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Waiting for Approval..How much is it if denied???



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Hi All

I am new to this forum and I am in the process of waiting to see if my insurance will cover the lap band. Does anyone know how much it is if I self-pay?

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Depends on where you go, what surgeon, etc.

Seems to run about 8k in Mexico and about 10k - 12k stateside. Of course there are sums above and below this. I don't know what actual averages are.

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My goodness! I just had my port replaced last week, and I got the hospital bill.......$17,000!!. That is NOT even the doctor bill. How can it be so much more just for that.

Crystal

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dear lord! why did you have to get your port replaced? how long have you had your band? that's really too bad...what a bundle of bills you must have! ugh!

My goodness! I just had my port replaced last week, and I got the hospital bill.......$17,000!!. That is NOT even the doctor bill. How can it be so much more just for that.

Crystal

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The ones that self payed. Why did your isurance deny you? Also someone told me that the band ajustments were not covered and are $250 every time. How often do you need to go?

I'm sorry I'm asking a lot of questions, its just that I have crappy insurance and don't want to be left with insane bills when all is done.

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No worries! Insurance didn't deny me - I never applied because I "knew" I would be denied and I didn't want to go through the stress of 6 months of waiting just to be denied. My BMI was 38 and I had no health problems (no diabetes, no sleep problems...pretty healthy except for the weight). But - I didn't want to wait 5 years and develop all of the health problems and be even heavier! Plus, I didn't want to wait just to be denied. It was worth the $$$ to not go through all of that. Since I was self-pay, everything is covered (all fills, office visits, etc) for a year for the 17.5K. I was just banded 3.5 weeks ago so i haven't had my first fill yet - but all set for monday to be fill number 1!

The ones that self payed. Why did your isurance deny you? Also someone told me that the band ajustments were not covered and are $250 every time. How often do you need to go?

I'm sorry I'm asking a lot of questions, its just that I have crappy insurance and don't want to be left with insane bills when all is done.

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I have had my band 4 years. I was pregnant and had my son with the band! The doctor said the metal connecter in the tubing had eroded from the inside out.

Crystal

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MY insurance has an exclusion for any 'bariatric' treatments so insurance was not an option for me. As I said, I am being banded Tuesday, April 1 in Dallas. My cost of $15,000 covers 10 fills or 2 yrs of adjustments.

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In Dallas my surgeon charges self-payers 15k, but that includes a year of fills for free and a year of doctor visits to see him for free. It also includes every aspect of the surgery including anestesia. Some people need 5-10 fills the first year depending on the band you get and how big you are and all that. One of my friends only needed 4 fills to lose all her weight, but she was a very low BMI'er to begin with and my other one needed 10 (but she was almost 400 pounds) and she's still losing, but she got a bigger 14cc band so hers had to be tightened more often. So, if I were you, I'd find a doctor that offers a great deal like this.

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Mine was $13,625.....and it includes adjustments/follow ups for the first year....and support through dietician/exercise physiologist forver.

My insurance had a written exclusion, so I didn't even bother.

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