Some questions for those who self paid

[bling 0]

My husband and I went for our 1st consultation yesterday and we both have to have testing done with different areas before getting the surgery. We are going to try going thru our insurance first, but I have a feeling they probably won't pay....

So, we are still going thru with the surgery even if we have to self pay. My questions are:

* what were all the costs involved? Was the initial amount given to you the full amount or are there hidden costs that I need to be taking into consideration

* if your BMI was between 35 to 40, does the center you went to still require you to have a comobidity to go along with your lower ranged BMI (I have a BMI of 36 or so and I'm not sure I have any comobidities - I will need to do a sleep apnea test and I know I have a higher range on blood pressure, but it's never been diagnosed (I have med records that show all my bp ranges, I'm sure).

* is there anything esle I need to be researching as for as self pay people go? I feel like I have researched and researched, but could still be missing something....

Oh, I did find a doctor who normally charges $12,500 but is running a "special" (I know that sounds bad, huh) of $9,500 thru 2/29. I thought that was a great deal being as that's lower then anywhere I have researched yet!

TIA

[luluc 6]

My husband and I went for our 1st consultation yesterday and we both have to have testing done with different areas before getting the surgery. We are going to try going thru our insurance first, but I have a feeling they probably won't pay....

So, we are still going thru with the surgery even if we have to self pay. My questions are:

* what were all the costs involved? Was the initial amount given to you the full amount or are there hidden costs that I need to be taking into consideration

* if your BMI was between 35 to 40, does the center you went to still require you to have a comobidity to go along with your lower ranged BMI (I have a BMI of 36 or so and I'm not sure I have any comobidities - I will need to do a sleep apnea test and I know I have a higher range on blood pressure, but it's never been diagnosed (I have med records that show all my bp ranges, I'm sure).

* is there anything esle I need to be researching as for as self pay people go? I feel like I have researched and researched, but could still be missing something....

Oh, I did find a doctor who normally charges $12,500 but is running a "special" (I know that sounds bad, huh) of $9,500 thru 2/29. I thought that was a great deal being as that's lower then anywhere I have researched yet!

TIA

Hi Bling,

My husband and I went through the process together as well. He had a BMI of 41, with High Blood Pressure and Mild sleep Apnea, My BMI was 37 with no comorbis.

We went through a lot of hoops with our Ins *BCBSTX* Company for 5 months before we decided to go self pay. We were actually notified the same wk we scheduled our surgeries that insurance had declined us both.

We researched our Dr a year before surgery, made sure we checked his stats / office / fill center etc, we felt and still do we made a good choice with our Surgeon. I personally find his after care very supportive, which I believe is very important.

Don't get me wrong it was expensive $15k each and that $30k check was hard to write, but has turned out to be well worth it!

Best of Luck to You and your Husband!

Lulu

[Skinny_Jill 36]

My BMI was 39 and I was self-pay. There were no hidden costs for me. The doctor said $12,900 and that is what I paid. That covers surgery only though, no pre-surgery testing. Be sure to ask you doctor if that covers everything.

By the way, it was totally worth it.

Good luck!

[VegasGrace 1]

what were all the costs involved? Was the initial amount given to you the full amount or are there hidden costs that I need to be taking into consideration

Paying more than 7-8 k for this you are just wasting your money. The inital amount given to me was $7,000. I paid $7,000. No other costs at all, it was all inclusive meaning surgicenter, surgeon fee, appliance cost, anesthesiologist, cardiologist, nutritionist, psych eval, meds, ...everything!

* if your BMI was between 35 to 40, does the center you went to still require you to have a comobidity to go along with your lower ranged BMI (I have a BMI of 36 or so and I'm not sure I have any comobidities - I will need to do a sleep apnea test and I know I have a higher range on blood pressure, but it's never been diagnosed (I have med records that show all my bp ranges, I'm sure).

Inamed, makers of the lapband say anyone w/ a BMI of 30 or more are candidates. The US docs say 35 just because alot of insurance companies require that...they want to avoid paying as much as possible so they upped it.

But yes, your surgeon should ensure he's just not doing the band to be doing business.

If you've ever had high blood pressure or a family history

If you've experienced shortness of breath climbing stairs

If you've experienced joint pain

If you don't sleep well at night and snore....

you'd be surprised what can qualify you for the band

* is there anything esle I need to be researching as for as self pay people go? I feel like I have researched and researched, but could still be missing something....

Of course. First, make sure you want to get the band...for real. Understand the band for alot of folks is a last resort. Understand what's involved. Getting a band doesn't cause weightloss. Know that? Its the adjustments that are to cause the weight loss. (although some patients have experienced weight loss on the preop diet and just by being banded...how lucky!)

Know you aren't going to inhale food anymore. That was a shock to my body...but a overdue one.

Know you may not ever be able to enjoy certain types of food.< /span>

Know you have to keep up with your adjustments on SCHEDULE.

Are you ready to change your life?

Oh, I did find a doctor who normally charges $12,500 but is running a "special" (I know that sounds bad, huh) of $9,500 thru 2/29. I thought that was a great deal being as that's lower then anywhere I have researched yet!

It's not uncommon for docs to run specials...competition is getting fierce out there. This isn't a procedure for the rich and famous anymore.

Just don't sell yourself short and go to someone in the middle of a nasty divorce, behind on mortgage payments, etc.

After you decide to have the band...select a physician/surgeon. Look at all your options. Going to the best will require you going out of the country as Lapband is new in the US and places like France and Mexico have been doing them a heck of a lot longer than US docs. But there are many well qualified docs here in the US.

Get references...and remember those references will be from 'good patients'. Do some digging and find other patients who will give you some info without the Doc knowing.

Good luck and keep us posted!

[luluc 6]

GREAT points Grace!

Be sure you know what your total package fee will include.

[Audie 0]

Hi there,

I was also self-pay. I found there were no "hidden" costs in the price my doctor gave me. The cost covered the surgery, anesthesia (sp), the same-day surgery clinic fees, and office visits for two months and one fill (every doctor is different on the office visits and fills).

Although, all testing required to get the insurance is not covered in the surgery price. My doctor told us how to get around those costs. My primary care provider (pcp) was on board with the surgery so I took lap band doc's orders to my pcp and my insurance paid for them all. The only thing my insurance would not pay for regardless of who prescribed was the psych evaluation.

My co-worker also did it around the same time as I did. She was barely overweight and since she was self-pay and passed her psych eval. they did it. She's been really happy with it. So it's just finding a doctor that is a good fit for you. Good luck to you and your husband!

[steph_co 9]

* what were all the costs involved? Was the initial amount given to you the full amount or are there hidden costs that I need to be taking into consideration

My cost was $10,850 and included the pre-op visits with nutritionist, social worker, surgeon, NP, the surgery, the surgical center costs, anesthesiologist, aftercare and fills for 3 months post-op. No hidden costs. Oh, I did have a blood draw that I paid for on my own but that wasn't done through their office. I want to say that was less than $100.

* if your BMI was between 35 to 40, does the center you went to still require you to have a comobidity to go along with your lower ranged BMI (I have a BMI of 36 or so and I'm not sure I have any comobidities - I will need to do a sleep apnea test and I know I have a higher range on blood pressure, but it's never been diagnosed (I have med records that show all my bp ranges, I'm sure).

I was just under 37 BMI. I didn't have any major medical co-morbidities, but more like nuisances... infertility (not proven that the weight was to blame, but heck, why not count it), aching joints, spider veins, plantar fasciitis. I think those are all of them. Oh, I think they also count depression and then there's also obesity-related hypoxia (haha...fancy word meaning you get winded doing physical activity...I did...going up stairs). Any kind of physical complaint you may have that you can blame on your weight...COUNT IT.

* is there anything esle I need to be researching as for as self pay people go? I feel like I have researched and researched, but could still be missing something....

Erm...the only thing I can think of is going into the FAQs section and they have questions you can ask your surgeon. Make sure your surgeon is part of a Center of Excellence.

Oh, I did find a doctor who normally charges $12,500 but is running a "special" (I know that sounds bad, huh) of $9,500 thru 2/29. I thought that was a great deal being as that's lower then anywhere I have researched yet!

That is an excellent deal. My surgeon used to charge $10,850, but recently lowered it to $9,900.

[NukeChik 1]

I was self pay and it was 13,800. Of course if you want to get techincal I had to pay the consultation fee of 250 bucks and I also had to pay for the psych evals which were 300 dollars. So I guess my cost was about 14,350. I don't really care, I invested in myself. Also my fee includes a year of followups (they are scheduled, but it is still as many as I need) and fills are 45 bucks a pop. Then after the year my followups are 50 bucks each and fills are 125. So I think that makes my surgeon pretty competitive with the aftercare included in the package. My surgeon is also the leader of a center of excellence, so that made me a little more comfortable.

I got the insurance to pay for my pre-op testing by getting my regular doctor to send me for the tests. I had to have several blood tests and an upper gi. For the upper gi my doc just said, "So you have heartburn, right???"

[mo925 0]

I paid $ 22,000 which included everything the day of the surgery and a couple months of fills.

[adorkbl 156]

I was selfpay. My cost was $9950 for the pre-op visit, nutritionist consultation (via phone), surgery, and 3 months of fills. Any fills after the initial 3 months are $15 for the life of the band.

MY surgeon didn't do pre-op testing. I was nervous about that, but he explained to me about it during the pre-op consultation and I was comfortable with his reasoning.

My BMI was 57 when he operated. I have sleep apnea and borderline hypertension... but otherwise in good health. I don't believe he requires co-morbidities.

[DonHoll1 0]

I went to Mexico to Dr. Zapata. He was great. Total cost with my air fare was 8,000. I was a self pay. It was a nice trip. Donna

[Longhorn 1]

I disagree that paying more than $7000 is "wasting money." I think it depends on what you're paying for. I got the best price I could find in my area at $12,500, which did not include pre-op testing and consultations (probably added up to another $1000) but did include 12 monthly visits, including fills.

I have a fairly tight work schedule and I don't get paid when I'm not working. By the time I add in the transportation costs for 12 after-care trips, the difference in price isn't so great. I also wanted to be near my doctor in case of complications or the sudden need for an unfill. My husband and I discussed my various options and we decided that the convenience of staying local was worth it to us. I'm envious of those who can work it out to get it done for less.

[SueSue 0]

Go Lorghorn, I couldn't of said it better.

[FurEllie 0]

PLEASE don't shop by price alone! Get referrals, talk to patients, ask here.

I was self pay, had a BMI of 39 and could have had insurance cover it but went to Dr. Ortiz in Mexico because he has the most experience in banding. I could have had it covered by BCBS here after my $5K deductible but wanted to go to the teacher

Again, MAKE SURE THE DOCTOR YOU USE IS EXPERIENCED AND HAS IMPECCABLE REFERENCES. Don't go somewhere just because they're "cheap". This is your health you're talking about!!

[Sooverit! 1]

Paying more than 7-8 k for this you are just wasting your money.

Hi Grace I liked your response except for this part. Can you explain what you mean. For someone living in NYC I don't think we have a choice as we have to pay 3x this amount out of pocket if the insurance company we have gets greedy. I thought about going to another state but the cost of airfare, hotel and the hassle of finding a doc who will do fills here just isn't worth it I think.