Toddy 758 Posted June 19, 2013 My daughter's insurance has denied coverage for wls. She is looking at lap-band with plication. I've had it done and it's the best thing I've every done for myself, but I had 100% insurance coverage, so my feelings may be skewed a little bit. In fact, I most likely would not have even considered wls if I hadn't had insurance coverage. I know the majority of people on this site say it's the best thing they've ever done, also. I'm just wondering about the perspective of those that have paid $12,000 to $16,000 (or more) and if they, too, think it was worth the cost. My daughter is 25 and has a bmi of 43. She does not currently have any co-morbidities, but having visited her lately and hearing her snore, she could probably use a sleep study and CPAP. However, with my history of high blood pressure and both sides of the family having history of diabetes, I feel like it's just a matter of time. Share this post Link to post Share on other sites
KAATNS 1,473 Posted June 19, 2013 Absolutely the best $12k ever spent! I did find out shortly after my surgery that the clinic I use reduced the cost of the sleeve to $7,500, which was a bummer but I'm still happy with my band. 1 Toddy reacted to this Share this post Link to post Share on other sites
Toddy 758 Posted June 19, 2013 The clinic I went to and want my daughter to go to reduces the band from 16K to 12K if you're self-pay. Unfortunately, the sleeve is twice that! She really wants the sleeve, but just can't afford it and won't accept help from her parents... Share this post Link to post Share on other sites
KAATNS 1,473 Posted June 19, 2013 It may be worth traveling to Cincinnati for the sleeve. Share this post Link to post Share on other sites
deleteme 176 Posted June 19, 2013 Because I was also found to have a hiatal hernia, my insurance will cover the cost to repair the hernia (think anesthesia, hospital fees, etc) so my surgeon is placing the band then. I am paying $5,500 out of pocket for the band because of this slight "loophole". Sent from my iPad using LapBandTalk 1 labwalker reacted to this Share this post Link to post Share on other sites
JACKIEO85 308 Posted June 19, 2013 My daughter's insurance has denied coverage for wls. Have they denied her or is it stated that their is NO coverage for WLS? Because an appeal can be done She is looking at lap-band with plication. I've had it done and it's the best thing I've every done for myself, but I had 100% insurance coverage, so my feelings may be skewed a little bit. In fact, I most likely would not have even considered wls if I hadn't had insurance coverage. Your probaly not alone I'm pretty sure allot of people with insurance coverage felt more inclined to have WLS surgery because of the coverage. I mean realistically WHO can just say HEY, I'll pay out 12-16 K for surgery NOT ME! Which I firmly believe is why allot of Ins. companies are going to WLS per lifetime in their policies. I know the majority of people on this site say it's the best thing they've ever done, also. Yes, reducing or eliminating Co-Morbidities and being Healthier is an awesome motivator I'm just wondering about the perspective of those that have paid $12,000 to $16,000 (or more) and if they, too, think it was worth the cost. NO, If I had to have paid all out of pocket I would have personally gone with the sleeve. My reasons are this: I'm a realist and even though I'm not having problems now, I keep an eye on complications, especially since they first said the band was permanent and now they say it's not. I don't believe any WLS surgery is without risks but I'm not looking forward to another one so I pray I won't need it. Surgery to me is a BIG DEAL, any surgery to me is invasive. JMO~ My daughter is 25 and has a bmi of 43. She does not currently have any co-morbidities, but having visited her lately and hearing her snore, she could probably use a sleep study and CPAP. Which is probably a great idea PRIOR to her decision for WLS. So many people have the belief that sleep apnea is just snoring and an inconvenience BUT it is and can be much more than that and is connected to Health issues long term. However, with my history of high blood pressure and both sides of the family having history of diabetes. Mine too, Genetic Stinks!! your such an awesome MOM for helping her thorough this I think with your Help she will make a Great decision!! keep us posted! . Share this post Link to post Share on other sites
MrsRyan2Be 13 Posted June 19, 2013 I'm a self-payer too. Best "investment" ever!!! Think of all the money she'll be saving on medications and possible diseases in the future had she not do it. I just keep tasking myself, how much is my health and happiness worth? Best of luck!! Share this post Link to post Share on other sites
Terry Poperszky 2,784 Posted June 19, 2013 11K here out of pocket, and I would do it again in a heartbeat. My quality of life is vastly improved over 6 months ago. 3 labwalker, MrsRyan2Be and KAATNS reacted to this Share this post Link to post Share on other sites
GuyMontag 1,264 Posted June 19, 2013 I paid $15,900 and with that I got the surgery plus 2 years of free adjustments and appointments. It was worth every penny for me. 2 KAATNS and labwalker reacted to this Share this post Link to post Share on other sites
ItsANewDay 119 Posted June 19, 2013 I paid 10k and have one year of follow up care included. Almost eight months and very happy. I would do it again in a heartbeat. 1 labwalker reacted to this Share this post Link to post Share on other sites
Toddy 758 Posted June 19, 2013 Was the $7500 just the surgeon's fee or the all-inclusive?? I can't imagine it being the hospital and anesthesia... that would definitely be worth the drive! 1 JACKIEO85 reacted to this Share this post Link to post Share on other sites
lilmispcl 298 Posted June 19, 2013 I was completely self-pay. Locally they wanted $18k but I was able to travel to Dallas TX to have it done for $10k. It includes 1 year of after care as often as you need or want to go but I probably won't be using that because the cost of travel and time off is equivalent to an office visit/fill here at the local place. Anyway...best 10k I have ever spent. I am only 2.5 months out but this has propelled me into a weightloss mission like no other! I don't have much fill in my band and don't feel restriction but I am eating great and recently started exercising. I really feel like the fact that I paid so much money for a tool is helping me to be successful. Share this post Link to post Share on other sites
feelinggood 152 Posted June 20, 2013 I'm probably going to get bashed for this but she might consider going to Mexico. $5500 with Dr. Kuri. I have also heard Dr. Ortiz is good. You may hear they use the "old" 4cc band that was banned in the US but they are still being manufactured by Allergan and used in Europe as well. Both of these doctors have done thousands of band surgeries and are well qualified. Just thought I would throw that option out there for her. 1 JACKIEO85 reacted to this Share this post Link to post Share on other sites