Self pay not a good idea?

So, I call Aetna and posed the question:

If I were to self-pay for WLS and had a complication like a leak, etc., would Aetna cover?

The lady called me back this morning and said 'no' that  the only way they would cover it is if I had Pre-cert on the surgey.

Now I'm convinced it could be really stupid of me to ignore the *what if-s* in this kind of scenario and self pay and be on my own as far as any future issues.

Anyone else had this dilemna? Thoughts or perspectives to share?
Thanks

I was a self pay.

I also have has the great experience of being a RN for 2 bariatric surgeons and dealing with insurance crap.

If Aetna covers your surgery, let them pay. You can get approval in 90 days. You need to read the policies for their 90 surgical preparatory program. Then it's all covered.

Many surgeons assume that the patients need a 6 month diet. Aetna is different. You can do a 6 month diet OR a 90 surg prep program.

As a cash pay, I knew I was walking in and would walk out. Although I was big, I was young and relatively healthy. I worked 12 hour shifts as a nurse. Barring a surgeon's slip up, my chances for complications were less than the published percentages.

If you have a lot of heath conditions, or are really big, BMI higher than 45, you should have insurance, because your risk for complications is higher than mine was.

Good luck!

Bonnie
RNY 6/3/05
264/150