Who does better? Self-pay or Insurance paid?

[Melinco 1]

I was thinking this morning about the correlation between those who paid for the lapband themselves versus those whose insurance paid, and how well they followed the "rules."

Do you think, if you were self-pay, that you were more aware of what you had to do and you followed the guidelines more closely? Conversely, if your insurance paid, were you more lax in following the guidelines?

I'm just curious about the results.

Thanks for your feedback!

[RestlessMonkey 7]

I think that people who are just getting it almost on a whim won't usually do it unless insurance pays for it. Usually.

Otherwise I don't think it correlates. I wanted the lap band since 2003, for example, but couldn't make myself pay out of pocket. Furthermore, there are many strongly committed people who would love to have the band and would most likely work wonders with it who don't have the wherewithal to scrape together 10-20K (plus the possibility of post op complications) to get it.

Whether I pay or my insurance pays, what matters is ME. That's true for each person. It's not fair or right to say "well if a person has to PAY for it he'll work it harder and better". You don't know that. Plus you don't know what some of us might have to tolerate etc to GET that insurance. It isn't "free". What matters is what's within, the dream, the gumption. How we realize that dream is almost secondary, for those of us who have insurance or the means to pay out of our own pockets.

[TSB 1]

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Whether I pay or my insurance pays, what matters is ME. That's true for each person. It's not fair or right to say "well if a person has to PAY for it he'll work it harder and better". You don't know that. Plus you don't know what some of us might have to tolerate etc to GET that insurance. It isn't "free". What matters is what's within, the dream, the gumption. How we realize that dream is almost secondary, for those of us who have insurance or the means to pay out of our own pockets.

I absolutely agree. I am not self-pay and there is no way I would have been able to have this surgery at this point in my life if my insurance had not covered it. Besides, I pay about $500/mo in premiums for my insurance for my family not to mention deductibles and co-pays for certain services, so my insurance damn well better provide good coverage!

I think "success" depends a lot on an individual's level of maturity and dedication. I also have come to the conclusion, through my own journey and having read about successes/failures here on LBT, that patient education/support is so key to succeeding. When I first started I was so impatient and frustrated by my surgeon's many pre-op requirements that went above and beyond my insurance company's requirements. Now I am so pleased with the outcome of my pre-op efforts and with support I received and still receive from my surgeon's staff. By the time I got through the lengthy pre-op process I knew exactly what I was getting into and went into surgery and the post-op phase of this journey feeling I had made a well-informed decision.

[Sluggo 0]

Well I am beginning the process of self-pay and I think I am doing an extraordinary amount of preparation and research because it is big $$ out of my pocket. I think that it is fair to say, though, that I would do the same if the leeches at my BCBS were paying for it. I will do much of the same clearance procedures but just not at their schedule and arbitrary requirements in their obvious efforts to pay for nada. I will just do it with respect to my own dignity and Quest for quality care. I think in this country we have come to believe, and expect, that if we want quality, we have to pay a great deal more for it. I suppose that is true in my case but it is proof why many foreign car manufacturers are whipping our domestic automakers.

[JUKU 1]

I don't know if it is true or not, but I was total self pay. Dang it, I am not just going to thow 20 grand down the drain.

[kiz 1]

One of the doctor's in the practice that I go to said in an info session that he has found that his self-pay patients are his most compliant.

I think a lot of it has to do with the fact that the self-payers get one year of fills and appointments with their contract, and after that, the fills can be very expensive. Also, if a self-pay patient needs a fill, they get a fill, without any additional paperwork, insurance approvals, or secondary appointments if the fill wasn't preplanned. All in all, the first year, it's easier to be a self-pay patient.

I have health insurance, but it doesn't cover weight loss surgery. I can't say that by paying out of pocket that I feel more motivated to make it work, because losing weight is something that I desperately want to do, and regardless of how the bill was paid, I am motivated.

Having this type of surgery is a huge commitment, so I would have been just as vigilant researching my options and then following the rules after the fact no matter how I was going to pay for the surgery.

[Melinco 1]

See, I was kind of comparing it to college. Many times (not all times) kids whose parents pay for their college tend to goof off more and not take it quite as seriously as those who have to pay for it themselves.

I know for me, since I am self-pay, I can't afford to do anything that would jack it up, because if I were to have to go in and do a revision, it would be out of my pocket.

I agree with what many of you said that you have struggled to get to this point and have done your research and you will work the program like it should be worked regardless of how it is or was paid for.

Thanks for all of your thoughts and feedback.

[RestlessMonkey 7]

I think it's more about being ready and knowing what you want than it is about who's paying. When I was 17 my parents paid for me to go to college. I was too young, had no idea what I wanted to do, would rather have gotten to work and knock around a while first. They were quite firm about "now or never" So I went. I got 100 hours, didn't finish. Later I wanted to go back but couldn't afford it because life has responsibilites we grown ups have to meet. Eventually in my late 40's I got a chance to go back and did. It wasn't because my mommy and daddy paid for me that I blew it off. But because I wasn't ready.

Had I been the one to pay for college when I was 17 I wouldn't have gone. Why? Because I DID NOT know what I wanted to take/learn/be yet. See?

The "it" factor is readiness, dedication, how well do you know what you're in for, how mature are you...not "who paid".

[Blazed 1]

I'm not sure who works harder but really everyone here made the decision to change their life and I am sure a lot have. So it doesn’t really matter who works harder just as long as you get to where you need/want to be. Personally I haven’t gotten banded yet (so scared!), but I will be self-pay. Though technically my grandfather is paying for the bill. My family is far from rich and just thinking that my grandfather loves me so much he would gladly pay the $15,000 well I’m just lucky to have him, because without him it wouldn’t be possible. Not only cause we really don’t have that kind of money but we have no insurance so I wouldn’t be able to get it done at all without him. As soon as the surgery is over I am going to start to pay him back. Anyways for me personally I know I will work my butt off, not just for myself but for my grandfather for wanting to see me healthy. As long as you have motivation everyone can succeed I’m sure of it.

[OnTheWay to Thin 0]

I dont think the money is the issue other than a lot more people would do it if they could find a way to pay for it or if their insurance covered. I was lucky my insurance paid, but I am not letting someone cut 5 holes in me for nothing! My friend was self pay over 22K she had to borrow from her 401K and is very aware with each paycheck of the cost, but she is having a harder time than I am. It depends on mindset and truly how many food demons you have.