Question:
Self Pay -- How do I make the surgery as economical as possible?
I live in Milwaukee, WI. I have been trying to have this surgery for four years now. I have been through insurance exclusion clauses, insurance covering but with 12 month dr. diet -- I changed jobs at the 8 month mark, and now I'm back to an exclusion clause!! But, I am finally in a position to afford to self-pay. I can't say I don't have other places I would rather spend the money, but this is only one life changing. However, I was wondering if anyone had any help on cutting expenses? I have worked with Suburban Surgical Care centers in IL up to this point and talked to the Barix Clinic, but both are approx. $25,000 for the surgery. I've seen some posts where the cost was $15,000 to $18,000. I was just wondering if anyone could lend some advise ?? Thank you so much for taking the time to read my post, Jenna — jennawoods (posted on April 12, 2006)
April 12, 2006
congrats on having surgery and also self pay. As for the monies, all I can
say is that here in Colorado, the normal insurance fee are approx. $50,000
plus. Right now I am up to approx. $75,000. The reason is I have had some
issues, 5 strictures, and a hernia. You just have to plan for these. a
stricture costs approx. $3000. ea. With the insurance, the hospitals bill
them however they never collect what the bill. I would say it runs
about$35,000. Good Luck
— Steve Cohen
April 12, 2006
Jenna,
Have you looked into having the surgery in some other country? I know Dr.
Baltasar, in Spain, is suspose to be an excellent doctor. Donna B
— donnabug57
April 12, 2006
I went to barix clinic and had mine. I had insurance and the total cost
was about $48,000.00
— brat73
April 12, 2006
Hi Jennifer,
I'm a self-pay patient. I went through the whole insurance nightmare
thing, too - twice, actually - two different insurance companies. What a
pain in the patootie!
Self-paying was so liberating! I did a LOT of research - I was actuallly
employed doing medical research at the time, so it was really cool to have
those resources available to me at that time. I decided which surgery that
I wanted (I know me best, and knew what I believed I would be best at
complying with as a post-op), and then started searching for a surgeon with
the most experience and the best surgical results.
That's how I found Dr. Baltasar. Yes, I went out of country for surgery -
it was a SUPER positive experience. So much so, that my husband followed
two years after I had my surgery for his own surgery with Dr. Baltasar.
The entire thing - surgery, travel, etc. can be done for $20,000 (that
would leave you some change), and remember - self-paying is tax deductible.
If you want to see some details, go to www.bodybybaltasar.com for the web
site that some of Dr. Baltasar's patients have put together; and you could
also see Dr. Baltasar's web site, too - at www.drbaltasar.com - it's got
lots of great info there.
BTW, Dr. Baltasar will be in San Francisco during the week of the ASBS
conference (www.asbs.org) and is doing consults with people who are wanting
to meet him.
Good for you for being proactive for your own health! You make me proud!
Blessings,
dina
— Dina McBride
April 12, 2006
I went to Mexico and am thrilled with my experience. I saw Dr. Alejandro
Aguirre. I think his cost is still under $10,000 for the open RNY but I
have been out of the loop for a couple years on cost. When I went it was
$8500 for the surgery/hospital, and with travel expenses for myself and a
friend plus meals it was right around $11,000. I stayed at a resort hotel
though - many have done that part cheaper. You can check my profile and
click on Dr. Aguirre's link and learn more if you like or email me if you
are interested in this avenue. There are a lot of options outside of the
states that are both safe and geared toward Americans. You just have to
spend time making sure you do your research on them. Good luck. Dina
— Dinka Doo
April 12, 2006
Dear Jennifer, I just paid for my RNY Bypass Revision (same cost as the
original) at George Washington University Hospital in Washington DC (the
best...) and my surgeon not only does WLS but he specializes in stomach
oncology (cancer). Who better to have to do it! It cost me $20,500
out-of-pocket because my insurance company only pays for revisions if you
have an active fistually. How stupid is that? If you had one, you'd be
lucky to make it to the OR table. Anyway, they worked extremely hard as a
hospital and a team to minimize the costs. Great surgery, great medical
team, comfortable stay. Hope this helps. Before you do go somewhere else
other than home, please research the docs and the hospitals. You should
easily be able to check licenses on-line. Good luck!!! Sherry
— sstrohm
April 12, 2006
jennifer the thing to be aware of. if you have complications your insurance
wouldnt cover them and costs can skyrocket. you might look into a part time
2nd job whos medical covers wls
— bob-haller
April 13, 2006
Jennifer ,
I went to Belvidere Il..BarixClinic and am 100% satisified with them, my
surgeon was Dr Vaugh, I did self pay also, it was $25,500 but I am
appealing my ins co (Humana) as my drs have written letters stating it was
medically necessary, so I am hoping to get something back...at least
keeping my fingers crossed... and now that the surgery is over and I am
dropping pounds even if I don't get a cent back it was worth every penny
spent!
Rosalind - Overland Park, KS
— Rembry
April 13, 2006
I had open distal RNY back in 2000. Due to an iron clad exclusion, I had
to self pay. Back then, it cost me $25,000.00 and that included only 2
days in the hospital. I really don't know what I would have done if I'd
had complications. Probably would have lost the house and everything I
own. Thankfully, that didn't happen, but it is something to take into
consideration. Twenty-five thousand is a good deal if you can get it...I
could have had mine cheaper, but I would have had a disruptable staple
line, (no transection) and been a very minimal proximal. I opted to go for
the open distal so I'd have the surgery I wanted. Self pay is a good thing
for that. You aren't forced into having any old surgery because insurance
pays for it. Many things to consider here.
Regards~
— Statuesque
April 14, 2006
Hi Jenna,
Due to an exclusion in my insurance policy I am also doing self-pay and
have been quoted about $25,000 (putting myself in debt for the rest of my
life it seems). I was told that I might be able to negotiate somewhat on
the costs of the surgeon and the hospital stay. But even if not, $25,000 is
going to be worth every penny to be healthy and happy. Best of luck to
you!!
— MichelleInAZ
April 14, 2006
After insurance denials (multiple) and lawyer not being able to get
anywhere... I decided to self-pay. I had the DS so it is a little more
expensive (but not too much). I am currently in Brazil recoverying. The
entire trip for my husband, myself surgery, 2 weeks in hotel for recovery
will probalby end up costing us around $14,000. However, I feel like I've
also gotten an exotic Brazillian vacation thrown in with the deal!
Definately consider travel outside of the US for self-pay, we have been so
impressed with the medical care here. Good luck!
— [Deactivated Member]
April 16, 2006
Hi,I had my gastric bypass surgery on 12/21/05 in the best Holly Cross
Hospital in Florida, performed by A+ surgen Robert Marema. My insuranse
covered some expencies, but I know that if you pay for this surgery on your
own, it will cost you 20,000{twenty thousand} dollars.
— Tatyana B.
April 18, 2006
Hi Jenna,
I just returned from DS surgury in Spain with Dr Baltasar. I am doing
great!! He is a great doctor! I have already lost 20lbs in 2 weeks. I know
it's scary to think of traveling out of the country, but I took a support
person plus a friend to guide us and the total for 3 person for 2 weeks
plus the surgury cost me about 21,000. That's includes villa, car rental,
airfare, gas, food, sightseeing and souvenirs. Please checkout Body by
Baltasar like Dina suggested it's a great site with lots of info, photo's
and story that are very helpful. I think DS is the only way to go. I thank
god everyday I found it before I went with RNY.
Good Luck Jenna
— Keighty S.
April 18, 2006
My mom had the surgery back in 2003 and at that time the ins co would not
cover it for what ever reason. So my mom ended up self-paying. I think her
total was around $28,000. Now that i am going through the process i am
hoping that the ins will cover my surgery. But if not i am grateful that my
family has the means to pay for my surgery if need be. According to my mom
it is tax deductable. Good Luck!
— phranny19
April 18, 2006
i forgot to mention that the estimated cost for my surgery will be between
$15,000-$18,000 depending on the kind of Thearpy i'll be needing
— phranny19
April 21, 2006
Hi Jenna, I live in Florida, and my insurance wouldn't pay either. The
hospital required $14,000 in advance. My Dr. is patiently waiting to see if
the insurance will pay his fee. If not, i will have to cough that up.
Anyway, i borrowed money on the credit card, where you can get a 0%
interest rate for a year?? It least you save on interest that way. Hope
that helps....good luck!!!!
peggy
— sunbrat
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