Self Pay

[NewDay 0]

Hi everyone,

I have been denied lapband for "non-medical necessity". Even though, I will be having the lap band even if I self pay it. I will appeal the denial. I'm sure you all know how it feels for the insurance company to pass illogical judgement. One of the things they say is I have to be on a medically supervised diet for 6 months. Are they kidding? I have been on every diet! Loss lots of pounds and put them and more back on. anyhow, do any of you know how much this is going to cost me? I'm a patient of Dr Haag in Springfield Ma.

Connecticare Insurance denied me. My BMI is 42 with no co-morbidities except GERD, depression, social anxiety, and overweight since I was a kid.

[TwinkleLiL_star 0]

I am so sorry for your denial..have your had your primary Dr or your psych Dr write a letter??

Try to have them send it again have your been going to WeightWatchers or other places to lose weight??..get letters from all of them..:heh:

Keep trying until they approve it

The price I am not sure try calling Dr.Haag's office and maybe Missy could help you...:gluck: :angel: :pray:

Good luck..

[Wheetsin 714]

One of the things they say is I have to be on a medically supervised diet for 6 months.

I wasn't required to do this, but I know a lot of people are. In most cases, 6 months is worth the costs of self-pay surgery.

I don't know how much that Dr. charges, but I know my insurance company was billed just under $30,000 plus additional sums for pre-ops. I've heard figures between $10,000 and $25,000 throws around for self-pay costs.

[mini_me 3]

I self-payed $15k for surgery with Dr. Spivak in Texas.

[JulyBandster 1]

I am a patient of Dr. Haag's too, and was denied by my insurance too, at first. I got an attorney, Steve Kalman (bandedlawyer.com!) for next to nothing and appealed and won. (I had Anthem Blue Cross/Shield of CT) When I first visited Dr. Haag, he quoted me a price of $12-$15,000 for the surgery out of pocket. This was a year ago.

Anyway, my insurance wanted to see diet history too - Because I had PCOS and Insulin resistance, I was visiting my gynecologist regularly, and she wrote up a letter for me, in addition to the letter from my PCP.

Also, check with the yahoo group about bandster's insurance companies - they regularly update and share their results with different companies...was very helpful to me at the time!

Good luck - don't give up!

[TwinkleLiL_star 0]

Amy have you lost weight ??? sorry about your gallbladder:confused:

I seem to be losing a few here and there:cool: since I stop eating so much junk food like "jolly ranchers"had an addiction to them for like 4 months really bad on sugar since starting to see Polly dietician have stopped a few habits...she was very helpful to me:clap2:

Wish all the people that need to appeal don't give up it's a battle but at the long run you will be a hero;)

[NewDay 0]

Hello massachusetts lapbanders,

Because my insurance has denied me, I'm considering Mexico for my lap band. Anyone else from MA have their surgery in MX? Who do you see for fills? Any local bariatric doctors around here happy to treat you even if they don't do your surgery?

[TwinkleLiL_star 0]

There are alot of people going to Mexico and it sounds all positive there are on other states ect...

About your fills better find that out first from the Dr's around this area..

Wishing you luck and a safe trip..

keep us inform..would love to know your progress..

[disneynut 0]

I have also read on this site that a lot of people went to Mexico and were thrilled. I believe I also read that the dr. in Mexico will help facilitate find doctors in this area that will do the fills. I don't know for a fact if that is true or not. Hope the appeal works but on the chance that it doesn't, Mexico seems that a good alternative. I also read something recently about companies that will loan money for the surgery.

[meganwf 0]

France is even cheaper than Mexico! I had a great doctor for 4400 Euro for everything- 3 nights in hospital and all the rest...and a great vacation! While I was there, someone told me Belgium is cheaper still, and they have been doing it the longest. I don't know how to find a Belgian doctor, but it can't be that hard.

[MonSoleil98 0]

Megan, how did you go about getting the process done ? how did you find a doctor there ? I fly for free so that might be easier for me than paying here ? even in belgium ? thanks !!!

[Elisabethsew 50]

I had my surgery 10 days ago and just checked what was billed to the insurance company... 20,500 for hosp and overnight stay, 2,800 for the surgeon and the anesthesiologists bill has not been submitted yet.

I was also denied surgery for lack of a medically supervised 6 month diet but had all my MDs write letters. I also faxed parts of my medical record to the insurance company. It was a fight but I finally won the appeal.

[lisanjason 0]

I was banded in Mexico by Dr Kuri,6 weeks ago.I was self pay.My insurance had an exclusion about anything having to do with weight loss.Dr Kuri does fills free for life .Surgery was 9k.

Lisa