Self Pay, Hernia, and Complication Questions!

[AuDBall 32]

Hi all,

I'm new to the process, so I was hoping to see if y'all could help me with a few questions.

1) My insurance requires 6 months of documented weight loss, but not only would the end of the 6 months be an inconvenient time for me to get surgery as I'm a student, but it would also be a really long time to wait. I started on this in March, but skipped the last two appointments because I was having doubts about surgery the longer I had to wait. My parents have offered to pay for the surgery out of pocket, and I would be able to get it done in a couple of months after I have been able to learn more about the process (nutrition pre and post surgery, what I need to do after, etc) and it will be at a more convenient time for me. What do you guys think about this? I feel like if my insurance will cover it that I should wait, but that is so much time to talk myself out of it. I want this change, but I'm the type of person who goes back and forth on everything if I have a lot of time to think about something. Anyone else have this experience?

2) With self pay, what happens if you have complications? If this happened to you, did insurance cover the cost of complications? I will contact my insurance about this at some point, but I wanted to get a feel for what others have experienced.

3) I also need to get a hernia repaired that the surgeon said he would do during my gastric sleeve surgery. Can I submit the hernia part for insurance coverage if I do self pay for the actual sleeve part? Again, I will contact my insurance, but I just wanted to see what others have experienced.

Thanks for any insight!

[GassyGurl 428]

My insurance would cover complications, doesn't matter where surgery was done, whether it was self pay, or they paid, etc. I had to ask, but they said it would be treated as any other claim. My Pcp was also on board, but she didn't need to know that it was self pay. She took care of all the pre op tests that the surgeon requested.

The hernia is probably covered, but not all surgeons will bill it like that. Dr Kim in Dallas advertises a hernia discount, but when I asked several surgeons in town, they never heard of doing it that way. This seems to reduce most peoples cost for the sleeve to about $5k.

I paid $8899 in coral springs, FL with Dr Amit Taggar. All inclusive, except pre op tests. I had a preop class, plenty of diet info, and follow ups via Skype for a year. (I'm 8 hours away). My consult to surgery was about a month. But I had been pondering and doing consults for over a month.

Blossom Bariatrics in Vegas was high on my list. Center of excellence, great website, great videos to get a feel for them.
Dr Borland in Louisiana also has a good self pay package.
Bariatrix Florida is who I went with, because we could drive.

Mexico, is also a great option, even with plane tickets, still less cost than the US. Don't discount it till you read the reviews. I would have gone, but decided on Florida instead. Dr illan or Dr Ariel Ortiz would have been my top choices.

Good luck!


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[AuDBall 32]

On 9/9/2017 at 3:22 PM, GassyGurl said:

My insurance would cover complications, doesn't matter where surgery was done, whether it was self pay, or they paid, etc. I had to ask, but they said it would be treated as any other claim. My Pcp was also on board, but she didn't need to know that it was self pay. She took care of all the pre op tests that the surgeon requested.

The hernia is probably covered, but not all surgeons will bill it like that. Dr Kim in Dallas advertises a hernia discount, but when I asked several surgeons in town, they never heard of doing it that way. This seems to reduce most peoples cost for the sleeve to about $5k.

I paid $8899 in coral springs, FL with Dr Amit Taggar. All inclusive, except pre op tests. I had a preop class, plenty of diet info, and follow ups via Skype for a year. (I'm 8 hours away). My consult to surgery was about a month. But I had been pondering and doing consults for over a month.

Blossom Bariatrics in Vegas was high on my list. Center of excellence, great website, great videos to get a feel for them.
Dr Borland in Louisiana also has a good self pay package.
Bariatrix Florida is who I went with, because we could drive.

Mexico, is also a great option, even with plane tickets, still less cost than the US. Don't discount it till you read the reviews. I would have gone, but decided on Florida instead. dr illan or Dr Ariel Ortiz would have been my top choices.

Good luck!


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Thank you! This was very helpful.

[celticblknative 3]

My insurance would cover complications, doesn't matter where surgery was done, whether it was self pay, or they paid, etc. I had to ask, but they said it would be treated as any other claim. My Pcp was also on board, but she didn't need to know that it was self pay. She took care of all the pre op tests that the surgeon requested.

The hernia is probably covered, but not all surgeons will bill it like that. Dr Kim in Dallas advertises a hernia discount, but when I asked several surgeons in town, they never heard of doing it that way. This seems to reduce most peoples cost for the sleeve to about $5k.

I paid $8899 in coral springs, FL with Dr Amit Taggar. All inclusive, except pre op tests. I had a preop class, plenty of diet info, and follow ups via Skype for a year. (I'm 8 hours away). My consult to surgery was about a month. But I had been pondering and doing consults for over a month.

Blossom Bariatrics in Vegas was high on my list. Center of excellence, great website, great videos to get a feel for them.
Dr Borland in Louisiana also has a good self pay package.
Bariatrix Florida is who I went with, because we could drive.

Mexico, is also a great option, even with plane tickets, still less cost than the US. Don't discount it till you read the reviews. I would have gone, but decided on Florida instead. Dr illan or Dr Ariel Ortiz would have been my top choices.

Good luck!


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This is super helpful. I'm in Florida and my wife wants to get the procedure done now. I just had surgery in August and my insurance (Tricare) covered it. She has Florida Blue and they won't cover it. At least this info can help her. Can you tell me what your experience was with Bariatrix Florida?

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[GassyGurl 428]

Sure! My overall experience was great. I had a few moments of panic where I was worried test results wouldn't be in in time, but everything worked out (I'm persistent). If I lived in FL, I would use them again. I pasted my review below. A few things to note: Dr Wizman does surgery at 2 hospitals, (I think) and offers BLIS insurance. Dr Taggar doesn't and does surgery at Coral springs medical center. one 'complaint' some have is the 6 week follow up is a group class, but I think you get private time with the PA for any specific questions. I'm fine with that. they have a moderately active Facebook group, and weekly support group. oh yea, they can be flexible on pre-op testing for self pay patients. I was able to waive a few because of my age, and another gal was able to waive one because of time/cost. and i like their pre-op/post diet plan. I was under 37 BMI to start, so I didn't really have a pre op diet. post op, I was on purees on day 4.

I've been pleased with post op communication. I had an issue with one of my incisions, and I texted Dr Taggar and he was quick to text me back. plus, I was going back to work the day Irma was supposed to hit us. I needed a work note, and all of FL was in preparation mode. they went out of their way to get into the office and get me my return to work note.

I've seen good things about Dr Shillingford too. He's also practices at Coral springs medical center.

I actually used Dr Wizman's partner, Dr Amit Taggar. I had been through numerous consults locally, but they were all cost was prohibitive. I saw where Bariatrix Florida was running a self pay special, so I signed up for a consult. Dr Taggar seemed young, easy going and said I would be a good candidate. I spoke with a coordinator, got the list of pre op tests (EKG, bloodwork, chest xray, psych eval) and made sure they were all sent back in time. I was able to get this all done in about 2 weeks. I paid Dr Taggar, then paid the hospital, and booked my hotel rooms for hubby. We arrived a day early to get settled, then showed up for surgery at Coral Springs Medical Center at 7am. I woke up in recovery around 11, had minimal pain and was discharged the next day. My hernia was huge and I feel so much better since surgery. for that alone, I am so thankful.

I am the type of patient where I do my research ahead of time and ask a lot of questions. I am not the type of patient where I expect numerous phone calls and hand holding - I didn't need it and I didn't get it. Everyone was great and I'm very satisfied with my whole experience. Had I needed more care, I'm sure I would have gotten it, but my goal was to get out of the hospital as soon as possible. and they advocated that, saying we always heal better at home. I agree!

My only 'complaint' is things seem to change sort of rapidly, and their info packet doesn't match the current info. For example, the instructions say to take protinox for 6 months, but they recently changed it to 1 month. They don't prescribe Actigall any more either, because the evidence didn't support it. I found these things out when I questioned my physical prescriptions vs the book. I felt like my case was tailored to me, which was great. He told me I didn't need post op blood thinners, because of my starting bmi. I appreciate the personal attention vs the one size fits all that some surgeons seem to use.

I travelled 10 hours to use Dr Taggar, and I would do it again.

[DisplacedYankee 27]

I am self pay also. Just had my EEG yesterday and she found a small hernia. She said that she would fix it while doing my sleeve. We just switched insurance and am really hoping that they do not run the hernia repair under insurance since the new deductible is so high.

I called the doctor and am waiting on the finance department to call back.

[ohgeeasleeve 12]

Sure! My overall experience was great. I had a few moments of panic where I was worried test results wouldn't be in in time, but everything worked out (I'm persistent). If I lived in FL, I would use them again. I pasted my review below. A few things to note: Dr Wizman does surgery at 2 hospitals, (I think) and offers BLIS insurance. Dr Taggar doesn't and does surgery at Coral springs medical center. one 'complaint' some have is the 6 week follow up is a group class, but I think you get private time with the PA for any specific questions. I'm fine with that. they have a moderately active Facebook group, and weekly support group. oh yea, they can be flexible on pre-op testing for self pay patients. I was able to waive a few because of my age, and another gal was able to waive one because of time/cost. and i like their pre-op/post diet plan. I was under 37 BMI to start, so I didn't really have a pre op diet. post op, I was on purees on day 4.
I've been pleased with post op communication. I had an issue with one of my incisions, and I texted Dr Taggar and he was quick to text me back. plus, I was going back to work the day Irma was supposed to hit us. I needed a work note, and all of FL was in preparation mode. they went out of their way to get into the office and get me my return to work note.
I've seen good things about Dr Shillingford too. He's also practices at Coral springs medical center.

I actually used Dr Wizman's partner, Dr Amit Taggar. I had been through numerous consults locally, but they were all cost was prohibitive. I saw where Bariatrix Florida was running a self pay special, so I signed up for a consult. Dr Taggar seemed young, easy going and said I would be a good candidate. I spoke with a coordinator, got the list of pre op tests (EKG, bloodwork, chest xray, psych eval) and made sure they were all sent back in time. I was able to get this all done in about 2 weeks. I paid Dr Taggar, then paid the hospital, and booked my hotel rooms for hubby. We arrived a day early to get settled, then showed up for surgery at Coral Springs Medical Center at 7am. I woke up in recovery around 11, had minimal pain and was discharged the next day. My hernia was huge and I feel so much better since surgery. for that alone, I am so thankful.

I am the type of patient where I do my research ahead of time and ask a lot of questions. I am not the type of patient where I expect numerous phone calls and hand holding - I didn't need it and I didn't get it. Everyone was great and I'm very satisfied with my whole experience. Had I needed more care, I'm sure I would have gotten it, but my goal was to get out of the hospital as soon as possible. and they advocated that, saying we always heal better at home. I agree!

My only 'complaint' is things seem to change sort of rapidly, and their info packet doesn't match the current info. For example, the instructions say to take protinox for 6 months, but they recently changed it to 1 month. They don't prescribe Actigall any more either, because the evidence didn't support it. I found these things out when I questioned my physical prescriptions vs the book. I felt like my case was tailored to me, which was great. He told me I didn't need post op blood thinners, because of my starting bmi. I appreciate the personal attention vs the one size fits all that some surgeons seem to use.

I travelled 10 hours to use Dr Taggar, and I would do it again.

Can I ask what you paid? I checked the website but didn't see pricing listed.

[GassyGurl 428]

Can I ask what you paid? I checked the website but didn't see pricing listed.

I paid $8999, but it might have been a special. They responded quick to my initial email inquiry. I've seen Omen one post the cost is around 10,500, but I don't know if that's an old price, new price, etc.

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[AuDBall 32]

I took the leap, and I am scheduled for surgery on December 13th. Eeeeeek! It's going to cost me an arm and a leg, but it's worth it. Thanks for helping with my questions!

[ShawnZ 17]

I just has my procedure this week. Health insurance in Texas is not required to cover weight loss surgeries... So the only people that get it covered are on large corporate plans that have demanded it. I'm not one of them since I own a company with 3 employees.

When looking into, the cost was about $15,000 for a sleeve. If I have a hernia, the insurance will pickup about $5000 worth of expenses. So my cost goes down to about $10,000.

$5,800 to the doctor which covers everything through the first year or so on his side. Part of this is an insurance policy that covers complications. About $4800 to the hospital.

My psyc eval insurance covered. The blood work for a nutritional baseline insurance covered. As a cash pay, I told everyone to bill my insurance and I'd make up the difference.

I has secured a $15,000 loan from my credit union at 7%-ish... That's a personal loan for medical reasons. The monthly payment for 5 years was about $300/month.

The endoscopy to diagnose the hernia my insurance picked up. At that point I was down to a $10,000 expense. That's my threshold of acceptable. If I went to Mexico, I'd be looking at about $7500 plus travel... So at $10,000, I decided it makes sense to stay in the states.

The doctors office took payment by credit card and provided me an explanation of what that payment was good for. The hospital was more complicated and didn't want to give a price before the procedure. When I finally got a price they had forgot the hernia and insurance coverage of it. I was floored that the price doubled. After having a mental breakdown, making a scene, and crying like a baby, they got it figured out. I put the hospital put on my credit card.

After each CC transaction cleared, I payed it off.

When I was in the hospital, the staff was VERY nice. I was HORRIBLY nervous before the surgery. Thy gave me a shot in my IV to calm me down. That hit like a freight train. I told them I was getting light headed and dissy... They told me that if I didn't like that, their other stuff will make me hallucinate... I told them disy is fine, I don't want to relive my 20's with hallucinogens.

When I woke in the hospital bed... I hardly remember it. My mom, dad, and partner was there. I remember my mom commenting how nice the room it and taking pictures to show the hospital where she works. My parents keep telling me the first comment when I woke and realized I was in pain was "what the f**k did I just do to myself?"

Anyways, it's 4 days out and things are getting much better. I'm happy with my decision so far. I haven't experienced hunger yet.

[lindsayAK 100]

My insurance would cover complications, doesn't matter where surgery was done, whether it was self pay, or they paid, etc. I had to ask, but they said it would be treated as any other claim. My Pcp was also on board, but she didn't need to know that it was self pay. She took care of all the pre op tests that the surgeon requested.

The hernia is probably covered, but not all surgeons will bill it like that. Dr Kim in Dallas advertises a hernia discount, but when I asked several surgeons in town, they never heard of doing it that way. This seems to reduce most peoples cost for the sleeve to about $5k.

I paid $8899 in coral springs, FL with Dr Amit Taggar. All inclusive, except pre op tests. I had a preop class, plenty of diet info, and follow ups via Skype for a year. (I'm 8 hours away). My consult to surgery was about a month. But I had been pondering and doing consults for over a month.

Blossom Bariatrics in Vegas was high on my list. Center of excellence, great website, great videos to get a feel for them.
Dr Borland in Louisiana also has a good self pay package.
Bariatrix Florida is who I went with, because we could drive.

Mexico, is also a great option, even with plane tickets, still less cost than the US. Don't discount it till you read the reviews. I would have gone, but decided on Florida instead. Dr illan or Dr Ariel Ortiz would have been my top choices.

Good luck!


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Did you ever get a quote from Blossom Bariatrics? I didn’t see a price listed on the website. Saw a surgeon in my area, Dr Patel in SATX, and he quoted me 9k or 5k if I have a hernia. I’m nervous that 9k will double somehow.

[GassyGurl 428]

Did you ever get a quote from Blossom Bariatrics? I didn’t see a price listed on the website. Saw a surgeon in my area, Dr Patel in SATX, and he quoted me 9k or 5k if I have a hernia. I’m nervous that 9k will double somehow.

From what I've seen, a flat rate includes every thing once you're admitted. Hospital, drugs, surgeon, anesthesiologist, etc. I used insurance for preop testing, psych consult, and post op prescriptions but everything else was included. It was actually a relief knowing I wouldn't get a bill after surgery. They should be able to tell you what isn't included.

I didn't get a quote from Blossom, but I think they're around $11,600.

The rate you got is a good deal. Especially if you have a hernia.

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[lindsayAK 100]

From what I've seen, a flat rate includes every thing once you're admitted. Hospital, drugs, surgeon, anesthesiologist, etc. I used insurance for preop testing, psych consult, and post op prescriptions but everything else was included. It was actually a relief knowing I wouldn't get a bill after surgery. They should be able to tell you what isn't included.

I didn't get a quote from Blossom, but I think they're around $11,600.

The rate you got is a good deal. Especially if you have a hernia.

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Thank you for the info. I have a follow up appointment on 1/05 to go over the results of my GI and to see the dietician. He is also having me complete a sleep study. Did you have to do that? I will confirm with him that his quote is a package price and not a guesstimate.

[GassyGurl 428]

I didn't have to do all that, but wish I did. I had a schedule to stick too (personal choice) because I wanted surgery done by Aug 15th . Everyone was pretty sure I had the hernia, but since I was self pay, the only testing I needed was bloodwork, ekg and psych eval. I got a post op diet plan, but didn't get any nutritional counseling. I can email the nurse or post in Facebook, but it's not really what I call education.

[lindsayAK 100]

I didn't have to do all that, but wish I did. I had a schedule to stick too (personal choice) because I wanted surgery done by Aug 15th . Everyone was pretty sure I had the hernia, but since I was self pay, the only testing I needed was bloodwork, ekg and psych eval. I got a post op diet plan, but didn't get any nutritional counseling. I can email the nurse or post in Facebook, but it's not really what I call education.

Wow that almost sounds scary. I am glad they are having me do testing even though I will be self pay. I am also on a timeline so I hope I can get it all done as soon as possible. Not really sure what the sleep study is for.

I’m sorry to ask you so many questions but I really appreciate your responses. I am wondering how your post op was. I am hoping to get my surgery done in the next month because I am able to take the most time off from work. However, my parents will be here visiting at the time, for about two months. Yes my parents visit every year for about two months! Lol. Anyways, I am only concerned that they will not be supportive in my recovery post op. I don’t want to postpone surgery if I don’t have to but I’m also worried I will not have any energy to spend time with them while they are here.