crushed

One thing to consider is taking a loan from a 401k if its allowed by your plan.  That's how I'm paying for my surgery rather than using cash.  The interest rate is 4.25% but I'm paying it to myself (i.e., it goes back into the 401K). That offsets some of the lost appreciation - presuming the stock market continues to do well.

Financial experts will generally argue against tapping your retirement savings; however, you have to be careful not to be 'penny wise and pound foolish.' There are credible statistics that suggest WLS pays for itself, on average, within the first year or two in terms of reduced medical expenses (medicines, co-payments), and honestly, the cost of food.  It wasn't cheep to maintain my weight at 291lbs. 

Insurance companies make actuarial decisions -- costs vs. benefits.  They pay for WLS, generally, because it's cheaper in the long run than obesity related disease. They will exclude WLS from coverage or make it expensive for employers up to the point where the actuarial models tell them differently. 

Some employers exclude WLS on philosophical grounds because obesity is to a certain extent a self-inflicted wound -- ultimately we all lifted fork to mouth.  Why make all the employees pay higher premiums as a result?  You can say the same thing about smokers, of course, which is why many employers are charging higher premiums for smokers or not hiring them in the first place.  Obesity is tougher. In some cases it's considered a protected disability under the ADA while not in others.  That means differential pricing or 'discriminatory' hiring (at least overt) are not so much an option.  Excluding certain coverage, however, is a means of keeping costs at a minimum. 

 Unfortunately, I've read each page over and over on the benefit book and it isn't covered anywhere else.

I too, love a spiteful ******* when the time is right lol.  

I did some research last night about Dr. Alvarez down in Mexico.  He seems to be who most people go to when they go down there.  I'm trying to sell my husband on that idea but his issue and I quote " I can't just sh*t out that much money".

He feels bad because he was 100% supportive in my choice to have WLS and he said he would talk to his HR on Monday but I told him that there is pretty much nothing that could be done.  

What really ****** me off, and I'm not starting a debate of any kind lol, but his policy will cover abortions if I'm not mistaken.  I anti-abortion unless it is necessary.  That's all I'm going to say on that.

So really, his company chose to include that policy but not the one that could provide me with a better lifestyle so that I can see my kids grow up and play with them.   

Part of me wants to be selfish and use part of our tax return.   But I doubt that would happen.



I just want to thank all of you for chiming in.  The benefit book I pulled right off the BCBS of AL website.

I have BCBS of Michigan, and on the website I could not find anywhere that it covered WLS of any type.  Just call the number on your BCBS card and speak to member services.  It couldn't hurt.  Then you will know for certain.  Don't go by what they have on the website.  I had my surgery this past Thursday, and if I had gone by what the website and online handbook had said, well I wouldn't be on the losing side now!  :) 

Hey Britt..!

The first thing I want to say, is you are heading in the right direction..You know what you want and you can make it happen..!
I am living proof of this statement (with the help of God and my determination)

There is not a lot of members, any longer that frequent the boards, that was here when I first started my journey into this surgery, but the ones that are still here, I'm sure, remember the MANY post I made about my struggles to have this surgery.

NO insurance and depend on my husband for EVERYTHING. He would tell me, we are going to get you that surgery..we just don't have the money right now...Give me a little more time..maybe next year...blah, blah, blah...this went on for almost 2 years..Promise today and take it away tomorrow..I was depleted of any confidence in my husband after begging and being let down time after time...I came here posting let down after let down, not knowing where to turn or HOW to get things going into the right direction...

After praying and seeking God's help and guidance for months, I went on line and took out a loan to have my surgery and when my husband came home one evening I told him of what I had done and that NO MATTER what..I was having this surgery..I told him that I knew IF I didn't have things done and done soon , I was going to be very ill, even critically ill, if I didn't have things done and fast and that would cost him a lot more money in the long run and I knew he would not want that...What cost $5000 for sleeve surgery..$800 for two plane tickets was nothing compared to what heart failure and surgeries for that would have cost and other health issues, as well down the road..He didn't like it and was very upset with me, but what was he going to do..divorce me..Oh well, is the way I looked at it..I had to get something done and I could see he was never going to say yes..NEVER..!

There is waaaay more to all this story..I only gave you a shorter version just to make a point..YOU are in control of your life..Your husband loves you I'm sure, but To me, he can only see the money side of things as they are now..He doesn't see what can and will happen to you and your health IF you don't get help now...You have started the ball rolling in the right direction..Weigh EVERY option, turn over EVERY stone(so to speak) and don't STOP looking for the right answer and solution for you..

You mentioned tax money..What better way to benefit you and your future and your children's future, than to use what is rightfully yours (half) for securing a better, healthy life..

Do what YOU have to do to get the HELP you need for you and your children..YOU can make it happen..DON"T GIVE UP...Every day keep looking at ways to make it happen..DON'T STOP..!!
YOU ARE HALF WAY THERE..!!

CHEERING YOU ONWARD..!

cyndy

So sorry you are feeling so crushed!!  I can definately understand how hard that would be.  I think the idea of Mexico is a great one.  If my insurance would not have covered it, that's what I would have done.  Out of pocket in the US is way to expensive.  I read about a poor women that took out a $17,000.oo  loan for her surgery, only to have the surgery then get a bill for $54,000 more.  The Mexico packages seem to be all inclusive, and there are many people on this forum that can give you really good advice on whch Surgeons are the best.  This would be a small loan compared to buying a car!  I know the thought of loan sounds hard, but it would be well worth it.  Hang in there & never give up, it will happen.  God Bless

Christy

It would not  be selfish for you to take some of your tax returen and do this..Infact in the long run it will benefit your whole family.Im taking some of my tax return to pay my out of pocket and decuctible and putting some back for my BOOBIE savings LOL...Most of us women never do for ourselves dont feel bad or selfish..Do something for yourself..If it takes going to Mexico, make sure to do your research but i have seen many on here go to Mexico and have wonderful results..I say go for it! Many more good things will come out of you getting healthier,and feeling better....Good luck

Consider this, too:  If you use that tax money to do this, you'll be able to claim your expenses (ALL your medical expenses this year in fact, added to this) on next year's taxes and probably make up for it. ;)

I was in the same boat. My employer excluded anything weight-loss related in their policy....so I went to Mexico.

I took out a loan from my 401k like another poster suggested with low interest and I paid MYSELF back the interest. If that is an option, I highly recommend it. I don't think it is selfish at all to use your tax returns either. I have saved SOOO much money on food and dr visits, meeds, etc since surgery, it will easily pay for itself.

You mentioned Dr. Alverez. Yes, many people have used him and have loved his services and results. He was top on my list when I was considering physicians and then I found Dr. Aceves and his stats were amazing and he was actually cheaper. I believe when I was considering Dr. Alvarez, he was $9,500 and when I had surgery with Dr. Aceves, I paid $8,750. I believe that is still his going rate. (Plus plane tickets.)

I couldn't be happier with my decision to have this surgery done. 20 weeks out I am down 78lbs and down from a 26/28 to a 18/20. I was so grateful for a husband that actually wanted this for my health more then I did and was willing to do whatever it took for me to have this surgery. He has sacrificed a lot. Now we go more places and do more things together with my new found confidence and energy. We workout daily together, eat healthy and our relationship is better then ever.

If you can work it out, you won't regret it.

 There was a statement similar to this in my insurance policy yet my insurance policy DID cover my sleeve.  Don't give up.  Give them a call and maybe even have your surgeon submit a pre-approval claim to see if it will be accepted.  In other words.....don't go down without a fight.

 You know, you are right, we as women don't do for ourselves.  We put our family before us.  That's my case.  I have always done for my family, esp my children and rarely have ever treated myself.  

I didn't know that about the medical expenses and taxes when filing next year.  Interesting.  I may just do it now! lol.

I'm going to let it sit for a day and do my research and then I'll talk to my husband about it.  I could tell last night as I was talking about it, he was kind of giving me that " she's setting herself up to be let down" look.