concerned

[hopetobebanded 0]

I have been seriously considering the band now for about one year. I have Aetna insurance and apparently they do not cover the band only the bypass surgery. I know for sure I want the band and I am pretty sure I want Dr. Ortiz in Mexico to do it. However...I do have a big question...What if by chance a mistake is made and something was punctured? Suppose you need more surgery to fix the problem? What would you do in this case? Would he take responsibility for it?

Even though he has a great reputation as do other doctors, what do people do in this situation? When you have insurance that covers this type of surgery at least you know that you wouldn't be paying for this mistake for the rest of your life unlike being a cash patient. This is the only major sticking point with me. Let's face it. Accidents do happen.

Any advice or comments would be greatly appreciated. Thanks.

[Marimaru 7]

If something like that were to happen, for the most part you are on your own. Sometimes insurance will cover issues like this, but sometimes not.

I think you should re-evaluate the idea of your insurance though. If they will cover the bypass, you should be able to get them to overturn the decision on the lap band. If you go to inamed.com, and contact them, they'll send you information that you need to help you with that. Usually if they cover the bypass but not the band, it's because they consider the band "investigational" which just isn't true.

[Guest j. lynn]

I have been seriously considering the band now for about one year. I have Aetna insurance and apparently they do not cover the band only the bypass surgery. I know for sure I want the band and I am pretty sure I want Dr. Ortiz in Mexico to do it.

Have you actually tried to get Aetna to approve the band? I've seen lots of people get denied, then win on appeal. Their insurance company called it investigational, which it's not. That's how they win.

[kellyk 0]

I had a phone conference with Dr. Ortiz about 2 weeks during which I asked that same question. He cannot answer whether there will be insurance coverage, but he told me that if the band had to be removed, he would not charge me any fee for his time to do it. I would still have to pay for the hospital. He said the hospital's fee is around $3,000. But at least he will waive his fee! May not be a perfect solution, but it is a compromise.

I would really encourage you to ask his office to arrange a phone conference for you to speak to Dr. Oritz directly. He was very generous with his time and patient with all my questions. I was extremely impressed by his professionalism and obvious pride in his work.

I am being banded by him on Wednesday. Leave tomorrow morning!