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PDXloser71

Self Pay and Complication worries

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I just met with a surgeon on Friday and found out that I do qualify for either gastric sleeve or bypass. My insurance doesn't cover either, so I will have to self pay. I called my insurance to ask how they would handle a claim if I were to have any complications related to this surgery and they said they would not pay it. My doctor said if you need a follow up surgery, just file bankruptcy! Not a good solution for me! Did this worry any of you who self-paid? Any advice or suggestions?

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Comments

  1. reading mom's Avatar
    It was a worry of mine. The research I did said complication rate was 3 or 4 percent. I did what I could to not be in that 3 or 4 %. I lost as much weight as I could before surgery. I did yoga and walking. I started taking vitamins the minute I decided I was going to pursue surgery. I very carefully followed my pre and post op instructions. My thought is the healthier you are the less likely you are to be in the 3 or 4 %. Some things we can't be in control of, but if you do your part and still have complications you will know you did your best. All in all I decided it was worth the risk for me. Being so overweight carries a lot of risk as well. Wishing you all the best!
  2. lil_lisa's Avatar
    thats a heck of a thing to say, they don't care as they wizz out of the parking lot in their new ferrari, ugh.
  3. SoNotABarbie's Avatar
    I guess I was lucky, I was a self pay too and about 3 weeks after surgery I developed an infection from a portal site where the stomach was removed. I have BCBS of Texas and they paid for it.
  4. Think's Avatar
    You do what you have to do in order to have a healthy life. I will be self pay this Saturday. I have absolute confidence in my surgeon, am in pretty decent health and have been making dietary changes over the past several months.

    If you had a child and your child needed cancer surgery you would do it, right? And worry about the money or bankruptcy later. Every parent (who didn't have a religious objection) would. You should have the same concern for your health.

    Sometimes you do what you have to do.
  5. sraebaer's Avatar
    I had the same thoughts, but just went for it. It's very scary though! We are nearing retirement, and are set financially, I'd hate to think of that being gone. I am very careful to follow every rule exactly. One week done, and so far so good.
  6. ltlsqueak's Avatar
    I had the same worries, but luckily my insurance covers 80%. I plan on making payment arrangements on the rest, but it's worth it with my numerous health problems. Best of luck to you and keep us posted.
  7. RoDean's Avatar
    If your going to have to be self pay for the surgery as well as any follow up care, you might just consider having the surgery in Mexico, it is so much less expensive you will have tons of money left over to pay for follow up appts. I had pretty much no complications except my 3 small incisions didn't close so I went to a wound care clinic and they were healed in 3 days.
  8. sraebaer's Avatar
    Some hospitals in the US offer insurance for complications. Mine did not, but if they had, I would have bought it for peace of mind.
  9. speedracer's Avatar
    Of course you quality for the surgery, if you are self-pay! lol all the hoops you generally jump through are for the insurance companies, generally speaking, not the doctors. If you go the mexico route (which I am not a fan of) but if you do, you don't have to do ANY pre op stuff from what I understand except a liquid diet.

    Filing bankruptcy? That's a tad extreme. If you get sick, you walk into ANY hospital e.r, they must treat you, period! Also, I don't think medical bills effect credit anymore. I know it goes ON credit, but I don't think you can get denied future credit if you have a bill in collections for example. Correct me if I am wrong anyone on here (who actually know, or are in the debt collection business).
    Unless of course you were planning on doing it anyway-
  10. OAM's Avatar
    Speekracer is right, no hospital can turn you away. And if you are one of the very few to have major complications, all you need to show is that you are willing to make some type of payment toward your bill and you will not get so much as a phone call. My BFF lost her husband after a heart attack about 15 years back. She herself is on disability as she is blind. She send the hospital $15.00 a month over the last 15 years.
  11. ThisIs4Me's Avatar
    The above post is correct, a hosp cannot turn u away! Plz don't let that b a reason y u don't get the surgery done. Good luck 2 u
  12. DaleLanc's Avatar
    Complications are very real. My wife had TWO revisions after her gastric bypass five years ago. Her nick-name is 3%. The revisions were in no way due to poor surgeon performance or after-care. Having lost over 200 pounds and keeping it off for 2 years, she had a major skin removal and breast reconstruction in June, followed by THREE surgeries to fix wounds that weren't healing (due to malnutrition). Again, 3%.

    Don't kid yourself. Be absofukinlutely sure you are a good candidate for either surgery. Research the hell out of why people either fail or have complications and make sure, being true to yourself, you don't set yourself up for failure and lots of pain and misfortune.

    Best to you!
  13. PDXloser71's Avatar
    Thank you everyone for all of the great responses!