I'm really bumbed...

[mel1106 0]

I started the process with my Dr to get the Lap Band. I was really super excited and went to the seminar at the surgeon's office that would be doing the procedure. At the seminar, I learned that while the procedure is "covered" by my insurance, the cost out of pocket for me is $11,000. The cost of the entire surgery is $18,000. My insurance will only cover $7,000. I am a single mom of a four and six year old. I can't afford to ge the surgery. I don't know what to do. I can't even barely cover my bills now, so financing is not an option. Just wondered if anyone has an idea I haven't thought of for paying for this..... any help/suggestions would be greatly appriciated!

[RestlessMonkey 7]

What is your insurance deductible, and then what is your max out of pocket for a year? If I know that, i maybe can help....

[mel1106 0]

Oh, man... I don't even know. The rep i was speaking to started droaning and all I heard was ELEVEN THOUSAND DOLLARS! I do know they don't cover the cost of the anestesia, and only cover 50% of the cost of the hospital expense. That's pretty much all he said. I am still moving forward as far as the leaps and bounds that are required to cover just the $7000 they WILL cover.....

[RestlessMonkey 7]

You REALLY should find out about your insurance. It's possible that they'll pay more if you use a different surgeon/hospital/anesthetist etc. If you have a PPO they won't pay top dollar unless you use an in-network facility and in-network surgeons. HMO's are even more strict. Its your money; it's worth calling and wading through some paper if it will save you 11K!

[mel1106 0]

It's an HMO benefit. There is only one surgical weight loss Dr or group in town they use, and one hospital. The surgeon's price is very good. It's just terrible that they won't cover the cost of the anestesia, and only 50% of the hospital cost. These are people and places that would be covered if it were a "non-elective" surgery. But for me it's NOT elective! I HAVE to do this. I don't know any way to make them see it. It makes me cry.

Oh, and thanks for responding! I really appriciate it so much!!

[IWANT2LOVE2LIVE 0]

dont be bumded.... Here a suggestion to you. I was banded on the 13th april 09. I tried to go thur my ins and becas i was a low BMI. But at the same time i had high blood pressure, and sleep problems all of which i was taking meds 4, but till was denided.Even if my ins were 2 accept me my out of pocket was going to be $11,000. I researched it over the net and founded a Dr.Joya in Mexico, Puerto Vallarta.He was great , the hospital was very clean and actually better the US hospital that my sisiter went 2 for her band. Private rm and your own nurse.I was up and walking without help in about 3 hours.I went under at 11:30 and i was talking to my husband at 12:52 pm. I had very little pain and my scar is very mininum.All of this for less then i would have paid via my INS.THE TOTAL PRICE WAS $7000.00.I would do it again in a heart beat.after seeing my recovery i have two more friends that are going in the next month.Think about it.He's great.