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Just curious...why do you suggest I avoid those places? So far the research I've done indicated lots of positive feedback in those facilities...? Do you have any suggestions? The doctors seem to be pretty practiced. The prices are in various ranges.
any feedback would be awesome!
That is probably the case...Thanks! I'm already going through the process of getting it done in Mexico. lots of great reviews of the doctors there, the facility is state of the art---hopefully will get it done by end of July. This was my plan all along if Ins refused to cover it....Thanks for the response!
on 5/22/13 2:41 pm
You also have to remember the surgery is not MAGIC---you will still have to make ALL the changes we 'hefty' people don't want to do...being on a diet will basically be a way of life after the surgery. but yes I think all the hoops they make you jump are a drop in the bucket in the "Big Picture". If you want it, just do it...do whatever they ask you to do...My insurance made me do the whole diet, psych evaluation, support group meetings, nutritional meetings..etc..etc...then they tell me "too bad, so sad...we're not covering the procedure!" WHAT?!?!?! So believe me I'm more pissed than you are...but you know what...I'm going to look into getting it done in Mexico...I hear it's not bad at all...so please keep up the good fight and get it done--if it's what you truly want, do it...anything worth having takes work and effort. I wish you all the luck!
Sorry you have to deal with this.
Surgery in Mexico is not bad, not bad at all but you have to do your research. Avoid Tijuana, juarez, and Monterrey. Don't shop by price but skill instead. It is probably more true in Mexico than anywhere that you do get what you pay for.
on 5/22/13 2:36 pm
How did you get CIGNA to even review your paperwork? I finished all the "steps' to a tee...and when the hospital submitted the paperwork, they denied th case saying CIGNA doesn't cover WLS?? That the person the Hosp initially spoke to and said they did was wrong---so after more than $500 in tests and fees and co-pays...I'm nowhere near getting this done...I almost cried...Just curious I suppose.
Cigna does cover WLS but perhaps your policy does not. WLS is an additional rider on your policy, it is very expensive. Most employers do not wish to pay for it. They can't just cover one person, it's all or none. Without that rider you won't have WLS benefits. Most do not. :o(
So Cigna does offer WLS benefits, your employer apparently opted not to purchase the rider.
Is your policy a group policy or an individual policy? Most, if not all, individual policies exclude WLS. If you have an individual policy, then this is the reason that you can't get CIGNA to review your paperwork. I'm not sure there is anything you can do to get them to change their decision on this.
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
You can deduct medical expenses (even mileage to and from doctor & hospital) in the amount over 7.5% of your adjusted gross income...but this is an item in your ITEMIZED DEDUCTIONS---if you do not itemize (meaning you use the standard federal deduction) then the amount is moot. go to the IRS website, print out a schedule A---this is where you would itemize your expenses (it's really NOT rocket science) fill in as much of the line items as possible (property taxes, mortgage interest, etc, etc...) if the end amount is bigger than your Standard Deduction...then you use that---this will only reduce your taxable income---meaninbg the amount of your income that taxes are calculated on. So the bigger the deductions the less you pay in taxes. Also remember that medical expenses also include insurance premiums, contact lenses/glasses, dental expenses, any medical equipment or appliances (braces, crutches, etc) that you pay out of pocket for, co-pays...the IRS website www.irs.gov has a search box just look up deductible "medical expenses" there's a wealth of info there.
Hope this was clear as mud! Sandra
You also have to remember the surgery is not MAGIC---you will still have to make ALL the changes we 'hefty' people don't want to do...being on a diet will basically be a way of life after the surgery. but yes I think all the hoops they make you jump are a drop in the bucket in the "Big Picture". If you want it, just do it...do whatever they ask you to do...My insurance made me do the whole diet, psych evaluation, support group meetings, nutritional meetings..etc..etc...then they tell me "too bad, so sad...we're not covering the procedure!" WHAT?!?!?! So believe me I'm more pissed than you are...but you know what...I'm going to look into getting it done in Mexico...I hear it's not bad at all...so please keep up the good fight and get it done--if it's what you truly want, do it...anything worth having takes work and effort. I wish you all the luck!
How did you get CIGNA to even review your paperwork? I finished all the "steps' to a tee...and when the hospital submitted the paperwork, they denied th case saying CIGNA doesn't cover WLS?? That the person the Hosp initially spoke to and said they did was wrong---so after more than $500 in tests and fees and co-pays...I'm nowhere near getting this done...I almost cried...Just curious I suppose.
I agree, the secondary is not going to pay before the primary pays. You will need to meet the requirements of both insurances and the primary will be billed first and the secondary second. I am also double covered and that is how it works. My visits are covered by my primary first and then by my husband's insurance (secondary).
good luck!
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
on 5/18/13 4:48 am
Self pay in Mexico is cheaper than going through your insurance. :( However, IF you do your research it is very safe. But as i told you in the revision forum, different states vary in laws of how they can code. Some can do a revision and the ins only pays for the band removal and some states are not permitted to change coding. Sounds like your state is one that is unable to change coding.