scheduled all my pre op visits. I was over the moon excited. Today they called and said it was a mistake. This has been such a roller coaster. I am still interested in moving forward and paying out of pocket and getting Blis Coverage. Can anyone who has done this tell me how much it cost and where you had the procedure done? Thank you -

I know this is so frustrating and it is definitely a roller coaster. But, this is a hard question to answer without there being many factors taken into consideration. Each surgeon's cash price will vary and you will want to find out if they have all-inclusive pricing which would include your hospital and anesthesia. Some do, some do not. Depends on if they are an employee of the hospital they operate out of or are just privileged there.

In our experience, cash pricing in the US is best in Nevada. However, if you are willing to go to Mexico, you can get all inclusive for under $10k depending on the surgery type. If you would like assistance in getting more cash pricing info, please feel free to email [email protected] and our Member Service team will be happy to assist.

Wishing you the best,

I would contact your insurance company directly and ask them to send you/ highlight for you the portion of your policy that covers bariatric Surgery.Usually either they do or they don't.

Part 2 though is their requirements for qualifications - BMI, Comorbidities etc... again information you should be able to get from them, so it wouldn't be such a mystery as to why they are saying no. It also helps you fogure out if there has been an error somewhere that they are missing in your case.

Good Luck!

My insurance did not pay for my gastric bypass. The good thing about being self pay you have a choice for your surgeon, hospital, program. Check out other surgeons in your area. The surgeon is important but you need aftercare (support groups, cooking classes, dietitians, exercise program) Luckily my local hospital has a great program. It was expensive but worth it!!! Ask your surgeon for the self pay price.

First appt with surgeon was $165, dietician $65 first appt ( afterwards $45), $400 for psychological evaluation,

Gastric Sleeve Procedure $17,000.00- (CPT 43775)

OR

Gastric Bypass Procedure $19,000.00- (CPT 43644)

The above prices include the facility and physician charge only

My insurance paid for anesthesia

*All pricing for procedure/physician and facility has been discounted at 70%

**Anesthesia and the Surgical Assist is NOT included in the above amounts**

Post-operative office visit (90 DAYS AFTER SURGERY DATE) and follow up visits -$59.70

I would NOT go to Mexico!!! Stay close to your house/city or state.