Question:
HELP! Self-Pay options needed!
It looks like I am going to have to go the self-pay route as my PCP isn't being cooperative in doing what Medicaid requires. I think I heard that Liv-Lite offers payment plans, do they? Any others offer financing? Thanks a million in advance for all you alls help. — arlene713 (posted on February 23, 2005)
February 23, 2005
I was a self pay. My surgeon was $3250.00 and, so far, out of pocket for
the surgery center I was in was $9,900.00. I am sure that I will receive
other bills but I am going to try and send them into insurance. I had my
surgery done by the Northern Colorado Surgical Center. My doctor was Dr.
Pettine. I highly recommend him and the surgery center. They will only do
the surgery at the surgery center if you are under 350 and do not have
allot of other comorbidities. They help with places to stay to, if you
travel. Something to think about. Hope you find something to work for
you. Terry
— Terry Lynn W.
February 23, 2005
i too am having to self pay. i was fortunate enough that someone else asked
a simular question several months back and some one offered their advice
about going to mexico. i have found dr. agguire in ensenada. he is doing
surgery under 10,000. i have read many post from his patients and i do
believe he is great.
— gogeko
February 23, 2005
Since you are going to self-pay, I hope you will look at the duodenal
switch procedure -- at least with self-pay, you can have your procedure of
CHOICE, without the insurance hassle.
— [Deactivated Member]
February 23, 2005
Look outside of the US. It's much cheaper elsewhere.
— PattyL
February 23, 2005
I have found self pay in Houston, TX for $19K including pre-op, post-op
visits and any complicatons within the first 6 months. Contact me if you
would like more information.
— Gina A
February 23, 2005
To me the issue here is your PCP. Get another one!!! There is no reason
to be self-pay if it's a matter of someone doing some paperwork or
following you for a while to document your weight loss attempts etc.
<p>If you do end up self-pay and go far away from home then make sure
you have a local doc that can follow you for problems should they arise. I
personally would not even go out of state, except to MAYO's in MN, due to
the possibility of problems. I spent the first 3 months after WLS seeing
my surgeon every 5-10 days due to incision healing problems. I ended up
needing a 2nd outpatient surgery to go in and get the darn stitches in the
fascia, that would not dissolve, out. Once they were gone it finally
healed up within about 5 weeks, which would be normal. I also saw the
surgeon every week or so for 8 weeks after my LBL due to fluid build up and
having to add drains back in etc. I'm a drainer, no question! I do not
know what I would have done in either of these cases had I gone far away
for surgery. I would have had to find a local surgeon who would be willing
to deal with these problems and normally that would be difficult. You'd
have to have it arranged ahead of time. I know many do go out of the
country or many states away, but for me personally it is not an option. I
want access to MY surgeon who knows exactly what he did etc. I did have
insurance coverage for the WLS and a sizeable portion of the PS's but I
still put out $20,000 related to the 3 PS's I've had. The legs were total
self-pay and I also paid for 2nd procedures on the first 2 surgeries that
insurance determined cosmetic. I could have probably had all three
surgeries completely done out of the country for tons less than the $20,000
I paid just for my portion. But for me it is not worth the issue of having
to deal with PO problems. I like being an hour or less away from my
surgeons.
<p>One last caution about giving up on Medicaid paying for WLS and
going self-pay. Keep in mind that if you go self-pay and have any
complications down the road that can in any way be related to WLS there is
almost a 99.99% chance it would not be covered. So you are taking on all
medical care related to WLS for the rest of your life most likely. While
many have had to do this because their insurance left them with no choice,
in your case it sounds like there still might be room for getting it paid
with the right PCP on your side. I wish you well in getting WLS! It
definitely is worth the fight!!
— zoedogcbr
February 23, 2005
Not to be rude, but if your on Medicaid - you cant afford to self pay...
and YOU shouldnt have to... Find another PCP - or call the surgeons office
you know uses medicaid and as them for 'friendly pcps'
— star .
February 24, 2005
The Bariatric Center at St. Vincents Hospital in Little Rock, AR has a
self-pay price of $15,000. Excellent surgeons too. Dr. Ozment is the
director and did mine. He is one of the pioneers of the RNY and has done
over 8,000 of them. Has had only 3 leaks out of all these. He is wonderful
and has an excellent bedside manner. If you have any questions just ask.
— Erin N.
February 24, 2005
I second that idea of changing PCPs. Thats what I did when I had major
issues with my PCP not supporting my quest for surgery. And now here I am
just waiting for my surgeons office to call with my surgery date. I had
other complications on why it took so long for me to get approved but
please feel free to read my profile and get some inspiration on fighting
the system and your right to have surgery. =) {{hugs}}
— ImANewDee
February 25, 2005
I agree that you should look for another PCP or perhaps surgeon that is
willing to do what Medicaid requires to have them finance and pay for it.
Dont give up on that avenue yet-pursue this approach first. If you have
done so and can not find any other way for insurance to pay for it, do you
own your own home, perhaps with equity in your home? You can take out a
2nd mortage or a home equity loan or re-finance your current home with a
lower interest rate and use the $ to pay for surgery. If you have a
retirement plan at work, sometimes you can borrow against that.
— Cindy R.
February 25, 2005
Arlene, I went straight to the Surgeon and let him and his Bariatric nurse
handle everything for me and I have MEDICARE...... Stop trying to go thru
your PCP...go straight to the surgeon whom you want to do the surgery for
you..................Good Luck and let me hear from you, Cindy
— cindirella
February 25, 2005
With Medicare you can let the surgeons office handle everything. With
Medicare though since it is state handled, 99% of the time you must have
referrals from your primary doctor to even schedule a consult. And even
then you may still be required to pay for it out of pocket.
— ImANewDee
February 25, 2005
Oopsie!! that second one should be Medicaid. Medicaid requires referrals.
Medicare does not preauth WLS.
— ImANewDee
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