Denied....Questions for Self-Pay RYN patients
Hey everyone,
I have been told that my insurance won't cover WLS under any exceptions. I have even been bugging my insurance lady at work about trying to add it but her person that she's been talking to that actually handles the insurance company said that they won't even consider it, which SUCKS. I am now going to look into doing self-pay.
I do have some questions to anyone that has self-paid for the Lap. RNY.
1....Has anyone had issues after the surgery, non-surgery related, that your insurance won't cover or gave you a hard time about because of the surgery? I am worried that if I have other issues not related to the surgery that the insurance will come back and say they won't cover it because I did self-pay on the WLS.
2....For those who went out of the country for the surgery: Would you do it again / recommend it to a family member? What were some pro/con's of going to Mexico to do it? Do you have a doctor here that you have been following up with?
3....With self pay, where did you go to get the money to pay for the surgery? I have seen the Health care credit cards that have pretty high interest rates. I have also seen health care loans with high interest rates. Unfortunatley I'm not lucky enough to just have the money lying around to pull out and hand it over. If I did, I would have done it long ago.
Thank you everyone for your help in trying to figure out this information and your support.
Tina
MyNiceSpace.comBarb
I did have to self pay. My insurance which was Cariten had an ironclad exclusion. They had even been taken to court over it (not by me) and had won. So, I knew better than even try that route. I looked into my husband's BCBS of TN policy and his company had added an exclusion as well. The exclusions are not by insurance company, they are by the company that you work for. And, there are actually pretty good reasons for them. To add WLS to a policy can cost over $100 per month per person. Of course the company will pass that cost over to the employee. The way they see it, why should 90% of their employees who don't need the surgery have to pay extra each month so the few can have this benefit. For us, that sucks, but for people who don't have to have the surgery, it makes sense.
Now, back to the self pay. I went thru www.capitalonehealthcarefinance.com . I got an interest rate of 9%, if I remember correctly. They have a limit of $25,000 for surgery. I borrowed it all. I am paying over $500 a month for 5 years. I also had to take out money from savings and 401K because I had to have a Greenfield filter placed the week before surgery that cost an additional $10,000. I had to have that because my BMI was over 50 which more than doubles the risk of pulmonary embolus. Would I do it again-absolutely! But, every month when I make that payment, I remember that I better not screw this up! As far as complications, I had a seroma from my surgery 10 days out. Since I had surgery 4 hours away, I went to the ER here where I worked. The bill was about $6000. Cariten paid every penny even though it was a complication. Boy, did I thank God for that!
It is a hard decision to selfpay for this. But for me, I was pretty sure I only had a couple more years to live and certainly less than one until I was wheelchair bound. I was planning on buying a new car this year, but I will keep driving my paid off 2002 Toyota until this note is paid. Hope this helps!
Marilyn
Marilyn
Smoky Mountain Obesity and WLS Support Group
1/17 6:30 LeConte Medical Center
I am sorry to hear about the insurance exclusion. I know how disappointed you feel..
Have you been to any of the WLS seminars at any of the area hospitals? I attended every seminar at each hospital (a few times LOL) and I remember them handing out to us information packets that included Self Pay Options and Financing available... just a thought....
Don't despair..I know that is easy for people to say isn't it? I know you have wonderful family support and somehow there will be a way..... You have your board family too that will help in anyway they can...
If you are asking for votes my vote is NO for Mexico......Trina
I have already put the out of country thought out of my mind. Mom and Dad don't want me going. I know I have a lot of support with them, stacy, and the board family. I'm not giving up. Now I just need to figure out where to get the money. Mom is helping me with that.
Anyone have any extra just laying around??? LOL
I'm going to talk to a loan officer at work and hopefully get something that is low interest through them.
Thanks everyone for your support.
Tina
