Insurance Drama

So I got a bit of bad news today and not sure where to go from here, so am going to post it on here in the hopes that someone out there has an idea for me and I am not just a lost cause.

I had been trying to get WLS for a few years now. My problem isn't that the insurance doesn't cover it, it is trying to find a doctor that accepts it. I finally got in to see a surgeon this year but now they aren't contracted with my insurance anymore. During this time I found this out, I had been researching a different procedure, the DS, and it sounded like the best one for me. This surgeon doesn't perform the DS anyways so I wasn't too bummed. Off to find another one.

Well, no one, and I mean no one, in my city (the state capitol >

 My suggestion is to cross reference the vetted DS surgeons from dsfacts.com with your insurance. I know there are several top rated vetted docs in CA. Perhaps some are within a reasonable travel distance.

Be glad your insurance covers it. I have the added problem of an exclusion clause, so I am trying to find a way to self pay with a vetted surgeon.

 and for me the closest vetted surgeons are 3+ hours away via car. I guess if it were easy, then I guess I wouldn't be prepared to stick to the life style changes after the surgery.

Hmm for some reason it didn't state my entire post. >
< I tried to get on my husbands insurance but that was a no go. Any advice is appreciated

Hm it still won't post what I say, maybe I am entering html and not knowing it lol. Lets try this again.

Insurance rep on the phone says anything medically necessary is covered. However, I can't seem to find a doctor who accepts my insurance in my city, sacramento, or even san francisco. Each time they say they are not contracted with my insurance or just simply don't take my insurance. I am not sure what to do at this point. Being on disability I cannot qualify for a loan and neither can the husband. I also cannot get on his insurance, which, happens to cover the surgery, until he gets promoted, which isn't going to happen because he has 2 jobs.

Anyone know anything else I can do for this? My insurance only works in california.

 Will your insurance pay out of network?   I am in a similiar boat.  My only option is to self pay. I am currently trying to find a way.

Maybe you should start with your PCP to write the appeal letter, that was the recommendation from all the surgeons' office I contacted.  Once you get your approval, something might become available.

There are a couple drs in southern CA too.

See, they haven't officially denied me. I was seing a bariatric surgeon, even though they weren't the surgery i wanted, but then suddenly find out the hospital isn't contracted with my insurance anymore. I really want the DS but I'm afraid I am not going to get anything now.

Do you know off-hand how much out of pocket is? I know there is the surgeons fee and the hospital. I doubt my insurance would pay for the hospital part if they wont pay the surgery part? lol. Well they would pay just no dr will accept my insurance Makes me feel like I have the plague or something.

 prices vary even among the top ten vetted doctors. You should find three or four good choices, regardless of location,and go from there. For me and my medical issues, it is DS or nothing. Dr Stewart in TX has rates that are very reasonble and comparable to going to Brazil. There are options available, you just need to do your research and choose what is right for you.

Have you tried looking at the in-network doctors to see if there are any bariatric surgeons in the group?  Also look at which hospitals are in-network.

By doing this maybe you can strike pay dirt and find someone who is covered that uses a network hospital.

When I looked online, there wasn't even a bariatric surgeon category. So I looked under surgeons and some of the names on there I knew to be bariatric surgeons but unfortunately when I called the office said they don't take my insurance. And I believe I found that using a state wide search instead of an in-network search. Anthem is confusing that way lol. The program I am part of only listed doctors in my city, which had no bariatric surgeons at all, let alone any that did DS.