Self Pay Banding

solaa5 · 10-18-2007, 05:27 PM

Hi all,

I have a question for those of you who self paid for the procedure. I have Cigna and submitted all my documents to the 10/11/07. We have still not heard from them (they said something about taking 30days).
Anyway, my BMI is 41, I weigh 235 and I am 5'2 with no co-ormobidities. I am a size 16 (comfortably) with most of it around my hips, thighs and butt.

O.K, my question...I am so anxious to get this done (my surgery date is Oct. 29th). At this point in my life, I am 29 and have been overweight all my life, and I cannot afford to do another six months of anything- although I don't think that will be the basis of denial from Cigna. I won't be fat at my 30th birthday.

No matter what, I am getting the surgery done even if I have to pay for it. So, I'd like to know how much it costs, for those of you who had to pay out of pocket? In addition, do the fills cost extra?

I can't imagine living another day of being fat and since I have made the decision to let this body go, I am ready to pay no matter what.

Any information regarding self paying would be great.

kagoscuba · 10-18-2007, 05:56 PM

$6000 for doctor surgical fee; $13000 for hospital surgical fee; $2430 for anesthesiologist's fee; $278 per fill From what I've seen, my doctor must charge the most in the country, because I haven't seen anything else here even close. So you can use my number as a statistical upper limit.

TerriDoodle · 10-18-2007, 07:22 PM

My doctor charged $12,900 and that included hospital, anesthesia and one year of follow-up (fills). It did not include any pre-op testing which might be required if you had serious co-morbidities like heart disease, diabetes, high BP, etc.

You will find that the prices range anywhere from $10,000 - $20,000. It pays to shop around but I do advise that you have a surgeon close to home...or at least have a place close by to have your fills done after the surgery. If you line up a different place to do your fills, they may charge anywhere from $75 - $300 for a fill. Some may charge in a lump fee like $1500 for a year, something like that.

AthinnerDenise · 10-18-2007, 07:47 PM

I paid 10,000.00. There were some extra costs involved. I had to have a swallow test the next day, and the hospital charged 100
for that. I had to have an EKG and I can't even remember how much that was. I also had to have a psych eval and that was 75.00

My dr. charges 160.00 for fills, but I haven't had to pay for one yet.

Cota129 · 10-18-2007, 07:50 PM

My fee is $18,600. I am also self pay. The fee includes all pre-op testing, psychologist, and 1 year post-op doctors visits, any blood tests, and fills. It will be worth every penny.

WASaBubbleButt · 10-19-2007, 12:07 AM

I paid $7800, that included absolutely everything including two nights in the hospital.

I would battle the insurance co though. If you have WLS coverage, you should fit the criteria.

Arria · 10-19-2007, 12:15 AM

I had to pay between 16,000 and 17,000 dollars. My fills are free for 6 months, and after that, well I'm not really sure how much they'll cost.

mare5569 · 10-19-2007, 04:00 AM

I had to pay $9500. Which included all doctor and hospital costs. Three months of follow-up are included but if Dr. K does your surgery, He only charges $15 for fills after that. I had surgery coverage, but the wait time with Kaiser was over a year. I am so glad I didn't wait. I would have had another 20 lbs to loose and I would have been another year older and sadder.

Sue's Eye · 10-20-2007, 02:14 PM

I paid $13,500 to the hospital on Tuesday. This includes the surgeon, the anesthesiologist, hospital fees, pre-op tests, and one year follow up and four fills.

I'm still fighting with Cigna and feel pretty sure they will deny it no matter what, since my BMI is 36 with no co-morbids. But I'm determined to turn my life around and consider this an investment in my future that is money well spent!

Good luck to you in your fight with them. They can be an incredibly stingy insurance company.

kacee · 10-20-2007, 02:23 PM

I too am Cigna. Their main requirement is 6 months of monitored doctor weight program. I didn't have that and wasn't going to mess with it for another half year, only to have them make some excuse to deny me anyway (BMI was 38 with co-morbidities). I self-paid once they said they would not waive the 6 months program. I paid $12,900. My first year fills are free. If I reach 50% of my weight loss within the first year (I have surpassed that only 5 months out) I get the second year free. This was money WELL SPENT and I don't think a THING about it.

solaa5 · 10-20-2007, 07:44 PM

That's my concern too...being denied based on the 6 month documented diet (I have a record for a few years back which I submitted and I am not sure if they will accept that) but like most of you who self paid, I am tired of waiting and will most likely not wait another day longer whether I am denied or not...so, I will self pay and get my life on track before it is too late.

Did any of you who self paid ever get approved and tried to get the money back from the insurance company?:omg:

CrystalTy · 10-20-2007, 08:11 PM

I paid a total of $14,400. $9500 was the hospital stay for one night, $3800 was the doctor's fee and $1100 was the anesthesologist.

WASaBubbleButt · 10-20-2007, 08:30 PM

Quote:

Originally Posted by CrystalTy

I paid a total of $14,400. $9500 was the hospital stay for one night, $3800 was the doctor's fee and $1100 was the anesthesologist.

$3800 for the surgeon fee is a very fair and realistic fee. Most docs charge $5K and up.

steph_co · 10-20-2007, 11:56 PM

I'll be paying $10,850. Doctor: $3,300; Medical center: $7,000; Anesthesiologist: $550.

I think it's a dang good deal based on everything I'm seeing around these boards! :)

DonHoll1 · 10-21-2007, 07:37 AM

I paid 8000 for everything including airfare and Dr. Zapata is very nice. Great trip to Mexico. Donna