Please help! Crushed! WLS excluded. Cost of self pay????

 I have been researching wls and have decided on the Roux-en-Y.  I even went to a couple of seminars and then my insurance got changed Jan 1 and they have a wls exclusion.  Yes, I did call them, twice, just to be certain, and its definitely excluded. Two Boston hospitals I contacted charge between $30,000 and $40,000.  Roger Williams in RI quoted me $13,000 for surgeon and hospital. (WOW!)  Did anyone have surgery at Roger Williams?  For those of you who self pay, what were your total costs?  Seems like lots of people self pay, but I am concerned about how I would be able to afford costs of complications on top of the surgery.  I was so excited about scheduling this at the beginning of the year and would like to get going as quickly as possible.  Took two years to make the decision, now I don't want to wait another day!  Thanks for any input!

Be really careful being self pay (I have been self pay twice) and additional costs. Doctors make it sound really inexpensive in comparison to other surgeons but they aren't typically including pre op testing, radiology fees, post op labs, nutritionist, or extended aftercare. Those costs add up in a big huge hurry. It is many thousands of dollars. The $13K sounds very misleading to me.

I'm going to throw something out there. Since you are self pay have you considered a sleeve? I'm not suggesting one surgery type is better than another, I'm thinking cost. The sleeve has the fewest long term risks and complications of all WLS types thus, it's cheaper long term. Will your ins pay for bypass labs for the rest of your life if they don't cover the surgery type? Sometimes they do and sometimes they don't but the first year with bypass you'll need your vitamin labs checked every three months due to malabsorption and that is thousands of dollars in cost. Then you'll need them every 6-12 months for the rest of your life after that. With a sleeve it's not malabsorptive so you don't need the mega vitamin labs. Those labs would be a lot easier to slide through insurance without their realizing they are paying for labs due to bariatrics. (The less they know the better.)

With the sleeve there is no aftercare, nothing. The weight loss is about the same as bypass without the extremes of bypass. It's a less expensive surgery, fewer complications, safer long term.

I'm not cut out for malabsorption due to vitamin issues. I simply wouldn't take them as I am supposed to. With the sleeve all I need is a multivitamin twice daily. That's it. Now, merely because I am female in my 40s I take Calcium Citrate as well but not because of the surgery, but because all women pretty well need calcium.

Sorry to hear that your insurane situation changed, that is a real bummer!  But, you are thinking about all the right things! You want to look at the whole picture of being a self pay patient - how much is pre-op costs (labs, EKG, etc) the actual surgery costs (hosptial, anesthesia, and surgeon), and the potential for costs of complications. It sounds as if you have already picked your surgeon, but may I offer a suggestion? Look into BLIS and see if there is a BLIS surgeon near you. The reason is that BLIS Surgeons are uniquely able to provide complication protection inlcuded in the price you pay them for surgery. This program works like a warranty, not traditional health insurance, and in the event of a complication, steps in to pay the medical bills for the care that you need that is authorized by your BLIS Surgeon. It will provide you with some peace of mind! Some BLIS Surgeons also have patient financing programs so that you can get surgery right away and pay off the cost of surgery over 48 months - a much more flexible and affordable way to pay for surgery! I hope this helps you and I wish you the best of luck! Let me know if you have any questions! Billie

Wow.... are you trying to steal some poor doctor's patient?

Tisk....

Not at all...I'm just to make sure that patients know they have options. And that there is a way not to be concerned about the potential cost of complication related care.  I only repsonded that way because there seemed to be a specific concern about just that and they should know there is a solution out there for some peace of mind. That being said, having confidence in your surgeon is of the utmost importance  and patients should always pick the best surgeon for them that meets all their needs and someone they feel comfortable with. I'm just trying to be informative and helpful!