Insurance change in 2020

Hi All,

I've recently started REALLY thinking about gastric bypass as a viable option for me. I've never really wanted to consider it before but I just can't seem to get anywhere on my own and now I'm 300+ lbs and every expanding :(
I just called my insurance and get this...this year they covered 100% of the procedure. Next year they will only cover 40%. WTF?!? Obviously this year isn't even a choice as it would take way longer than 2 months to even get approved.

It's open enrollment now so I could try to change insurance (I have a sky high deductible anyway $6,300) but even doing the research to see who and what plans will allow me to stay with my doctor and understand the monthly fees vs. the benefits is so complicated that I my head spins! I pay $471 a month now and next year my same plan will be $538! Unreal.

I'm not sure what my question is exactly other than in California, is there an insurance any of you would recommend to cover this type of surgery?

Thank you,

all insurance companies cover it. The thing is, your employer has to buy the rider for the coverage for their employers. It is expensive coverage and that is why many companies do not buy the coverage.

You will just have to research what is available to you and see if there is one that covers it. Many people in the US who do not have coverage get their surgery done in Mexico, so that is another option to research.

Thank you, and you're right. Somehow researching insurance sours my mood for days on end lol.
I do live in San Diego so Mexico is a real option for me if it's done close to the boarder. I'm not sure I'd have the courage to go to another country for this. Elective surgery is scary, and this is one that from what I understand can have several complications.

I really appreciate your thoughts, it's another piece of the puzzle to sort through.

I had surgery in my and had no complications. You need to be aware that complications can occur in the states too or anywhere else. But certainly having insurance to cover any comp relieves a lot of worry about it.

My friend had her sleeve done in Mexico as did her 15 year old daughter. The experience was wonderful for them both. Very clean facility, better than the US by what they said. So that can be an option.

Hiring a very good insurance agent who can help you navigate the insurance field in your area may be something worth wile for you. But if your employer offers group insurance, going for individual insurance may not offer you the choices you would like.

note the "a very good" insurance agent. Because anything other than that - you basically would contribute to someones earnings while they do really do much work for you. And getting them off your account or getting a new agent can be difficult.

Call your insurance company and ask for the coverage guidelines. If your insurance plan doesn't require a supervised diet, it may actually be possible to get everything together and be scheduled before the end of the year. Odds aren't great, but it couldn't hurt to check.

If your deductible is over $6k, you might want to look into surgery in Mexico. In Tijuana, the price for a VSG is $4.6k and an RNY is $6.5k, so it would probably work out to be cheaper. You'll just need to make sure you can identify a surgeon in California who is willing to handle your after-care.

https://www.tijuanabariatrics.com/cost-and-financing