Going it alone, Self Pay

[Livingthe Dream 0]

Hey Guys,

I am in the final stages of the lap band discovery process and the only thing left to do it set the date. I had to go to my traditional doctor for a letter and even though he wrote the letter he has planted the seeds of doubt. The good news is I have saved for this surgery and have enough to do the self pay option. Since I am at 34 BMI it is a route I have decided to go. My concern is that my doctor is going to be out of state (Colorado, Dr. K.) and if I have ANY complications my options are going to be pretty expensive. I can fly to Colorado or if it is really bad go to a emergency room where everything is going to cost me since my insurance wont cover anything that has been caused by the lap band they didn't recognize as being needed. I feel like I need to take this leap of faith but cat afford a 25,000 expense that is not covered by insurance.

[Ambrosia 1]

Living the Dream,

I'm afraid I can't answer your question but wanted to send you good wishes. I was self pay and although I haven't had any complications, my doctor is here in town so it isn't an issue.

All I can tell you is it was the best decision I've ever made and would do it again in a heartbeat. Good luck with your decision.

[Amanda Sizemore 0]

Living The Dream-

I Was In Ur Shoes About 10 Months Ago When I Was Trying Every Way Possible To Get My Insurance To Pay For The Surgery Here In The States. I Had No Luck So That's When I Made Up My Mind That I Wasn't Going To Pay $19,900 To Have It Done In Iowa Since It Only Cost $8,500 In Mexico. I Did Alot Of Research About The Doctor There And Was Very Confident In Him. I Being A Nurse Myself Was Very Picky On Choosing My Surgeon. He Actualy Lives In San Diego And Just Drives Over The Boarder Every Day To Work. I Also Liked Knowing That. I Haven't Had And Complications And I Was Able To Follow Up With A Doctor Here Where I Live. If I Were You I'ld Keep Looking At Options On Where To Have Surgery Done. Dr. Ortiz In Tijuania Was Excellant And It Was Very Clean And Such A Nice Hospital. Feel Free To Ask More Question If You Would Consider Surgery In Mexico. I Have Pics Also. Best Of Luck!!

[Jazlady 1]

I was in your shoes also as far as self-pay. I wanted lapband so bad I was willing to trust that everything would work out OK which it did. What's the worst thing that could happen? You could have complications and have to go to a hospital and get a bill. You could then arrange payments which would be so worth it. But as you'll see, most of us here never had any complications at all. So don't worry. This is the first time in my life I know I'll never be a size 22 again and that's a miracle. I am off my insulin, my joints don't hurt and I'm in a size 12! Oh, and I'm a beauty queen now. Now if that doesn't give you hope. Do it. Have faith and trust. You can always turn to us here for support. You are not alone.

[ShelbiCallie 0]

I'm a Dr. K, CO patient, too. I had my surgery 9/19/07. I traveled from NC, was self-pay and had so many pre-op doubts. I am VERY glad I went through with this. Of course, I was a BMI 43 and older with obesity-related sleep apnea, high cholesterol. From my experience, you can't go wrong with Dr. K. He's an excellent surgeon. I've had no complications, and would probably be at higher risk than you since I'm older, larger and have co-morbidities (you didn't mention that you had any). But honestly only you can determine if the potential benefits outweigh the potential risks. Good Luck to you in your journey! Check out the Dr. K thread under "Doctors and Hosptials".

[nina874 48]

I am sorry that I cant give you any practical advice as I am based in the UK, I just wanted to say that there are loads of women on the site that have gone self-pay in the US, I am sure that they will set your mind at ease whichever route you decide to choose.

Best of luck whatever you decide, the one thing that I am sure of is that you won't regret it wherever you go.

Nina x

[JosieK 120]

hi living the dream,

is there a reason you arent looking for a doctor close to your home?.

for me...the aftercare was just as important if not more important than the operation.

i had a few issues (caused by me...not the band) and i really needed my doctor's assistance.

i was self pay too. this was the single best thing i've done for myself....no regrets

good luck

[JosieK 120]

also...my aftercare is covered 100 pct by the doctor (ie fills, appts, etc) for 1 year

i think alot of doctors offer this.

[want2bmeagain 0]

I was banded 8 days before Shelbicallie by Dr. K in Denver. I also have all the positives to say about him that she does! I was in the process of going ahead with Mexico, then decided to go with Dr. K.

An important thing that changed my mind is the price of fills if I could find a doc near me to do them. I have read anywhere from $200-$500+ from an aftercare doc. For the first 3 months, Dr. Kirshenbaum does not charge, then after that, he charges $15 per fill. Many of his patients fly back to him if they live near a large airport and can get a reasonably priced ticket. Sometimes just the ticket can be less than the fills! I am a 6 hour drive away, so it actually takes me longer to get there and back than most who fly in.

I, too, worry about an emergency. But, it looks like most common, have to get taken care of now, emergencies involve getting an unfill. I did talk to a local surgeon here and asked him if I were in enough of an emergency and couldn't get to Denver for an unfill, would he help me. He's a great guy, and said "Sure! and if I have trouble, we'll call Denver!". I don't know if you could talk to a local surgeon that would help...if not, I have read over and over that any nurse who does chemo should be able to access our ports.

Of course port flipping, slippage, erosion, etc would just about always be handled by a persons surgoeon who did the banding...And if we were in a dire emergency because of those, we'd have to figure out how to get to our surgeon anyway...does that make sense?

I once posted asking opinions if I HAD to get to the local ER because I was blocked or whatever, what would insurance do (since it wouldn't cover the band)??? Someone responded that he believed insurance would cover a true emergency because of the liability. But, something like slippage, they wouldn't. Makes sense to me. Everyone's policy is different, but if I were in a TRUE emergency and ins. didn't cover, there is a huge open door with appeals.

So much of this is a leap of faith. There are a lot of long term unknowns since this is a relatively new procedure. I hope nothing horid ever happens with my band, but feel great with the leap of faith I took and have never looked back!

You will LOVE Dr. K

oh, he has also been GREAT financially in handling any problems with people. He is a fair, honest, skilled surgeon!