Insurance doesn't cover in US, need help with Mexico doc

[bobainsocalif 0]

Hi all. I have Kaiser Permanente in California, which refuses to pay for lap-band surgery, only the invasive gastric bypass (and even then you have to spend months and months going through a pre-op program, which I cannot miss that much work for). I am going to have lap-band done in Mexico, either through my own research or through a medical travel firm. Any recommendations? I've seen varying prices from $5,500 from a doc in Tijuana who has gotten some pretty bad reviews, to $8,000 by a doctor Ortiz, who has gotten good reviews. Any other advice? Money is an issue, since I'm paying for this myself, but I also don't want to go with the lowest possible price if the doc is dangerous. Help! Thanks.

[Oregondaisy 2,021]

If you want to get a band in the US, Dr. Tersigni here in Oregon just lowered his prices to 10,000.00

The only dr. I would trust in MX is Dr. Alberto Aceves.

Dr. Ortiz does not do his surgery in a hospital, he does it in a clinic, and you recover in a hotel. Dr. Aceves will have someone pick you up in San Diego and you will stay in a beautiful hospital.

Look for a thread called researching Mexican doctors.

[Crimson Tide 7]

Hi new to forum.I'm going to use Dr. Ortiz in Mexico the first Monday in April. My wife used him in November and I was really impressed with the place . It is not your typical clinic it is an Obesity Center. They have preformed thousand's of surgeries with no complications.

you decide best of luck||||

:tongue2:

[Oregondaisy 2,021]

That is not true. I am sure he is a good dr. but no complications? He was just on the news here in Oregon a few weeks ago about someone who had severe complications from his surgery. She came back to Oregon and ended up back in the hospital from the complications and his office would not return her phone calls.

[MacMadame 81]

Kaiser in CA will pay for the band. Lots of people on this site have gotten their band from Kaiser in CA.

Kaiser does the bypass, the band and, in some places, the sleeve -- though they try to get you to do bypass and at the info seminar, they may not talk about the band and will most likely not talk about the sleeve.

When you have surgical consult, bring up the band and tell them you want it and don't let them talk you out of it and you'll be fine.

[bobainsocalif 0]

I went to the informational seminar at Kaiser and asked about the Band, and they flat out said they would not offer the Band to me under any circumstances, that I could only get gastric bypass. Now I'm confused. Were they lying to me?

[MacMadame 81]

Maybe. :tongue2: But first my bias: I hate Kaiser's WLS program and I've heard of cases where I don't believe they were honest with people in order to force them into doing what they wanted.

First: They really try to get everyone to do the bypass. As I said, sometimes they won't even talk about the band at the seminar. They make *you* bring it up. They also do the sleeve but it's even harder to make them give you that. Usually you can just insist you want a band and they'll cave but for the sleeve, you almost always have to meet some special criteria.

Second: every location does things a little differently and you could have a very different experience depending on which surgeon you get assigned to. Some surgeons are much easier to get the band out of than others. Some programs are easier to get a band out of than others.

I'm going to go out on a limb and make a guess.... your BMI is over 50?? If that was true, I can see Kaiser, based on what people I know who have Kaiser tell me and my own experience with Kaiser many years go, saying "we only do bypass on people with High BMIs".

But if you don't, then who knows what is going on? The person you talked to could be misinformed. Or they could hate the band. Or they could honestly think you should get a bypass.

But here's the cool thing: If you go into the consult and they deny you a band, you can appeal to the DMHC and the DMHC has a really good attitude towards WLS and will most likely support you. The DMHC has made Kaiser pay 100% for people's DS surgery done by an outside doctor, for example.

So I think it's worth continuing with them and seeing how it plays out.

Going to Mexico is always an option that will be there. But, if you go to Mexico, will Kaiser cover your fills? If not, you'll be paying for them too.

So you could end up spending a lot of money when it you can probably get Kaiser to give you the band for free. (Minus co-pays.)

I recommend going to the CA section of the board and asking "who had a band at [your Kaiser]" and seeing what kind of response you get.