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 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?

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?

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?