jog312

My insurance policy is a PPO with BC/BS of Illinois. In order to cover the procedure, I must have: a) A diagnosis of morbid obesity (BMI of 40 or more) -and- :rose: At least 2 co-morbidity conditions: Hypertension, Dyslipidemia (high cholesteral), Diabetes, Heart disease, Sleap apnea -and- c) at least a 5 year history of morbid obesity supported by medical records I'm not sure that I meet all of those qualifications. Certainly, my BMI is over 40, but it hasn't been that way for 5 years. And I'm not sure that I have 2 co-morbidity conditions. I'd hate to go all the way through the 6-month medically supervised diet, and then find that BC/BS will deny me. Is there any way I can find out in advance whether I'm likely to be denied, and thereby save myself the time and trouble and just focus on the self-pay option? Anyone out there have experience with BC/BS of Illinois denying coverage at the end of the 6-month diet program? --JOG312

My insurance won't cover me, so I'm going the self-pay route. I attended a seminar at the Kane Center in Arlington Heights, and was told that there self-pay price is $16,500. Yikes! Anyone know of a more reasonable self pay doctor in or around Chicago? I'm willing to drive 3 hours to find a doctor who charges reasonably.

I just attended my first seminar in the Northwest suburbs of Chicago, and was told the self-pay cost was $16,500. Yikes!!! Does anyone know of other lap band clinics in the Chicago area, or Northern Illinois area, where the self-pay price is cheaper? I know it's a lot cheaper in Mexico, but I'm a little leary about going that route. I'd rather stay close to home. Why is it so darn expensive? Do you think the self-pay price will come down as doctors compete more for the business? Anyway, I'd love to find a doctor here in the Chicago area who's self-pay option is more reasonable. Please let me know if you know of anyone. I'd even go as far as Bloomington IL, Decalb, or even Rockford, if it was a more reasonable price.

Spice: Thanks for all the great information you provided! You answered all the questions I wanted to ask about those 3 hospitals. They all seem sooo expensive for self-payers. I wonder what U of I Hospital charges?

Just curious: How much do the doctors in Champaign charge for self-payers? Here in Chicago, they start at $16,500 and up. I'm wondering if there's somewhere else in Illinois (within 3 hours of Chicago), where they might charge less. Anyone know?

I'm located in Chicago. Self-pay doctors here start at $16,500 and up. If I lived within a couple of hours of Cincinatti, I would definitely go there - $12,500 is cheap. Unfortunately, Cincinatti is about a 7 hour car ride - too far for me. Anyone know of a self-pay doctor closer to Chicago who is cheaper than $16,500?

I'm considering the lap band surgery, but it won't be easy to get my insurance plan to cover it. I'll have to do the 6-month medically supervised diet, and hope that BCBS of IL will approve me after the diet. However, I have a $5,000 insurance deductible, and the cost of the diet (plus all the pre-op tests) will not be covered. So this is likely to cost me close to $10,000 WITH insurance coverage!!! Part of me says to skip the 6-month diet, and just have the lap band performed in Mexico, where I could get it done for about $7,500. But I'm afraid - what if there's a complication and I'm in a foreign country? Or what if a complication develops later, after I return to the US? If I do go to Mexico, I'm inclined to go to Monterrey, just because it's closer to the Midwest (where I live), as opposed to Tijuana. Anyone have experience with Monterrey doctors? Should I go to Monterrey? Or should I play it safe and do the 6-month diet, and hope that my insurance approves it?

Kbinaz: Thanks - you've given me some good advice to think about. --JOG312

I just attended one seminar in the Northwest suburbs of Chicago, and was told the self-pay cost was $16,500. Yikes!!! Does anyone know of other lap band clinics in the Chicago area, where the self-pay price is cheaper? I know it's a lot cheaper in Mexico, but I'm a little leary about going that route. I'd rather stay close to home. Why is it so darn expensive? Do you think the self-pay price will come down as doctors compete more for the business? Anyway, I'd love to find a doctor here in the Chicago area who's self-pay option is more reasonable. Please let me know if you know of anyone. I'd even go as far as Bloomington IL, Decalb, or even Rockford, if it was a more reasonable price.

My insurance policy is a PPO with BC/BS of Illinois. In order to cover the procedure, I must have: a) A diagnosis of morbid obesity (BMI of 40 or more) -and- :rose: At least 2 co-morbidity conditions: Hypertension, Dyslipidemia (high cholesteral), Diabetes, Heart disease, Sleap apnea -and- c) at least a 5 year history of morbid obesity supported by medical records I'm not sure that I meet all of those qualifications. Certainly, my BMI is over 40, but it hasn't been that way for 5 years. And I'm not sure that I have 2 co-morbidity conditions. I'd hate to go all the way through the 6-month medically supervised diet, and then find that BC/BS will deny me. Is there any way I can find out in advance whether I'm likely to be denied, and thereby save myself the time and trouble and just focus on the self-pay option? Anyone out there have experience with BC/BS of Illinois denying coverage at the end of the 6-month diet program?