Question:
How would I go about getting the surgery if it is excluded from my benefits?

I took all the steps necesary, including a letter of medical necesity from my PCP, but the insurance gave us the response of the surgery being excluded, I find that to be discrimination, but I was told that there's nothing else to do. Please HELP    — sherlyne (posted on January 27, 2006)

January 27, 2006
Sherlyne, You could always consider self-paying. It's done all the time. It's what both my husband and I ended up deciding to do. We both had surgery with Dr. Aniceto Baltasar in Alcoy, Spain. Dr. Baltasar is a world-leader in the field of bariatrics - and just the nicest guy there is. Plus - going out of country saved us tens of thousands of dollars. My criteria when I was searching had high at the top of the list the most skilled and experienced surgeon I could find - the truth of the matter is that I was a really crappy surgical risk. After throughly researching Dr. Baltasar's credentials (along with the help of two of my physicians), I knew he was the surgeon I needed. My surgery was a little over 3.5 years ago, my husband's was a little over 2.5 years ago. We have both done fantastically since surgery and are thrilled with the quality of life we enjoy. To be frank - it was a huge relief to get to side-step the whole insurance rigamarole and choose the surgeon that I felt confident in, and the surgery that I was passionate about. There was a great sense of liberation in stepping away from the hassels of the insurance industry! Please let me know if I can answer any questions, okay? Blessings, dina
   — Dina McBride

January 27, 2006
self pay, is so common for the ds, visit the DS forum, many will recomend the resturant, tell you about the favorite nurses, share pics, let alone the particulars of the surgery, and 13k to save your life, is less than 300 on a credit card.
   — walter A.

January 27, 2006
I work with the insurance part for precerting surgeries and I run across that alot, the best thing to tell you is to get it financed or borrow, but the one thing about out of the country dr's is you will not have a physician to follow up with you if something should happen..you need to have someone closer to take one on one care of you and not have to fly somewhere to get it..just be careful...
   — Parker

January 27, 2006
Self pay or try Medicaid. For me, I had no insurance, and went and applied for Medicaid. Of course if you have a job and insurance you may not qualify. But it was worth a try for me and I got it. It paid for all of my surgery, except 10.00 :)
   — Angelfirewithwings