Mexico - an answer to insurance bait-and-switch.

Stop me if you've heard this one. A year ago, I made the decision to have WLS, and called my insurance company to check on coverage. The confidant reply (via phone - no committment in writing) was "No problem, we cover it if your doctor says it's medically necessary." A couple of months ago, after spending thousands of dollars and months of time on tests and preliminaries, I was ready for surgery - except for getting the formal precertification. Not only did American National decline, but when I pushed them a little with a lawyer, they rescinded my coverage, sticking me with tens of thousands of dollars in medical bills they had been dragging their feet over. I'm now in the middle of a Chapter 7 bankruptcy. So, I approached the hospital where the surgery was scheduled, inquiring about self-pay prices & options. They wanted $60,000 up front, and said it could run to as much as $200,000. No, thanks. This was Tampa General in Tampa, FL. After a lot of shopping and research, I found a clinic in San Antonio that does an open RNY for $15,000.00, including everything - hospital, anesthesia, surgeon, everything. This is the self-pay price, and I thought it was pretty fair. I was going with the open procedure for cost considrations - the lap procedure was a lot more. A few days ago, after being referred through a friend, I found a very reputable surgeon in Brownsville-Matamoros, named Rene Perea. Dr. Perea prefers to do lap-band, but after some discussion we agreed on a lap RNY. The price was a lot less than San Antonio, and I feel good about the doc, his staff, and the facility. Surgery is in about two weeks, September 2. Anybody else had or planning a RNY in Mexico? Comments, advice?

I basically had the same thing happen but I was just in the beginning of the process when the State of Texas went into budget cuts and put and specific exclusion in the policy stating that even if Medically Necessary it would NOT be covered. I began doing research and i found a Dr. in Mexico that is charing my 6900.00 for the surgery including hospital stay. He does the open RNY... I have no problem with the surgery nor do I have a problem with using a Mexican Dr., because the insurance companies in the states do not want to cover the surgery and I am sorry I don't have the funds to pay that kind of money for the surgery. I don't know if they don't realize that they would end up saving more money if they would allow us to go on and have the surgery. Good Luck to you and you will be in our thoughts and prayers...

I had a laparascopic RNY (Fobi pouch) done in Monterrey, Mexico on 22 July 2003, with Drs. Zorrilla and Zapata. The total cost, including hospital, was $12,500. I also paid around $350 for pre-op tests the day before (xrays, sonogram, bloodwork, EKG, etc.), as well as about $450 for a hotel for a couple of days before surgery, and for three days after discharge from the hospital (surgery on a Tuesday, discharge on Friday, return home following Monday). My plane ticket from northeast part of the country was about $500. I have Kaiser, who not only did I know would not agree to the surgery, but also have been nasty about providing even minimal aftercare -- they did remove the drains, albeit grudgingly. (I'll be changing insurers at the next available window of opportunity, even if it costs more!) The Mexican doctors I dealt with were very competent, and I was impressed. No problems communicating with them, although since I speak no Spanish, I admit it was a little difficult to communicate in the hospital with the nursing staff --- obviously though, I survived. I also was alone for the entire time, and I imagine it might help to have someone else there, but really it was no problem. I have not had any complications at all, and have lost 23 pounds so far (starting BMI about 41, I think). As far as the hospital, I had a private room and bathroom. Some things are a little old fashioned, but it was clean and professional. Hope this helps.