Can I afford it? Please read.

[Policeman116 0]

Well I got my insurance approval from my insurance company in 3 days. I was told that my insurance would cover everything and I was told the day of approval they are changing our coverage to only cover $15000 total for everything. This means that once they reach $15000 they will no longer pay. I was told that it could cost around $20000 to $25000 for the surgery. That mean all the fills and follow ups is out of pocket. It also mean that if complication and have to have it removed or replaced they advised me if I am past the $15000 point it is all out of pocket. Well this sucks but here is the questions

How much does a fill cost?

How often do you have to go to get a fill?

How much did everyone els pay for their surgery?

Would anyone know where I can find out how much payments would be for $10000 of the surgery being financed?

I know I am asking a lot but they truth is I don't have a lot of money, cops are paid so well. I need estimates and help in general. I just fell like I seen a light at the end of the tunnel and someone slammed it shut. Any answers, help, and suggestions would be very appreciated. :tongue2:

[RestlessMonkey 7]

My doc charges 15K for self pay for the band. I suggest you find a surgeon you're comfortable with that will accept in payment what your insurance will pay.

[stylist43 0]

i'm doing mine self pay and i was charged in the neighborhood of $20,000 for mine. That includes the surgeon charges, assistant charges, overnight stay in the hospital, and nutrition classes at the hospital.

That also included my first follow up/fill visit. After that, I'll have to pay more for those.

The only stinky part for me is that because I'm self pay the hospital that I'm having it done at required me to pay the entire amount up front so I'm not able to make payments on it. That's something that I would check on if you know you're insurance is only covering part of it.

I know that there are places online that you can go and be approved pretty much instantly for a loan or credit. Capital One has a good health loan. Another place i've heard of is carecredit.com.

i hope that it all works out for you :tongue2:

[shelley2b 0]

I did mine in Toronto and it was $16,000 Canadian - which would definitely leave you budget on your insurance for fills locally. Good surgeon too - Dr. Yau at Slimband. Have a look at their website.

[krtork 0]

I am a teacher and our insurance would not cover the band. I paid $15000 up front to the hospital. That included the all pre-op visits, surgery (all inclusive), post-op visits and my first two fills. It did not include overnight, as the surgery is outpatient for my dr. I put it on a credit card - 0% interest, etc. I did have to pay the hospital the whole amount up front. Kind of scary, but well worth the cost.

I feel fortunate have the dr that I have, my fills are only $100. I have seen others post and it is really expensive, in the $3-400 range!

Make sure you know what you are getting with the surgery cost and how much fills are. I feel fortunate to have my husband support this decision, it has made it a bit easier when I have to go in for fills each month.

It is well worth what you pay for the surgery. I also think knowing that we are paying off the bill each month really helps me stay committed to losing the weight and changing my lifestyle!

Hope this helps!

[susan1961 0]

It sounds like there is tremendous variability in the cost of the post-op care. I have heard of some including a year of f/u and fills, and others charging you from the get-go. While quality should be your #1 driver, not cost, there appear to be plenty of competent surgeons out there, so if your insurance allows you to pick your provider I would do some shopping around and find someone who is willing to give you a year of office-based office care for their global fee.

Obviously, even with careful planning, you can't control all the variables with the band. There's no guarantee against a flipped port, needing flouro for your fills, having a leak in teh tubing, etc. If you really are looking for predictable costs I'd research the sleeve (vertical sleeve gastrectomy). I seriously considered this option, but in the end it wasn't an option my surgeon thought was right for me (since my pre-op BMI was only 32). The sleeve does not require as much aftercare as the band. On the other hand, it's not reversible.

Best wishes.

[Totallytater 1]

My surgeon was just under $10,000 for EVERYTHING and I flew to Denver (one trip) for it. It was nice not to have all of the pre-op testing and charges and none of the follow up visits and costs. I flew back and forth to Denver a few times because his fills were free for 3 months and then just $15 each fill forever. My surgeon Dr K's quality and prices are just fantastic. I got tired of going back and forth to Denver so now I get my fills from Fill Centers USA for something like $175 each (I can't remember exactly what it is- $175 or $185 I think). So it is pretty reasonable. My surgeon doesn't accept insurance but if yours allows you to go out of network you might be able to turn in for reimbursement from your insurance company.

[amberd910 0]

Don't forget that the insurance company will pay a "negoiated rate" to the hospital. Say the hospital charged $20,000 for everything. Insurance might say well the going rate is $16,000 (example) for that procedure and thats what they will pay. There is no way for you to actully know what won't be covered is until after surgery and the final bills are submitted to insurance. You would then be billed by the hospital for anything over the $15,000 if that is all insurance said they would pay (but who knows, the negoiated rate might be less then that)! And don't forget the dr office visits are not included in the surgery bill. Insurance might end up paying those (depending on how they are coded) or you will just have to pay the dr's office afterwards if the bill is denied.

If you do finance the procedure, CALL your hospital first to see if they take CareCredit (LapBands financing company). My insurance compnay denied by and I was approved for CareCredit except my hospital doesnt accept that! Also Capital One does financing or you can always take out a credit card and shoot for 0% interest but with the economy in the pits creditors are locking down on limits. G/L to you! I hope my info helps!

[Policeman116 0]

What is the negoiated rate rate

[Policeman116 0]

What is the negoiated rate?

[RestlessMonkey 7]

What is the negoiated rate rate

Most insurance companies pay a rate that is "reasonable and common" or some such verbiage which means the hospital can bill whatever it wants to but insurance will pay only a set amount for each procedure etc. Same with surgeons, anesthetists, x-ray docs, etc. They agree, in order to get the business, to accept that "common and reasonable" payment and write off the rest. You don't "get" that rate unless your insurance has "made the deal". No insurance, no insurance rates. For example my doc billed several thousand for the surgery, he GOT $800.

Your best bet, if you have no insurance, is to find a doctor (like the one in Denver) offering a package deal.

[RestlessMonkey 7]

Policeman116...I just reread your post. Check with your surgeon. It's possible that your 20K (or whatever surgery) will now be done for 15k. If they still accept your insurance, then they will accept that rate. You may be "borrowing trouble" as my granny used to say. If your doc/hospital accept your insurance and it is a PPO or an HMO they have to do the surgery on you for what insurance will pay. Period. You may have to pay a deductible and some out of pocket copay, but they can't legally charge you an additional 10k to "make up" the difference.

[amberd910 0]

Most insurance companies pay a rate that is "reasonable and common" or some such verbiage which means the hospital can bill whatever it wants to but insurance will pay only a set amount for each procedure etc. Same with surgeons, anesthetists, x-ray docs, etc. They agree, in order to get the business, to accept that "common and reasonable" payment and write off the rest. You don't "get" that rate unless your insurance has "made the deal". No insurance, no insurance rates. For example my doc billed several thousand for the surgery, he GOT $800.

Your best bet, if you have no insurance, is to find a doctor (like the one in Denver) offering a package deal.

Exactly! I havent seen any bills for my procedure (and I shouldnt) but when I had my c-section with my son, everything was over $23,000 and payments were made totaling only around $14,000. Those are considered

"reasonable & common" by the inusurance company. I, of course, didnt have to come up with anything since the dr office, hospital, etc, has to write off the rest.....

[Blue Bug 0]

Well I got my insurance approval from my insurance company in 3 days. I was told that my insurance would cover everything and I was told the day of approval they are changing our coverage to only cover $15000 total for everything. This means that once they reach $15000 they will no longer pay. I was told that it could cost around $20000 to $25000 for the surgery. That mean all the fills and follow ups is out of pocket. It also mean that if complication and have to have it removed or replaced they advised me if I am past the $15000 point it is all out of pocket. Well this sucks but here is the questions

How much does a fill cost?

How often do you have to go to get a fill?

How much did everyone els pay for their surgery?

Would anyone know where I can find out how much payments would be for $10000 of the surgery being financed?

I know I am asking a lot but they truth is I don't have a lot of money, cops are paid so well. I need estimates and help in general. I just fell like I seen a light at the end of the tunnel and someone slammed it shut. Any answers, help, and suggestions would be very appreciated.

Thanks for putting into words exactly how I feel - I felt like I had seen a light at the end of the tunnel and someone slammed it shut too. :sad_smile:My insurance will only cover $7500 lifetime maximum, and from what the surgeon's office told me, there's no way I can afford it. They said my out of pocket for the surgery could be more than $20,000 plus all of the fills, etc. At least your max is double what mine is, but I would ask the surgeon's office specifically what they think your out of pocket expense will be (including fills)...That way there are no questions down the road. Good luck to you.

[taylorgirl1 1]

My hospital billed my insurance $44,000 ! I was there less than 24 hrs, the insurance has paid $6000 surgeon billed $5000 they paid $1200! That was BC PPO