Question:
If i pay cash for my surgery, will my HMO pay if I have complications later?

My insurance company covers the surgery, but it is very strict in their approvals. My problem is I need 6 months supervised diet and I don't have that. With a BMI of 41, if I follow a diet for 6 months I'll lose just enough weight not to qualify, then once I regain (like most of us do)I'll have to start the whole process over again. HMMM. Vicious cycle. I decided to pay cash for the surgery but I can't afford to pay for three additional surgeries should I have strictures of other complications! Worried that I won't be able to pay and be left without a resource for treatment. Is this is a bad idea? Help please. Thanks!    — denisel (posted on September 1, 2002)


August 31, 2002
I have Cigna and when I got my first denial letter, it stated I was free to proceed and pay for the procedure myself, but Cigna would not reimburse or pay any associated charges with such a procedure, so I'd guess they would not pay. It's best, however, to check with your policy and see what their liabilities would be.
   — Cathy S.

September 1, 2002
Denise, Though I was approved by my insurance Co. I to had to provide past diet history. I have tried every diet there is out there but god is only the that truely knows when, how long and the weight I lost. I just knew if I lost 10 pounds then 16 of his friends showed back up! I guessed there is NO WAY for them to verify things like weight watchers, jenny craig, ediets (online) etc. Try sumbitting a diet history (I have known people to use others diet histories). Any of the Jenny Craigs (ETC) are sometimes considered by Insurance as supervised! Give it a try... you really have nothing to loose! I had my surgery 08/23/02 LAP RNY Medial and I am doing great! I can't see why I waited! Jessica in NM
   — jessmessen

September 1, 2002
I paid cash for my surgery and everything went fine. I was worried about having complications and ending up with a $80,000 hospital bill or something. I was talking with a lady who works at the hospital about this concern. She told me that if I had to be admitted again for a problem my insurance would have to pay because treatment would be medically necessary. I had my surgery July 11th and as the bills are coming in, I've found that my insurance (who REFUSES to pay for this surgery) is paying for certain parts. They paid some to my surgeons, to radiology, to anesthesia, and a couple of other things. Of course, they didn't pay anything towards my $32,000 hospital bill. But I didn't really expect them to. I figure that at least I'll be healthy in 40 years when I finish paying the hospital! =) Good luck to you!
   — Tanya B.

September 1, 2002
Who says you have to "stick" to the dr. supervised diet. My insurance co wanted the same thing, and the only thing that they were looking for was documentation on my dr med records that he was monitoring me once a month for 6 mos. I simply had to go and weigh in, they noted my "non weight loss or a pound or 2 of loss" and then I went on my merry way...Sometimes you have to play their games for a few months to get them to pay and it sounds like that is what you are going to have to do. They're playing games with you asking for 6 mos supervised diets..that's just a "put off ploy for them"..so they can make you wait for 6 mos.Beat them at their own game.....
   — Joi G.

September 1, 2002
I'd do their "diet" as there is no way they can watch you to know what you do or don't eat. Eat what you want and say you are eating what they tell you. As far as if you self pay, then later have problems. It would be "medically necessary" so they would have to pay. I've found that you have to play their stupid games. I had to have councelling in order to have gender reasignment surgeries. Believe me, you HAVE to PLAY THEIR GAME. I don't like lying, but sometimes there is no way to get out of it. Unfortunatly you can't always get through this life by being honest. Sad but true.
   — Danmark

September 1, 2002
I have a friend that self paid. SHe was a revision and had numerous complications following her surgery requiring her to be in the hospital for numerous weeks following the surgery. Her insurance company did not pick up any of the charges from the prolonged hospitalization. IN addition, she now needs a hernia repair, which the insurance has also denied as being related to the original surgery. I do not know what insurance she has, but find out how your insurance would handle these things if they come up. My friend is now in bankruptcy.
   — Vicki L.

September 1, 2002
I would appeal the HMO's decision first before concidering self pay. It is quite possible that they will not pay for anything other then an emergency room visit. It becomes a very sticky situation when dealing with an HMO. They hold the cards and control the medical care decisions. You may even consider changing insurance. It would be cheaper to do that then to pay out of pocket.
   — Sue A.

September 1, 2002
See the Doc and meet the insurance rule, but DONT loose any weight. Just put in the 6 months. Then let insurance cover you. they are doing this to try to save money, hoping you loose interest... We really should organize to get WLSA covered by law everywhere. I wonder ifd this could be done on a federal basis?
   — bob-haller

September 1, 2002
Denise, I was in your situation earlier this year. My HMO required one-year of supervised dieting with their nutritionist, their doctor, their psychologist, and their group exercise program. If you weren't deemed to be "compliant" (i.e., if you didn't lose weight as expected), then they wouldn't approve you for surgery. If you lost weight and no longer qualified based on BMI, then they wouldn't approve you for surgery. For "lightweights" like me, it was a Catch-22! I decided to go ahead and self-pay rather than doing their program. My HMO "officially" won't pay for complications that are a direct result of a non-covered surgical procedure, but so far, they've been pretty good... including covering one out-of-network ER visit, CT scan, and overnight hosptialization when I became dehydrated about two weeks post-op. They've also covered my post-op blood work so far. Also, when I mentioned to my primary care doctor that the HMO had said that they wouldn't cover a late complication such as a bowel obstruction, she said, "I'd like to see them try to tell ME that." So, if your HMO has a written exclusion for complications following non-authorized procedures (most do), then it is a definite financial risk... but one that I was willing to take. I didn't see much other choice, if I wanted to have this surgery. People who have non-covered plastic surgery do this all the time... they just cross their fingers and hope for the best. Good luck with your decision!
   — Tally

September 2, 2002
Another big factor is in billing. Once the surgery is over and done with, there won't be any billing for "obesity-related services." When I spoke to my doctor's office about insurance billing, they told me that any further services performed would be for treatment of "chronic malabsorbtion" (I think that's what they called it) This means that any strictures, stoma problems, etc. would be covered because it is no longer a treatment for obesity, it's a treatment to ensure you get the nutrition your body needs. I wish you the best of luck with your struggle with the insurance company and with your surgery!!
   — Laura S.




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