BIG NEWS,BIG NEWS, BIG NEWS, DID I SAY BIG YET?

Hi everybody, Ok this is it. I have been fighting with BC/BS since 2002ish. The good news is not about them, They still stink. I have been talking with my banker and he said he thinks it would be shouldn't be a big problem in getting my house refinanced so I can self pay for my surgery!!!!!!!!!!!!!!! I won't start the actual process until Tuesday, but I am so excited I could scream!!!!! Please keep your fingers crossed that everything goes as planned. I will probably be having Lap Band since it is the most affordable of the surgeries and the last doctor said that would probably be best for me. The only thing is if I go to Mexico and have it I can save about $4000.00 and that is nothing to sneeze at. I have a room that I would like to remodel and put hard wood floors in and that would cover that and some other things. If I have it here I would still have to travel to Dalton, GA, but at least it is not as far as Mexico and my kids could go with us. Any thoughts on this? Thanks for listening and keep praying.In the mean time I am going to be doing a happy dance. Nicky

Nicky, I'm glad things are finally going you're way. Have you thought about talking to the doctor in Dalton and inquiring how much of a discount you might receive if you pay cash? These insurance companies don't pay full price, they pay a negotiated price. Can't hurt to try. Best of luck. Michelle

Michelle, Yes, Thank you. They have a fee for cash paying customers. It is 13700.00. That pays for everything,except your stay in the hotel after the hospital. They want you to stay for 2 days afterwards. I see your date is coming up. I wish you the best. I can't wait to hear about your experience. Nicky

If it's the doctors I am thinking about don't they also have an office in Chattanooga, TN? That would be a little bit closer. Also, on the Mexico thing, IMHO I would NOT risk my health to save $4000. Who knows what kind of standards they have in Mexico. And if you had problems who would care for you. Please reconsider the Mexico thing. May God give you wisdom to make the right decision. Jeanette

Hey Monique...Glad things are looking up for you. NO WAY would I go to Mexico to have Surgery,I hope you really reconsider on that one!!!!!! April

Hi, I wanted to thank everyone for their replys. I don't want to give the impression that I would just go to Mexico to save the $4000.00. The two doctors that I am condersidering there are tops in the field. One of them is actually a teaching surgeon that was chosen by the company that makes the Lap Band to teach other doctors the surgery procedure. He teaches doctors here in the US. They operate in state of the art hospitals, and they have actually got more experience than the doctors in the US because they have had approval to use the band longer. As for the clinic in Chattanooga, it is the same one as in Georgia. The one in Georgia is only 30 minutes farther than Chattanooga. The doctor in Georgia has done more procedures though. I hope everyone is doing well and thanks again. Nicky

Nicky.... Have you checked with Dr. Lindy Hruska there in Clarksville? I had my surgery June 30 wiith her. She is very good and have had no problems with her or the surgery....I only ask because I see you are from Clarksville. Her offiice is at the hospital(gateway). Good luck in your choice. I am sure where ever you go things will work out just fine. Good Luck. Karen RNY/286/230

Karen, I had an appointment with her 8-24-04. Her price is 5000.00 for her and 15,000.00 for the hospital give or take a few thousand(for the hospital) I have a health savings program that negotiates reduced fees with hospitals and I am waiting on them to call me back to see what kind of reduced fee Gateway might take. Thanks for writing and continued success with your weight loss. Nicky

Nicky....Not wanting to burst your bubble or anything...BUT, be sure you consider the possibility of a less than perfect surgery and outcome. While everyone would like to have an uncomplicated surgery and no problems as a result, the ugly fact is that problems and complications do arise. Read your insurance policy carefully. MOST, not all but MOST insurance companies will not cover complications of a procedure that they would not have covered initially. So, ifyou pay the fee and have the surgery--and if you were the unfortunate one to suffer from complications, could you afford the thousands and hundreds of thousands of dollars in cost for that? Just consider the cost of being in ICU for one day and multiply that by 10 or 20 or 30 days and you will begin to realize what I am talking about. For example, if your chose to have a tummy tuck and your insurance ruled it to be cosmetic and would not cover it--but you went ahead and did it as a self pay--then had a reaction to the anesthesia and spent weeks hospitalized and on a ventilator in ICU--the insurance company likewise would not cover that. Same situation if you developed an infection or had excessive blood loss and had to remain hospitalized for treatment of it. The bottom line is, unless you have VERY deep pockets, going into a procedure as a self pay patient can absolutely spell financial ruin. Again, I hope that your procedure is flawless and that you have the best of recoveries, but be aware that complications are a possibility and be prepared to face that risk. Good Luck to you.

Carolyn, You didn't burst my bubble. It is true they will not cover complications likely, just as they don't cover the surgery now. I have had 6 surgeries in my life so far and thank God came through all of the just fine. I know things can happen and I know the cost of ICU's (my youngest son was in ther for 3 days after his birth) My thing is I can try to do something now and live a happier & healthier life or I can get sicker and sicker over the years due to complications from obesity. I see you have BC/BS also. Are you one of the luck ones who's policy will pay. I heard that come 1-1-05 BC/BS was going to try to exclude WLS from all policies. I wish you the best on your journey, whatever you decide. Take care NIcky