Help and Disappointment!!!!!!!!

Help some of old timers, Or anyone that has payed out of pocket HOw much for everything ?  I feel so bad for Tina she finally wants this surgery and her Ins. won't cover it. She has BCBS of TN PPO with Wilson Bank.  Anyone work there? I know one girl has this BUT both Centennial and Baptist said that her Ins. does'nt cover this . Don,t know where to go from here any idea will help( PLEASE)  If I had all the money people owe me I could pay for it LOL. You can pm me or just put on here. Thanks Sue W

Have you called BCBS to verify if they cover it?  I had BCBS PPO with Metro and they covered it.  Also, for the five years worth of Dr. visits etc, I did not have that so I was allowed to submit pics showing how large I actually was.  Good luck! Beth

Thanks Beth,       I called they said that WLS was excluded from her,s So for now i,m trying to find out what she would have to pay out of pocket. She has been getting things gathered togeather also pics, Dr forms any weight loss things she did. I just fell so bad for her she was all in a cloud this week went to 2 seminars.                                                                 Sue

Hey Sue, I had to pay out of pocket myself.  It cost about $25,000 for everything.  I also had a Greenfield IVC Filter placed which was another $5000.  I got a loan through CapitalOneHealthcare Finance and also used some savings and 401K money. Unfortunately, not all BCBS is created alike.  Policies are written differently for different businesses.  The companies that choose to pay for WLS have slightly higher premiums.  My husband's company had an exclusion to their BCBS of TN policy and my company had an exclusion for Cariten.  For me, the surgery and paying for it each month is worth it, plus I have the added incentive that I am paying for this, so I don't want to waste $30,000 by not working at losing the weight.  Hope something work out for ya'll. Marilyn

Change that to read "The companies that choose to pay for WLS have SIGNIFICANTLY HIGHER premiums."  While we were researching insurance policies for Trevecca, we asked about adding WLS coverage to the policy. The difference in premiums was over $1,500 per year for each person on the policy even though only a handful of people "might" use the coverage. That came out to an increase of almost $20,000 per month in premiums. Most of this increase would have had to be passed on to the employees. Sue - Have you asked at Baptist and Centennial to see what their self-pay cost is? I know Baptist gives a discount to self-pays and I believe Centennial does too.

 Thanks Susan,   Called both today to send info on selfpay. Was up  till late last night on the puter looking for help and I don,t know that much about them lol.  But I want to do everything I can to help her. I may have to get a PT job to help.   Anyone need a good babysitter!!!!!!!!!!                                                 Thanks Sue

Sorry for the news on the insurance.  My insurance did not cover the lapband procedure.  I had it at Vandy on May 5th.  The first payment was like around $17,500.  After the surgery I received another bill (not expecting it) of another $7500.  Then another one this week for $375.  I am going to have to check on the last two bills.  The office had previously told me it could go up to $23,000.  So I was expecting this.  Anyway they can get money they will!!!!  I didn't have any complications during the surgery or after the surgery.  So for that I am thankful.  I hated so bad to spend the money but I am looking at it as an investment in my body.  I am praying that I will live longer and have an extended healthy life.  At first i felt guilty for thinking about spending the money but after talking to my husband and brothers they made me realize that it may prolong my life and in time I may be able to save money in the long run.  Hope you can work it out.