28 replies to this topic

[Daniel Boone]

Second year and another fight with insurance companys.  Just tired of fighting with them.  Health is getting worse.  

THose who have been to Mexico can you give me the place you went for the gastric and give me the pro and cons.

My US doctor has totally said he would not go out of the states.

[poet_kelly]

I think you have to do a lot of research if you are going out of the country.  Find out what the experience and training of the surgeon is and how they are accredited.  I know some people have good experiences doing that, but others don't.  I would be really careful if deciding to do it.

My biggest worry would be about follow up care.  What happens if you get home and have a problem?  And who does your long-term follow up?

Also, most of the time if you go out of the country, you get to skip the things like a six-month diet, required visits with a dietician, and a psych eval.  But those can be good things.  You'll need to make sure you get all the care you need on your own.

Kelly

[Godsblessedme]

personally i would ask some at obesityhelp.com  there are several that have gone to Mexico for their surgeries and MOST had wonderful experiences :)

[suebry05]

Daniel Boone said:

Second year and another fight with insurance companys.  Just tired of fighting with them.  Health is getting worse.  

THose who have been to Mexico can you give me the place you went for the gastric and give me the pro and cons.

My US doctor has totally said he would not go out of the states.

are they giving you a reason for the denials?

[LyndasRoom]

Daniel Boone said:

Second year and another fight with insurance companys. Just tired of fighting with them. Health is getting worse.

THose who have been to Mexico can you give me the place you went for the gastric and give me the pro and cons.

My US doctor has totally said he would not go out of the states.

Check with your US medical provider.  Would they cover you in the event of complications?  How far are you from the border.  YES, there is excellent care in Mexico...BUT...DO YOU SPEAK THE language?  How many surgeries has the doctor performed?  can you find someone who has had an experience with THIS doctor?  so many questions...it is your LIFE you are talking about.  Best of luck!

[birdy36]

My sister had the banding done in Mexico a bit over two years ago.  She has been happy with it, and says they treated her well.  The hardest thing for her has been that her insurance will not cover anything related to the banding.  She had a problem a few months ago.. she got the flu.  Because of vomitting, etc. she had some swelling at the site of the band.  It created a total blockage.  She couldn't eat or drink.  She finally had to go to the ER and have the fluid drained from the band, but it was all out of pocket expenses, as was the fill that she got after she healed back up.  

She did not get the education that I received prior to my surgery.  She never even had labs drawn up until recently to see how things were going.  I think she paid about 7,000 for the surgery, but has paid twice that or more since then.  On a positive note, she has dropped over 70 lbs, and looks and feels fantastic.

[Daniel Boone]

suebry05 said:

are they giving you a reason for the denials?

Not a covered policy.  Now they totally agree it should be but are not wanting to cover it.  I have a hearing coming soon.  This is the second insurance company with my job that I have tried.  If It fails,  I will have to try and find a way to pay for it myself.  I cant wait another year.  Currently taking 12 meds and three hunulin shots a day.:mad:  Doctor is saying I need to do something.
DB

[Daniel Boone]

LyndasRoom said:

Check with your US medical provider.  Would they cover you in the event of complications?  How far are you from the border.  YES, there is excellent care in Mexico...BUT...DO YOU SPEAK THE language?  How many surgeries has the doctor performed?  can you find someone who has had an experience with THIS doctor?  so many questions...it is your LIFE you are talking about.  Best of luck!

Mine is Community Care Insurance  HMO.  Im being told that others on this policy had it done a few years back.  BUt there telling me they no longer provide this at all.  I may be getting the run around.  Ill continue to fight them here.  

Thanks
DB

The state insurence totally denied me and I fought all the way to the capititol.  All agreed on the board it should be covered but not one as the courage to pass it.

[Daniel Boone]

birdy36 said:

My sister had the banding done in Mexico a bit over two years ago.  She has been happy with it, and says they treated her well.  The hardest thing for her has been that her insurance will not cover anything related to the banding.  She had a problem a few months ago.. she got the flu.  Because of vomitting, etc. she had some swelling at the site of the band.  It created a total blockage.  She couldn't eat or drink.  She finally had to go to the ER and have the fluid drained from the band, but it was all out of pocket expenses, as was the fill that she got after she healed back up.  

She did not get the education that I received prior to my surgery.  She never even had labs drawn up until recently to see how things were going.  I think she paid about 7,000 for the surgery, but has paid twice that or more since then.  On a positive note, she has dropped over 70 lbs, and looks and feels fantastic.

She totally against me going to Mexico.  But she supports me in my decision.
Friedn of mine got her done through Medicare and is advising me not to go out the country.  
DB

[Mz_Desz]

MOO, I would suggest you not go outside of the country. The aftercare is so important. If you read through the personal threads on this site there are many that have had some serious complications. But on the other hand there are those that have not, but that doesn't mean they never will. Would you be able to cover those cost out of pocket if you had to? Continue to fight with your insurance company. Hopefully someone on here can give you some valuable info that can assist you. Maybe you can look into getting your own private insurance...I don't know. Just throwing something out there. I do wish you luck in your plight.

[Jobu]

Excelsior (Mexico City) 1/14/08

The author of “El Secuestro en Mexico” (”Kidnapping in Mexico”), Jose A. Ortega, is also the president of Mexico’s Citizens’ Council for Public Security and Penal Justice. Some of his findings and statistics reveal that organized crime claimed the lives of more than five thousand 500 persons in Mexico during 2008, a figure 20% higher than the total of U.S. military deaths in Iraq since the start of that conflict in May, 2003. There were also 1,028 kidnapping reports in Mexico last year; 65 of those victims were killed


I wouldn't go to Mexico for a taco much less a surgery. LOL.

[mburgs]

Hi,
I just posted to a similar thread the other day. It can be found here:

http://www.thinnerti...uth-border.html

It was older but got restarted. Kizzy is going to Mexico so you may want to talk to her, there are ohers but I can't remember who specifically! Below is what I said on the other thread:

mburgs said:

I guess some things I would want to know would be:

• What are the country's regulations for healthcare standards? Is there a certifying board or are doctors affiliated with any international bodies?
  
• What will you need to pay if there are complications while you are out of the country?
  
• What is your healthcare carrier's policies about you going out of network for the surgery (in the US or outside?)
  
• Will the healthcare carrier cover any complications? Do you have to be back in the US?

I'm personally bummed enough I have to go to San Diego from Orange County for mine! I'd also gauge what kind of communication you have with the doctor and his/her staff to see if you are comfortable putting your life in their hands. Make sure you ask all the questions you would of a surgeon in the US including their expertise, complication rate, and any other questions even if it's just to make sure they know the answers you already know.

The surgery has been going on all over the world so I would like to think it's safe, but you have to make sure you've seen the facility and you have to stop the process if you feel an iota of doubt just ike usual. There are a lot of quack doctors out there, everywhere, so you have to protect yourself.

EDIT: OK, WOW, JUST NOTICED THIS IS AN OLD THREAD, I GOT CONFUSED BECAUSE IT WAS UP TOP! Well I'm going to keep it in case people find it searching. I was a little confused because I know Baron's been around a LONG time!

Don't know what the board's etiquette is for linking to other threads, but wanted to in case there's info that can help! There may also be other threads if you perform a search!

Good luck, I hope you're able to find the best solution for you.

[mburgs]

Also, just wanted to confirm- you've tried 2 plans with your employer and neither plan covers WLS? Have you spoken with a benefits rep where you work? When they look for new plans or renegotiate their contracts with the plan provider they can choose to get the coverage, though it could amount to a higher premium for the group including your company.

I apologize if I've misunderstood, what you've said but that's how I've read it. If the plan doesn't cover it, it doesn't cover it. It's another story if it's covered and you are being denied. :mad:

[kizzy]

Daniel Boone said:

Second year and another fight with insurance companys.  Just tired of fighting with them.  Health is getting worse.  

THose who have been to Mexico can you give me the place you went for the gastric and give me the pro and cons.

My US doctor has totally said he would not go out of the states.

Hi hi hi!
I'm going to Mexico. I've done tons and I mean tons of research and I think if you find the right doctor you'd be ok...my husband is from Mexico his brother is a nurse there and I've gotten him to check out the hosptial and the Dr. and has verified that everything is good.

Yes, it might be hard to find a doctor here in the states that will take you post op BUT its not impossible! I've found several doctors in my area (dallas) that will see me after surgery. A lot of drs. will tell you they wont give you post op care BUT if you run into a complication because of the surgery they'll see you. Now these are all Bariatric specialist. I think any PCP will take you.

The doctor I've chosen is Dr. Joya in Puerto Vallerta. DrJoya.com GASTRIC SLEEVE, RNY, LAPBAND, SURGERY: Laparoscopic Obesity Surgery you can see some people who've had surgery already with him on youtube. Go to YouTube - Broadcast Yourself. and search "Dr Joya" watch FaithKP's videos she just had her surgery done 2 months ago...she has very helpful information

Dr. Joya's staff is wonderful very fast to respond to all my questions just a phone call or email away...


As far as price its almost 1/2 the price here...Dr. Joyas price include EVERYTHING...airfair, hotel (which is located on the beach and I've heard wonderful reviews), hospital, surgery, dr. fee...EVERYTHING....

Dr. Joya also offers a complication plan for $500 extra it'll cover anything that might happen during the surgery...

On another note...he has only had one death and it was because of a problem exsisting before the surgery that the patient did not tell him about.


Not sure when exactly you're getting yours done but I'm getting mine done HOPEFULLY this November...the way things are going I might be getting it done SOONER yay anyways if you have any questions about Dr. Joya or going to mexico let me know!! :D

[kizzy]

Oh and another thing Dr. Joya has had training in the United States. FYI big plus

[Mz_Desz]

kizzy said:

Hi hi hi!
I'm going to Mexico. I've done tons and I mean tons of research and I think if you find the right doctor you'd be ok...my husband is from Mexico his brother is a nurse there and I've gotten him to check out the hosptial and the Dr. and has verified that everything is good.

Yes, it might be hard to find a doctor here in the states that will take you post op BUT its not impossible! I've found several doctors in my area (dallas) that will see me after surgery. A lot of drs. will tell you they wont give you post op care BUT if you run into a complication because of the surgery they'll see you. Now these are all Bariatric specialist. I think any PCP will take you.

The doctor I've chosen is Dr. Joya in Puerto Vallerta. DrJoya.com GASTRIC SLEEVE, RNY, LAPBAND, SURGERY: Laparoscopic Obesity Surgery you can see some people who've had surgery already with him on youtube. Go to YouTube - Broadcast Yourself. and search "Dr Joya" watch FaithKP's videos she just had her surgery done 2 months ago...she has very helpful information

Dr. Joya's staff is wonderful very fast to respond to all my questions just a phone call or email away...


As far as price its almost 1/2 the price here...Dr. Joyas price include EVERYTHING...airfair, hotel (which is located on the beach and I've heard wonderful reviews), hospital, surgery, dr. fee...EVERYTHING....

Dr. Joya also offers a complication plan for $500 extra it'll cover anything that might happen during the surgery...

On another note...he has only had one death and it was because of a problem exsisting before the surgery that the patient did not tell him about.


Not sure when exactly you're getting yours done but I'm getting mine done HOPEFULLY this November...the way things are going I might be getting it done SOONER yay anyways if you have any questions about Dr. Joya or going to mexico let me know!! :D

The question you didn't answer is will your insurance cover the cost post op for any doctor's visits regarding the surgery or complications? If so, past your insurance company's info on to the poster.

[kizzy]

:eek:

Daniel Boone said:

My US doctor has totally said he would not go out of the states.

I'm pretty sure you're US doctor said this so you wouldn't go and instead pay him

[kizzy]

Mz_Desz said:

The question you didn't answer is will your insurance cover the cost post op for any doctor's visits regarding the surgery or complications? If so, past your insurance company's info on to the poster.

Sorry, I do not have insurance so I wouldn't be able to answer that question HOWEVER when I was calling doctors around my area to see if they'd see me post op a few asked me if I would be using insurance so I'm assuming they'd accept it if I had it? :confused:

[Mz_Desz]

kizzy said:

Sorry, I do not have insurance so I wouldn't be able to answer that question HOWEVER when I was calling doctors around my area to see if they'd see me post op a few asked me if I would be using insurance so I'm assuming they'd accept it if I had it? :confused:

Doctors will see you regardless if you have insurance or not as long as you have the money to pay them. Insurances however will not cover any doctors appt and complications pertaining to this surgery if its done in Mexico. So any post op procedures that may arise will be solely out of pocket for the original poster. That can be very expensive. I just want to make them aware of that aspect.

[kizzy]

Well I dunno, I'm paying out of pocket...the best thing would to call your insurance and see if they would or call a few doctors and see if they'd accept your insurance after you have surgery in Mexico.