should i have the lapband surgery?

ralheit · July 31, 2006

My insurance covers my fills. I had some complications right after surgery, which is rare. But everything has been fine since. I'm a little of a slow loser, but I'd still do it again.

NewSho · July 31, 2006

Speaking for myself :

I've been banded since the dawn of time (feels like :bananapartyhat: ) and I've never paid nor been asked to pay $800-$1000 for a fill under flouro. Fills aren't cheap but in big cities the places to get them tend to be more plentiful, often having more options.

And to answer PattyBlueEyes:

When all is good in the Band Universe, the insurance covers my fills, and I either pay a Co-Pay (usually $20 or $30) if I've met my deductible. (Even then the most they've ever billed my insurance was for a $425 at hospital, under flouro. I paid $20 CoPay for that.
Sometimes I go out-of-network or get fills with a cash band doc. My normal cash price for a fill ranges from $100-$250 depending on whether it's under flouro or not ($100-$150 in office, $200-$250 under flouro).
DS is short for Duodenal Switch which is another form of bypass weight loss surgery. We've got a couple of successful Band-to-DS'ers here (like Geezer, Rachele, and others) who can tell you more about this alternative procedure.

Oh, and there is tons of information at this website: www.duodenalswitch.com

Good Luck on your decision, either way.:bananapartyhat:

...Band people HAVE TO HAVE adjustments and they CAN cost quite a bit. (Up to $800-1000 per adjustment at the big city hospitals with fluroscopy.) If you haven't factored in the aftercare costs, it would be a good idea to do so.
Again...a few people need NO adjustments. But in the first two years I had my band, I had about a dozen. Ka-CHING!!!

Good luck!

GeezerSue · July 31, 2006

NewSho...remember, I was banded back when in the greater Los Angeles area, your choices were the guys at Cedars or Quebbemann in Newport Beach. As new band docs came on board, one or two would CONSIDER doing a fill for Mexican surgeon's patient, if--and only if--I had endoscopy first.

My last Cedars' fill (circa 8/2004), insurance was billed around $850-900 and I paid about $300 out of pocket and insurance paid MOST of the rest. (I think.)

The thing about "what insurance covers" and "what insurance doesn't cover" is that it can change every plan year. In my case, it didn't cover banding at all when I was banded. Then it changed TO cover banding and the fills. Later it changed to exclude BMI's over 50 from banding. Now they have this little ditty: "Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline. Note: medical necessity criteria for adjustments are based on whether or not the original surgery was considered medically necessary.

Note that it DOESN'T say by WHOM it has to have been considered medically necessary. Any surgeon in any country? What if the insurance you had at the time okayed banding for BMI's of 51, but this insurance does not...would that still be considered to be retroactively medically necessary? (Can you tell there are too many attorneys in my family? LOL.)

Sue

DonnaB · July 31, 2006

Should YOU have the band surgery? Only you--if honest with yourself--will be able to figure that out. Do you eat "too much" at three meals a day...or do you graze and eat most of the time? What is your relationship with sweets? . . . . .
Oh...one other thing. Do you have the resources for the required follow-up for whatever wls you choose? I'm picky and spend a good deal on Vitamins and supplements because I had the band removed and now have the DS. DS people HAVE TO HAVE special Vitamins and supplements. Band people HAVE TO HAVE adjustments and they CAN cost quite a bit. (Up to $800-1000 per adjustment at the big city hospitals with fluroscopy.) If you haven't factored in the aftercare costs, it would be a good idea to do so.

Wow is THAT a glass half empty! I've never heard of anyone paying that much for a fill. The most I've heard of locally (Dallas/Ft. Worth) was $250 with fluroscopy.

My insurance wouldn't cover my band so I was a self-pay. I just assumed I'd be in that $250 per fill group and I STILL thought having lap band surgery would be worth it. As it turns out, my insurance will cover my fills and I only pay a $50 co-pay.

I DO agree with Geezer Sue when she recommends assessing your own situation. The lap band has slow, limited, or no success with people who WANT to eat around the band. By that I mean that band surgery won't keep you from eating a pint or two of ice cream every day. It won't help you if you graze (eat small amounts) all day long. It won't help you if chocolate or cheesecake or any other easy-to-eat-crappy-for-you food calls your name and you MUST obey. It takes willpower, committment, and determination to have success with a gastric band. All the things, in fact, you have to have if you simply diet. The difference is, with the band, when you fall off the diet wagon, you can only do so in limited quantities and that gives you time to re-group, climb back up onto the wagon (climb down off of the ledge - choose your own simile) and get back on track, without wreaking too much havoc with the progress you've already made.

You must choose your own path, but know that if you choose the lap band you'll have plenty of support and feedback here on LBT. These ladies (and gents!) are THE BEST! Good luck on your weight loss journey.

health1st · July 31, 2006

Robin, if you don't mind sharing, what complications did you have right after surgery?

GeezerSue · July 31, 2006

You guys are making me doubt my sanity...so I went to the files.

On 8/10/04, I had a required preliminary appointment with the doctor at Cedars. Insurance was billed $340, actually paid $108.18 and I paid $27.04.

On 8/24/04, I was billed $621.04 for "Health Services." Insurance paid $224.58, I paid $148.06. AND...I was billed $446.00 for "Surgery" and $90.00 for "Testing / X-ray / Lab." Insurance paid $296.20 and I paid $74.05. AND...I was billed $74.00 for "Testing / X-ray / Lab." Insurance paid $8.58 and I paid $2.15.

So, to get a fill at Cedars-Sinai, in August of 2004:

~~Cedars and the doctor billed a total of $1573.06; and

~~My insurance paid $637.54; and

~~I paid $251.30.

So I DID overestimate, but still, it was WAY more than a couple of hundred bucks. AND, if I hadn't had insurance I'd have had to make prior price arrangements or be responsible for the whole $1573.06.

Add THAT to the cost of an apartment in Los Angeles and you get an idea of why--even though the pay is higher--many people won't come here to work!

Leona06 · July 31, 2006

My doc looked up the prices and said that because we have to use the flouroscopy at the hospital it would cost 750... but the first year of fills are free with the surgery so thats good!

GeezerSue · August 1, 2006

Leona,

That would mean--with the doctors I've deal with--that their fees are included. But the hospital fees are not. I hope yours is all inclusive.

BTW, even with my Mexican surgeon, the "free lifetime adjustments" did involve a fluorscopy fee.

NewSho · August 1, 2006

NewSho...remember, I was banded back when in the greater Los Angeles area, your choices were the guys at Cedars or Quebbemann in Newport Beach. As new band docs came on board, one or two would CONSIDER doing a fill for Mexican surgeon's patient, if--and only if--I had endoscopy first.
Sue

(*slaps forehead*)

Oh yeah Sue. I hadn't forgotten you were banded but I did forget you were banded in Mexico. Yep, Mexican-banded patients are often charged much more because (even here) fewer surgeons will take them as patients.

It's all Supply and Demand, I guess. More demand, fewer to supply, more

wanttobethin1 · August 2, 2006

health1st see my Journal it will tell to whole story but you know if you would ask now would I do it again I would say yes.. Good thing no one ask me back then.....