Medical Tourism Insurence Questions

[galaxygrrl]

Hi all,

I'm not sure this is really the right Forum for this question, but after being all over the internet, I actually think this is the most educated, engaged and wise forum I have had. @Larra Thank you for guiding me here!

So, I'm going to Mexico for my switch. The pieces are starting to line up nicely! I have the Dr, the PCP Dr when I come back and my best friend is coming! Yes! And today I started reaching Medical Tourism insurance.

I don't really understand it. I want something that will cover complications in Mexico and once I get home for a given time period.

This is a hard one. Looking for answers to these questions

(1) How does this work?
(2) What are the companies I should look at? So far, I really only found a program for
(3) Any catches I should be aware of?

Thanks

 

[Clematis]

The insurance is inked to a specific doctor. The only Mexican doctor vetted for the DS is Dr Equerra in Mexicali. There is no insurance program connected with him.

In general, when I researched complication insurance I found it worthless when one looked at the fine print. They boast $50,000 payouts for a $2500 premium and yet if one reads carefully, the payout is up to $3000 for medical care, and up to $47,000 for transportation back home. Read the policy carefully.

One popular insurance vehicle for US surgeons doesn;t make it clear that it does not cover complications from the DS.

 

[galaxygrrl]

Thanks.

I'm going to go to Dr. Equerra - does not seem like there is another safe option to be honest. My US insurance would only cover $9,000 and wont cover complications, so I said screw it, I'm going to Mexico.

I was looking at your signature. You also had a cholecystectomy. So, I asked about that with Dr. Equerra's office and I was told it's not standard. And I read this ncbi.nlm.nih.gov/pubmed/17903779 - which says it's not necessary - sorry about the lack of a live link, the forum wont let me post a link yet because I'm a newbie.

My PCP who had the DS said she has it done and that Dr. Rabkin (our San Francisco DS expert) does it as standard. Do you mind me asking why you did it? I'm trying to figure out if it's the right move.

Thanks

 

[Clematis]

When I did research it looked like the majority of people had trouble with their GB within a year after surgery and many had to get it out. (This is a result of major weight loss, not the DS.) The last time I lost a significant amount of weight I had some sort of pain, went to the ER the next day and they found nothing but suspected it was a GB problem. People on here said to get it out. Of course insurance would have covered it later on but I didn;t want a second surgery. Just better to get it out. It was an extra $2k.

You'll do great with Esquerra. There is no complication insurance available for him. Fortunately I've never heard of an Esquerra patient with a complication.

 

[Clematis]

I just read your posts. Does Esquerra's office know you have a BMI of 60? I didn't think they took anyone with a BMI over about 45.

 

[galaxygrrl]

Thanks for the support.

Yes, Esquerra knows my weight. And they said I need to bring it down before surgery. I'm not sure you are right about that BMI. I was not told that, though I'm still in finalizing stage, but I've filled out all the forms, etc. I've looked at a ton of videos of people, and there are people with over a 45 BMI I suspect. My date is Aug 19. My plan is to do a liquid fast, it's the easiest diet for me. It seems I can do either no food or lots of food. Never been able to be in the middle. I do no food pretty well though.

 

[Clematis]

Sorry if I came off as alarmist. There are some who decide on a surgeon without ever speaking to anyone at the office. I have no data to support the 45 BMI besides someone here posting something to that effect.

The first time I lost 100# I did so on Slim Fast liquid diet. Not the healthiest but I did lose 100 in about 7 months. It was nice to just not think at all about what I was eating... because I wasn't.

You'll be thrilled to be able to eat with DS. Weird. Takes getting used to.

Good luck to you!

 

[Spiky Bugger]

When I did research it looked like the majority of people had trouble with their GB within a year after surgery and many had to get it out. (This is a result of major weight loss, not the DS.) The last time I lost a significant amount of weight I had some sort of pain, went to the ER the next day and they found nothing but suspected it was a GB problem. People on here said to get it out. Of course insurance would have covered it later on but I didn;t want a second surgery. Just better to get it out. It was an extra $2k.

You'll do great with Esquerra. There is no complication insurance available for him. Fortunately I've never heard of an Esquerra patient with a complication.

I recall an old Phil Donahue show, where a good number of people in the audience were former NutriSystem (back when it first started...different program now) customers who had rapidly lost a bunch of weight and also lost their gall bladders.

 

[harrietvane]

Re the insurance, I bought it but as the others said, it's not cheap and what it will cover in the event of a complication isn't that significant - both of which I knew when I made the decision to get it.

 

[-Flo-]

Back to the gallbladder, my surgeon takes it out on everybody. Unfortunately, with my prior weight loss attempts I already needed my gall bladder out and I got to tell you, gall stones are super painful. If you have an extra 2k, totally go for the gallbladder removal.

 

[galaxygrrl]

@Clematis - No worries! If my BMI was 45 I would be getting the Mini Gastric Bypass which to me makes the most sense.

@harrietvane - Do you mind sharing which insurance company you used. At this point, I'm leaning against it.

@ everyone else Thanks all! I have never had gallstones and I've lost weight fast and slowly. I really appreciate the advice!!! I think i"m going to pass on the gall bladder because I read this article. When you back out the math, only 10% of people need their gallbladder removed.

Routine cholecystectomy during laparoscopic biliopancreatic diversion with duodenal switch is not necessary.
Bardaro SJ1, Gagner M, Consten E, Inabnet WB, Herron D, Dakin G, Pomp A.
Author information
Abstract
BACKGROUND:
Similar to gastric bypass patients, a regimen of ursodeoxycholic acid in the immediate postoperative period might obviate the need for routine cholecystectomy. Routine cholecystectomy has been recommended for patients who undergo biliopancreatic diversion (BPD), because of the high prevalence of gallstones in the obese patient and presumed development of gallstones postoperatively. We have considered elective cholecystectomy only if gallbladder disease were present. The aim of this study was to assess the need for cholecystectomy in the postoperative period in such patients.

METHODS:
In this retrospective study, the data from 219 patients who had undergone BPD with duodenal switch (BPD/DS), from January 1999 to January 2003, were analyzed. We performed a 150-cm alimentary limb and 100-cm common channel BPD/DS. The patients received 600 mg ursodeoxycholic acid orally daily for 6 months. The following data were recorded: demographics, medical history, medication, weight loss, diagnostic evaluation, and operative and pathologic data.

RESULTS:
Of the 219 patients who underwent surgery, 59 were men (26.9%) and 160 women were (73.1%) (mean age 41.7 years, mean body mass index 55.7 kg/m(2)). The mean follow-up was 30 months (range 12-48). Of the 219 patients, 57 (19.6%) underwent cholecystectomy: 28 (12.7%) preoperatively, 10 (4.5%) simultaneously, and 19 (8.7%) postoperatively. Simultaneous cholecystectomy was performed when the patient had a history of colic episodes with gallbladder disease (disclosed by preoperative ultrasonography). The postoperative cholecystectomy pathology reports showed cholecystitis in only 7 patients.

CONCLUSION:
The results of our study have shown that the incidence of postoperative cholecystectomy in BPD/DS patients is low, and cholecystitis is rare. Routine cholecystectomy in BPD/DS patients is no longer recommended.

 

[Munchkin]

Think REAL hard about that GB! I can't tell you how many people spoke glowingly about their doc 'saving' their GB who ended up with another surgery a year later to have it removed. Some even took Actigall for months postop to no avail. Most people who have been heavy for any significant period in their lives have some degree of GB disease. It's a ticking time bomb waiting to explode!

 

[galaxygrrl]

@ munchkin - yep, I understand. It's just the data says it's a 10% risk. I'm making this decision off of data, not stories here or there. If there is data that says it's a 25% risk or more, than, I think it's worth considering. I will find more data about it before I make a decision.

 

[southernlady]

All I know is six months after my DS, I was back in having my gall bladder removed.

 

[newanatomy]

My surgeon removes the GB at the time of the DS. I had already had my gallbladder removed prior to my surgery so it didn't matter anyway. If I had to pay cash to have it removed in Mexico vs. waiting to see if problems occurred and having my insurance cover the cost in the US, I might consider the wait and see approach. I have a huge deductible so really, it hardly would matter either way. It is two surgeries but, a cholecystectomy is nothing compared to getting the DS as far as recovery goes.