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Paid for surgery out of pocket?



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Hi, everyone! I'm a pharmacy student on the brink of making a decision on the Lap-Band. My issue...I'm on school insurance and have an absolute exclusion for anything weight loss related. I think I may be willing to finance it, but of course it's a lot of money. Then again, it's far less than I've spent on cars already in my life (and I'm only 30), and this would last me forever. I had almost gotten the surgery last summer, and a year later I regret not having done it then because I would have been more than a year closer to goal by now. Anyway, would I be a sucker to pay out of pocket? A year from now I'll have graduated and will have real insurance. I'm an intern at Target, and I know their insurance covers it for some patients (I may or may not qualify), and it's likely I'll work for them after graduation. So is it worth the difference in time spent without the band in order to not have to pay out of pocket? If you did have insurance pay, would it have been worth it to you to pay yourself and not have gone through the approval hassle? I'd love any advice you guys have!

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I have BC/BS and they told me I'd have to wait 6 months and be on supervised diet and I knew in 6 months I would be almost to goal and I just didn't want to waste more time and possibly gain more weight. I self payed and had it done in Monterrey Mexico and it was 8500.00 and that included everything and free fills for life and it was a wonderful experience. They put the states hospitals to shame in some respects and Dr. Sanchez was marvelous. You have to do what you feel good about and everyone has different issues. I did what I had to do and so far no problems at all. It's been 2 months and I've lost 40 pounds. I could not have done it any other way. Good luck with your decision. If you have any questions feel free to pm me.

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Hi, everyone! I'm a pharmacy student on the brink of making a decision on the Lap-Band. My issue...I'm on school insurance and have an absolute exclusion for anything weight loss related. I think I may be willing to finance it, but of course it's a lot of money. Then again, it's far less than I've spent on cars already in my life (and I'm only 30), and this would last me forever. I had almost gotten the surgery last summer, and a year later I regret not having done it then because I would have been more than a year closer to goal by now. Anyway, would I be a sucker to pay out of pocket? A year from now I'll have graduated and will have real insurance. I'm an intern at Target, and I know their insurance covers it for some patients (I may or may not qualify), and it's likely I'll work for them after graduation. So is it worth the difference in time spent without the band in order to not have to pay out of pocket? If you did have insurance pay, would it have been worth it to you to pay yourself and not have gone through the approval hassle? I'd love any advice you guys have!

Veronda,

It really depends on your financial situation. If after graduation you have to start paying your student loans, then I would wait until you are working and your full coverage insurance kicks in. Do your research with your current insurance now, find out exactly what their criteria for approval is; you could be laying that ground work now (medically supervised weight loss program, exercise program, to name a few). These are the things that most insurance companies will want documentation for. The approval process is designed to weed out individuals that are not serious about loosing the weight. For me, having 2 children in college and my husband and I pay for our childrens education, (housing and everything else) out of our own pockets; financing my lap band surgery was not an option. You have time, do your research and make the best decision for you. Good Luck. :)

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I paid for my surgery and I've never regretted it. There are two things I do regret. I spent two months waiting for insurance approval that never came. That was wasted time. The other regret is that I didn't look into the Mexico hospitals. From what I've learned on here, they are about half the price and the quality is every bit as good. Going for fills would be a hassle but the extra $8000 I paid would pay for lots of fills if I chose not to go back to Mexico.

I say if you can afford it, do it and do it now. We never know what tomorrow holds and we should live each day to the fullest!

Good luck.

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I'm having surgery in November and will be self-pay. My insurance doesn't pay (although other plans thru my company do if the BMI is high enough and there are co-morbidities). I feel like I'm making an investment in myself. From what I understand, there are financing options---I believe Capital One has a plan.

Denise

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i am also being banded in november 11-07-06, wish it were sooner. whenis your date denisec and are u going to mexico? jackye:sick

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I am in a similar situation. My job now has insurance that will not cover the surgery. My previous insurance (BCBS State Plan) wouldn't cover it either. I thought about checking out other companies that have insurance that would cover the surgery.

Bottom line is that I am tired of waiting. I am also a student. I am a grad student, so I am borrowing up to the max to cover the surgery. After get my refund in January I should be able to finance the surgery. I could definitely use the $$ in other ways, but I am really determined now to get this surgery. I don't know if this is an option for you. The interest rate on student loans seem to be way cheaper than these finance companies. Plus, by the time you have to repay it you will already be out of school and working.

Right now my plan is finding a doctor in Mexico b/c it's a lot cheaper.

Good luck!!

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My insurance also excludes any weight loss surgery -- and most insurance excludes the lap-band (but will cover gastric bypass).

Lots of folks on this board self-pay for this reason... I can't even calculate how much I've spent on weight loss products over the course of my life, and hopefully this is the final expense (besides new clothes!)

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I also did self-pay. I knew my insurance wouldn't cover it, and thought that if I did pay for it myself, I'd have a lot more respect for my band. Every month when I make that $200 payment, I'm reminded of why I have the band and how important this decision was to my health and self-esteem.

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I had been denied by BCBS of TX, 2 times, and was going to have to do a lengthy documentation process all over again, because I was injured in a car accident in the middle of my first documentation period. In the end, I received a settlement from the accident, and used it to go to Mexico and have it done. Almost 5 months later, and I am down over 60 pounds...if I had waited to attempt to redo the supervised documentation thing, I would still have 1-7 more months of that to do...Instead I am halfway to goal, and feeling AWESOME!!!! It is a personal decision, only you know what your finances are, and how your health will react to the continued wait. For me self pay was the right answer...no regrets at all!!!

Kat

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Jackye,

My surgery is on November 2nd. I'm having it done in Richmond, VA at the VCU/MCV obesity center. Dr. Alfredo Carbonell is my surgeon.

Denise

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Thanks for sharing your stories! My plan, if I go through with it, is that I could pay a little more than a third of the cost with leftover student loans, and then for the rest I'd try to talk my credit card company into giving me a very low rate (I say, they either get all that fee they charge the surgeon plus the small amout of interest, or they get nothing!). It's also possible that I could borrow the money from my parents, but I'm trying to keep them out of it. SmittyJulesberg, I was thinking the same thing...that I would probably take my band more seriously if I'm shelling out all the money for it. Kat817 (does your birthday happen to be 8/17 like mine?!), I was worried about the waiting period and requirements before surgery too, so that even if it is covered for me in a year, it could be two before I even get scheduled. Besides, I can't find a doctor who will help me lose weight other than "write down what you eat" (duh) and "exercise" (I already do!), so what counts as doctor-supervised weight loss? I had thought about going to Mexico for the half-price thing, but I'm just too scared to do it and to try to find the aftercare (I live in Arizona, and most doctors here won't even look at Mexican bands), and while I've read of good experiences on here, I've also heard some horror stories. If I am banded, it will be on November 1. I have the consultation with the surgeon next Thursday. I just can't make up my mind! Oh, and I'm getting married next summer right after I graduate. So I was thinking I'm crazy to want to spend my extra money on the band when I have a wedding and honeymoon to pay for...but then I think about how much happier I'd be at said wedding and honeymoon if I were skinny!!!

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Yes Veronda...817, is indeed August 17th....however I notice, yours is just a few (:) ) years after mine!!! Good Luck in making your decision!

Kat

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Hi Veronda--I'm a nursing student, and I too am a ways away from work! But I see you're an intern, hopefully that can help with income. I was self-pay and banded on 9/11...I've never spent this much on anything before (except for school, lol) but I figure my health is SO worth it. I'm 27, and I don't want to become diabetic, have cancer, need joint replacements, etc...so I just went ahead and did it. I will be able to pay it off as I'll make a good salary as a nurse practitioner in a couple of years, and you'll do great as a pharmacist. I'd say go for it, but do whatever your gut says to do. sammysue78, seattle, wa

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