outside*looking*in 0 Posted February 1, 2011 Has anyone had to pay to have your band removed? I paid nearly $19,000 to have it put in a year ago (2/3/10) and may have to consider having it out. Self pay again! I have been dealing with espohagitis and bile reflux since the removal of my gall bladder and have not been well for nearly 4 months. It seems the band irritates my esophagitis. I have been unfilled since mid December and have had some improvement but nothing close to being normal. I take prilosec twice a day and carafate 4 times a day. Thanks. Share this post Link to post Share on other sites
Spartan 4 Posted February 2, 2011 Has anyone had to pay to have your band removed? I paid nearly $19,000 to have it put in a year ago (2/3/10) and may have to consider having it out. Self pay again! I have been dealing with espohagitis and bile reflux since the removal of my gall bladder and have not been well for nearly 4 months. It seems the band irritates my esophagitis. I have been unfilled since mid December and have had some improvement but nothing close to being normal. I take prilosec twice a day and carafate 4 times a day. Thanks. Outside, I'm sorry you are having this difficulty. It really depends on the surgeon and facility, as to the cost of removal. The cost does approach that of installation, though. I would seek some additional opinions before you have it removed. There might be something else going on. Also, if you do decide to have it removed, you might be a perfect candidate for a Sleeve. Your situation is something the Sleeve is really perfect for. And, you might find a surgeon that will perform a Sleeve and remove the Band at the same time, at little or no extra cost. I would seriously look into that if i were you. Best of Luck! S. Share this post Link to post Share on other sites
xavier 153 Posted February 22, 2011 Generally self pay means you are not sick, or fat enough to get the band paid for (I was a not quite fat enough) but when you ARE sick (esophagitis, reflux that isnt taken care of by meds etc) insurance covers. Share this post Link to post Share on other sites
Ponderer 14 Posted March 6, 2011 Generally self pay means you are not sick, or fat enough to get the band paid for (I was a not quite fat enough) but when you ARE sick (esophagitis, reflux that isnt taken care of by meds etc) insurance covers. Many self pays are due to it being a very specific exclusion in their medical insurance, regardless of their BMI. I am more then "fat" enough but am also fortunate enough to be relatively healthy despite that. Share this post Link to post Share on other sites
Sarah C 0 Posted March 8, 2011 I'm hoping mine will go through insurance. I'm having it out the same time as my gallbladder (which is covered). I have terrible reflux and the ability of my stomach to empty has been damaged. I can't take any medications to help it either because I seem to have reactions to every medication the specialist has put me on (fainted once, hives once, throat closed with one, threw up after another.) I didn't have to pay to put it in, so I don't know how much it could cost if it doesn't go through insurance. Share this post Link to post Share on other sites
Day Dreamer 23 Posted March 8, 2011 Generally self pay means you are not sick, or fat enough to get the band paid for (I was a not quite fat enough) but when you ARE sick (esophagitis, reflux that isnt taken care of by meds etc) insurance covers. Hmmm... I would like to clarify this statement by saying.. many self pays either have a exclusion in their insurance or they have NO insurance. If you have Bariatric exclusions, your insurance may not cover removal. If you have NO insurance - well, that's not rocket science either - you will be a self pay again. Many bariatric groups offer complication insurance to self-pay clients especially for these reasons. Anyway, good luck to the topic starter. Share this post Link to post Share on other sites
options123 3 Posted March 25, 2011 Dr Spivak does not charge to remove his band placements. The facility charges 3400.00. The best doctor in Texas. Share this post Link to post Share on other sites
options123 3 Posted March 25, 2011 I would like more into. About bariatric removal insurance. Share this post Link to post Share on other sites
Sangeeth@11 0 Posted April 29, 2011 Some people can't afford the Lap Band Surgery Costs .Like that situation can we cover that from a insurance.if not what are the option that can do ? Share this post Link to post Share on other sites
readytoroll 1 Posted May 23, 2011 Many self pays are due to it being a very specific exclusion in their medical insurance, regardless of their BMI. I am more then "fat" enough but am also fortunate enough to be relatively healthy despite that. I agree with you! My insurance covers it, according to my plan. Except, it has a 6 months waiting period and here are some interesting pieces of "qualifying" events: 1. MUST be 40+ BMI (no co-morbid conditions) 2. MUST be 35+ BMI (2 co-morbid conditions) All of the following apply to both above: MUST have followed a medically supervised diet program for 6 months (unsuccessfully), MUST have tried x-amount of other programs in the past x-amount of time and then there are a few other qualifying events. Even at that, there is no 100% approval rate. In other words, here I was, with a BMI of 34.4 (yes, .6 below the required 35) but I had no documented conditions that would be considered co-morbid. However, I was short of breath, feeling aches and pains in my body, sleeping poorly at night, and emotionally drained from my weight gain. So, I would have had to gain enough weight to have a BMI of 40+ and live like that for at least 6 months. I ended up paying myself because I hit the highest I had ever been, and I just needed a life style change asap. This losing 40-50 pounds at a time and then not being able to keep it off is not feasible, or even healthy in my opinion. I NEED a tool to help me sustain a life long change. It isn't about "looking my best" first and foremost. I want to live a healthy and energetic life - looking my best will be a wonderful reward from that. Do I believe that my insurance should have covered it without the 2 co-morbid conditions? Yes, because it makes me healthier period. On the other hand, being the devil's advocate - I never had a weight problem when I was younger and I do BLAME myself for being where I am at now (ate unhealthy and did not stick with my "new changes" - and, I believe that because of this, I programmed my brain and stomach that it needed more and more). So, maybe it is right I pay for it. I hope I am making sense. **Please note, that I do not think everyone is to blame for their weight - some people have true medical conditions that have caused them to get where they are and I think insurance should be there for them. Share this post Link to post Share on other sites
esch 3 Posted June 16, 2011 Sometimes once you get the band (self-pay), the insurance won't cover anything having to do with it sadly even for removal. you'd have to call... Share this post Link to post Share on other sites
feliciadawn 22 Posted August 10, 2011 I am going to Mexico to be banded by Dr. Ortiz in Tijuana in October. I've been researching for about a year, and he seems like the best choice. My insurance covers $5000 of lap band surgery, if I have it done by their doctor on their terms, giving them my diet history, having psych evals, and going on a 3 month medicially supervised (by them) diet. The doctor they use is not as experienced, does not seem as professional, and I do not trust him as much as I do Dr Ortiz, due to what I have heard about him. The portion of my surgery I would be responsible for would be $11000. Dr Ortiz is charging $6000 including free fills and aftercare for life (I am lucky to live in Vegas, which is only a few hours from his facility in TJ). To get to the point here, I contacted my insurance company and specifically asked them this: "If I get lap band surgery in Mexico and have an emergency for which I cannot take the time to go back to the hospital in Mexico to have fixed, would insurance cover this?" The answer was that they legally have to cover life threatening emergencies. So, if you go to the ER with band slippage, erosion, or whatever, they legally have to cover it. Even if they do not cover it, the ER cannot legally turn away ANYONE with a life threatening emergency. If they bill you later, so be it, at least you will have your health. That being said, if you get your band in Mexico, or anywhere besides where you live, you can go to fill centers USA, which is a company specifically for people who got their bands either out of the country, state, or anywhere else, and cannot find a surgeon to do fills/after care. They are not cheap ($250 for the first fill, about $4-500 total for the first fill and membership, fills are less after the first) but at least you know there is SOMEONE there who can help. They are in almost every major city. The only problem with them is that they don't always use fluro for the fills, which in my opinion, is dangerous and stupid. But, again, at least you know they are there if you need help. For me living in Vegas, I will go back to Dr. Ortiz for my fills and aftercare, but if I can't, I know that there is a Fill Centers USA dr. here in Vegas, one about 200 miles away which uses fluro in CA, and Dr Ortiz a couple hundred miles from there. 1 g25 reacted to this Share this post Link to post Share on other sites
BandPrincess 0 Posted November 15, 2011 Spartan-how was your esophigitis and bile reflux diagnosed? What symptoms did you have? Thanks for the I to. Share this post Link to post Share on other sites
BandPrincess 0 Posted November 15, 2011 Sorry my question was for Outside (trying this from my phone) Share this post Link to post Share on other sites