Guest guest Posted May 29, 2001 Report Share Posted May 29, 2001 After struggling for so long with what appear to be iron-clad insurance exclusions, I am interested (desperate really) to hear from anyone who has gone self-pay, or intends to do so. Private posts much appreciated. Annette poohbar@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 29, 2001 Report Share Posted May 29, 2001 I'm a self-payer - what do you need to know? -Sherry (Lake Marcel, WA) BPD/DS Feb. 2, 2001 self-pay 5'5 " / 329 pounds / 33 years old Have lost 82 pounds since surgery! (Lost 9 pounds in pre-op weight loss efforts) Total of 91 pounds gone forEVER! http://www.fluffynet.com/wls/ > After struggling for so long with what appear to be iron-clad > insurance exclusions, I am interested (desperate really) to hear from > anyone who has gone self-pay, or intends to do so. Private posts much > appreciated. > Annette > poohbar@q... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2001 Report Share Posted May 30, 2001 Hi Annette! I also intend to self-pay and chose Dr. Baltasar as his expertise/experience is excellent and his fees are very reasonable as in comparison to U.S. Right now I am looking into obtaining a loan to cover the "total Spain bill" which comes to about or a bit more than $10,500. And then I am outta here and on to Spain! a Self-Pay After struggling for so long with what appear to be iron-cladinsurance exclusions, I am interested (desperate really) to hear fromanyone who has gone self-pay, or intends to do so. Private posts muchappreciated.Annettepoohbar@...---------------------------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2001 Report Share Posted May 30, 2001 > After struggling for so long with what appear to be iron-clad > insurance exclusions, I am interested (desperate really) to hear from anyone who has gone self-pay> Annette, I had the BPD/DS(lap) at Mt. Sinai with Dr. Gagner on 11/6/00 without complications. So far I have lost over 70 pounds and feel great. I have not gotten Dr. Gagner's bill yet(!) but can tell you that so far I have spent about $20,000 for hospital, tests, and anesthesiologist. I believe Gagner's charge is around $12,000, which will bring my total to around $32,000. It makes for a heck of an income tax deduction, at least. My guess is that it costs less outside of NYC. By the way, Mt. Sinai insisted that I pay $9000 or so of its costs up front. Aetna/US Healthcare refused to cover me on the ground that the surgery is " investigational, " which as we know is nonsense since they paid for the same procedure at the same hospital for another patient after denying my pre-approval. I appealed and Aetna denied the appeal, and I simultaneously appealed directly to my employer, which funds the plan, and which ultimately decides whether it will be covered. They sent it to an outside medical agency for review, which has told them they can deny it. Even though I'm pretty sure my health insurance policy would have paid for the RNY, I'm glad I had the BPD/DS, given my own pathological interest in food. If your BMI is in the low 40s,and if your policy will cover it, you might want to give serious thought to the RNY. (My BMI was 43 and Gagner agreed to do the BPD/DS. Apparently that's close to his lower limit. I've met people with starting BMIs of 41 who say that Gagner refused to do the BPD/DS on them, and those people have been fine with the RNY. And I've met people with starting BMIs in the 50s who have also been fine with the RNY. It's a very personal decision.) If you decide to self-pay, be aware that you are running a great risk: if you have post-op complications, you may end up spending a lot more money than I did. Some people (e.g., Joe Frost) ended up spending a couple of months in the hospital and having 5 or 6 surgeries. I don't know what something like that would cost, but my guess is it is in the hundreds of thousands. While the risk is very small, it is real. And as I understand it, a health insurer that will not pay for the initial operation will probably not pay for any subsequent treatment for complications of that operation. Even if I had gone broke, though, it would have been worth it to me. Whatever you decide, good luck. Deborah Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2001 Report Share Posted May 30, 2001 Quite a few self-pays have the procedure with Dr. Baltasar in Spain and hold him in very high regard. Apparently, even including air fare, the total cost is comparatively quite low. I think there are two women over there now recuperating from a DS with him. --Steve -- ---------------------------------------------------------------------- Steve Goldstein, age 61 Lap BPD/DS on May 2, 2001 Dr. Elariny, INOVA Fairfax Hospital, Virginia Starting (05/02/01) BMI = 51 BMI on 05/30 = 45.4 Quote Link to comment Share on other sites More sharing options...
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