Artsynursingstudent

Self-Pay or wait for graduation and (possible) insurance?

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So, I’m new here, and I thought about posting this in the intro forum, but it is somewhat financial, so I thought I’d post it here. 

As a brief intro, I’m 27 and have been overweight if not obese since I was ten years old, around the time puberty really ramped up. I have Polycystic Ovary Syndrome (PCOS). I developed hypertension about two years ago, so its time to do something about my health. 

Problem is, right now I don’t have coverage for the surgery. I’m a nursing student and have my school’s student insurance. It’s actually quite good, and our on-campus health center is excellent, but it doesn’t cover bariatric surgery. That’s not surprising, since I was on an ACA Marketplace plan for a while that also did not. I have next summer off, and graduate December 2019. Doing the surgery during summer 2019 (perhaps May or June) would be ideal timing, but it would also mean paying $15,000 out of pocket on top of student loans (the surgery I’m looking into is the sleeve, and one hospital near where I live has that as a very well-priced package). 

I can certainly wait a while until I have a nursing job and potential insurance coverage, but I’m worried about whether I should wait until after I’ve been working for a while. I could develop diabetes in the near future, or excess weight could hinder my getting hired. 

The people I’ve talked to so far, my current primary care doctor and a nursing school professor who is a good source of professional advice, said I would be better off after I had been working a job for about a year (which would mean surgery about 3 years in the future). I’m just curious as to what you all think of this, or if some of you would advise going ahead with it next summer, even if it means lots of debt. Thanks!

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I think it would be worth every penny, and the self-confidence you'd get from it might land you an even better job. But I also hate debt so much that I'd probably wait if it were me.

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There is merit to both, and ultimately the decision is yours. Having had my original WLS at 28, I personally wish I had waited longer. Once again, you aren't me, so you may not face the same issues I did back then adjusting to life after surgery.

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Thanks guys. I think I'm leaning towards waiting for right now. Aussie Bear, what kind of issues did you face the first time, that you wish you'd waited for? I know this is the finance forum, but I'm curious. My mom had the VSG in August 2017, so I'm pretty familiar now with the struggles that go along with it, but its also been pretty life-changing for her. Between that and having her gallbladder removed, her fibromyalgia symptoms have improved enough that she's going back to work part-time. 

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4 hours ago, Artsynursingstudent said:

Aussie Bear, what kind of issues did you face the first time, that you wish you'd waited for? 

 

I was an emotional wreck, and that's putting it nicely. I went from the unloved fat girl in the corner to being a "catch". It was really tough for me to negotiate the vicious dating scene, and work became a nightmare on steroids at the same time. I was very lucky to have an observant family doctor who started asking all the right questions and getting me the help I needed. You just can't prepare for the emotional changes that can happen after surgery....and if you have to negotiate them alone it is even tougher. As if you don't put enough pressure on yourself to lose weight, it seems most other will be putting pressure on you to gain it.....mostly for their own reasons I've since learned, but their criticisms will be couched in terms of concerns for your health. I get it all again this time around, I'm just better equipped now to handle it, plus I'm a far better judge of character these days.

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Those are good points, and although I know I can't fully prepare for the emotional impact until I experience it, I'm going to be starting sessions shortly with counseling services on campus. I know I won't be able to resolve everything that's going on emotionally in my life prior to the surgery, but I know that if I do some "homework" beforehand it will be at least a bit easier. I'm also going to work with an on-campus dietician to help with my eating, since I'll have to work with one before and after the surgery, and learning to make some changes now may make the physical aspects easier to deal with, too. 

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Welcome, @Artsynursingstudent :) 

You're right...you can't fully prepare for the emotional impact of this process until you experience it. But seeking counseling now is most definitely a great head start in that direction! The more homework you can do on yourself and the weight loss journey itself, the better you will be able to handle things as they unfold. This is a GREAT place to be, and we are all here for support and friendship :) Whether you choose to wait or have your surgery now...we will be here ❤️

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As someone who found herself saddled with a lot of debt at a relatively young age, I say wait. (My only exception would be if you were having complications from comorbidities, but you don't mention any current ones.) I think if you find yourself having trouble getting hired, or start seeing your health deteriorate, then absolutely look into the self pay, but otherwise I'd hold off for the financial support of health insurance and steady income if you think it's in your future.

I realize that there is for sure a stigma against hiring heavy people, but I will also say that I've never had a problem getting a job. I wouldn't assume the worst quite yet.  

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My only exception would be if you were having complications from comorbidities, but you don't mention any current ones.

My lipids are great, but I recently became prediabetic (A1c of 5.9; 6.5 or above is full-blown diabetes). It's pretty significant that I did, since my A1c was under 5 just last year. That's my only real complication right now, but the potential for diabetes at my age is scary. 

On 3/23/2018 at 11:18 PM, kristinwitha_k said:

I realize that there is for sure a stigma against hiring heavy people, but I will also say that I've never had a problem getting a job. I wouldn't assume the worst quite yet.  

I do think my size won't hinder me getting a nursing job, but I do think it prevented me from getting another job. I have a Master of Health Administration (MHA) that I wasn't able to get a job with, and for at least one interview they seemed extremely excited to see me until I was there in person. Obviously, it could have been many other factors at work, but I can't help but wonder if my size played a role. The woman who would have been my supervisor was extemely thin, as were most of the other people working there. (For those who wonder, I'm getting a nursing degree now because of the difficulty with the MHA, but also because many health management jobs actually require a background as a nurse). 

Edited by Artsynursingstudent
Typo

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I do not know where you live, or the laws of your state, but in Massachusetts if you are low income you probably qualify for MassHealth health care coverage paid by the state.  MassHealth pays for weight loss surgery if you have a high BMI.  Thus, it is possible that you may be able to get weight loss surgery paid by your state even if you have no health care coverage.

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1 hour ago, Res Ipsa said:

I do not know where you live, or the laws of your state, but in Massachusetts if you are low income you probably qualify for MassHealth health care coverage paid by the state.  MassHealth pays for weight loss surgery if you have a high BMI.  Thus, it is possible that you may be able to get weight loss surgery paid by your state even if you have no health care coverage.

Unfortunately, I live in South Carolina. No Medicaid expansion, and our ACA plans don’t cover WLS. 

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15 hours ago, Artsynursingstudent said:

Unfortunately, I live in South Carolina. No Medicaid expansion, and our ACA plans don’t cover WLS. 

Sorry. :(

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@Artsynursingstudent

I have a bit of a different perspective. I wish I had the surgery long ago. I think that losing weight in a difficult but permanent manner would have saved me years of heartache and self hatred. 

I traveled to Mexico and had GB at a reputable hospital. My surgery was $11K *but* that is because 1) I had GB which is more expensive than the sleeve and 2) I picked the best hospital in the region. I found several clinics that do the sleeve for about $6K. While my bank account took a hit, I don’t regret a single penny. I’ve lost 90lbs and my diabetes is in remission. 

I can sympathize with enormous school debt. I borrowed $120K for my education. I don’t regret this decision but it’s a hard pill to swallow. 

Ultimately, the decision is yours. You know your body, finances and mental well being better than anyone else. Trust your instincts. All my best to you.  

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I think it depends on how you'll pay out of pocket. If you have to finance, I would wait. If you can borrow from family or someone who doesn't care if it takes you years to pay off, go for it.

You don't want the $15K you finance for your surgery to grow to $25k or $30k if it takes you longer to pay off than you anticipate. 

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