| Notices | Unregistered,! Please click here for more information on the 2008 National Lap-Band Conference event. | Anyone pay out of pocket? This is a discussion on Anyone pay out of pocket? within the Insurance & Financing forums.
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05-17-2008, 05:08 PM
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#1 | | Registered User Thread Starter  
Join Date: May 2008 Age: 25
Posts: 4
| Anyone pay out of pocket?
After reading quite a few of the threads on this board I see that there is a BMI requirement and/or co-morbidities needed to get approval from your insurance.
I don't think I'll qualify. I haven't called yet but plan to on Monday.
Anyone pay completely out of pocket? How much (if I can be so blunt)?
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05-17-2008, 05:40 PM
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#2 | | Registered User
Join Date: Mar 2008 Age: 56
Posts: 24
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I did not get any support from my insurance. They flat out said no coverage for bariatric surgery no matter what. I paid $7,000 and had it done in Mexico with Dr. Zapata in Monterey. It was an awesome experience.
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05-17-2008, 05:48 PM
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#3 | | Registered User
Join Date: Apr 2008 Age: 34
Posts: 60
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Most insurances, if they cover it, require a BMI of 40 or will do it if it is above 35 with 2 co-morbities (e.g. high BP, cholesteral, diabetics etc). My BMI is 32 and I paid for my surgery this Friday, getting it done next Thursday. When I think of what I have spent on personal trainers the last 3 years, diets, doctors, nutri-system, etc., this is going to be cheap |
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05-17-2008, 06:22 PM
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#4 | | Registered User
Join Date: Apr 2008 Age: 41
Posts: 180
City: Waterloo State: Ontario | Quote:
Originally Posted by Demeter After reading quite a few of the threads on this board I see that there is a BMI requirement and/or co-morbidities needed to get approval from your insurance.
I don't think I'll qualify. I haven't called yet but plan to on Monday.
Anyone pay completely out of pocket? How much (if I can be so blunt)? | I am paying $18,000.
__________________ *Love* - 'Life is not measured by the number of breaths we take, but by the moments that take our breath away.' 183.6 High / 176.8 Pre-Op / 153.4 Now / 138.0 Goal Apr. 09/08 - Phone Consult, Apr. 14/08 - Labwork & ECG May 22/08 - Banded (self-pay) by Dr. Yau @ TLBC Aug. 11/08 - 1st Fill @ 3cc, Oct. 22/08 - 2nd Fill |
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05-17-2008, 07:01 PM
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#5 | | Mama
Join Date: Apr 2008
Posts: 161
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$16,000 out of pocket in Ontario, Canada.
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05-17-2008, 07:11 PM
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#6 | | Registered User
Join Date: May 2008 Age: 38
Posts: 17
City: Atlanta State: Georgia |
hey. It really depends on your insurance company, and sometimes your employer, who can choose to exclude the benefit from the policy. Absolutely call your insurance company and ask them. You may want to have the procedure code (from surgeon) to give them. Many are seeing the light and realizing that this is curing much bigger and more expensive illnesses down the line. Mine did, BCBS, and they are paying 90%. I hope it all works out for you! Never give up. Best Wishes
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05-17-2008, 08:12 PM
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#7 | | josieb from TX
Join Date: Mar 2007 Age: 50
Posts: 378
City: katy, tx |
hi
i paid $12,900 in texas. this included 1 year of doctor visits and fills/unfills.
each person's insurance depends on how their employer set up the plan. it is not decided by the insurance company.
__________________  Weight 270h/249s/157c/155g Weight: H-highest S-surgery C-current G-goal Height 5'8" Inches lost: 48" Banded 3/30/07 Dr Hadar Spivak-Houston TX |
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05-18-2008, 10:36 PM
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#8 | | Banded 5/21/08
Join Date: Jan 2008 Age: 46
Posts: 54
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My husband hopes to have his surgery soon.
We decided after having a terrible experience dealing with the bariatric coordinator in Peoria, IL that we would just pay out of pocket for him rather than go to SFMC where he would be covered.
Here is what we have found in central IL:
Galesburg - Cottage 38000
Moline - Trinity 16000
Peoria - Methodist 12000
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05-18-2008, 10:39 PM
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#9 | | Registered User
Join Date: Jan 2008 Age: 59
Posts: 130
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Dr Tom Brown, DEnver $9,900 and Dr Kishbaum, Denver $9,900. DEnver is pretty reasonable comapred to other parts of the country
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Sadie from Colorado (holding a sedated Lynx!) One M&M is too many and a thousand is not enough!
Banded w/ 10 cc Band, 3/3/08, Dr.Brown, Denver
First fill 4/2/2008 4cc
Second Fill 4/23/2008 1.6 cc At my Sweet Spot!  |
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05-26-2008, 03:44 PM
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#10 | | Banded Medical Student
Join Date: Feb 2008 Age: 23
Posts: 27
City: St. Louis State: Missouri |
Has anyone paid an extra ~3500 for their pre-op tests (EKG, chest x-ray, etc.)??? I just got a bill from my hospital for that much--and they want my self-pay $11,000 next Thursday!  
The original quote for my self-pay surgery is 11000 for the hospital, 5000 for the doctor's fee, and 1000 for anesthesia... for a total of $17,000. But, if these pre-op tests aren't covered, that makes the total $20,500.
Please help!!!! Poor student living on loan money... |
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05-26-2008, 04:04 PM
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#11 | | Lets get the ball rolling
Join Date: Mar 2008 Age: 23
Posts: 147
City: Bellingham State: WA |
i paid $17,300 at Northwest Weight Loss Surgery in Everett Washington. That includes fills for 1 year, and any surgery that might have to be done if anything goes wrong for 2 years.
__________________  I Was Banded on May 20th 2008! Dr. Kevin Montgomery NWWLS Start: 265 ~ Current: 241 ~ Goal: 150 |
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05-26-2008, 05:14 PM
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#12 | | Sucess Story
Join Date: Jul 2007 Age: 38
Posts: 1,195
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I, too, paid out of pocket. June of 07, yes 1 year now.
Mine was all inclusive at $7,000.
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05-27-2008, 03:49 PM
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#13 | | Self-Payin' Law Student
Join Date: Jan 2008 Age: 26
Posts: 124
State: del.. uh.. where? |
I'm self-pay because my insurance has a bariatric policy exclusion.
Doctor's surgery fee is $6,000
Hospital fee is $11,000
Program fee is $550
Pre-op visits, consults, and tests: so far, over $5,000(!) luckily, my insurance picked up most of that.
__________________ banded 5-30-08 4.5ccs in a 9cc REALIZE Band |
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05-27-2008, 04:15 PM
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#14 | | Registered User
Join Date: May 2008
Posts: 1
City: Haughton State: Louisiana |
I paid 14,000 in North West Louisiana. I have Aetna who requires a BMI of 40 for 5 years along with 2 co-morbidities uncontrolled for 5 years. My BMI was 38.4 just began B?P meds that controlled B/P. Hubby and I decided to pay and bypass the co-morbidities that were sure to come. Good luck in your quest whether you or your insurance pays.
__________________ Brenda
of Louisiana Lap-Band 5/19/08 Dr William Norwood Shreveport City, LA 226H/219S/212C/140G "I can do everything through him who gives me strength." Philippians 4:13 |
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05-28-2008, 09:31 PM
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#15 | | Registered User
Join Date: Dec 2006 Age: 56
Posts: 20
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I paid $17,300 cash. that included all the pre surgery testing and all fills for one year and never have to pay for visits again no matter how many times I go for appointments.
__________________
___________________
Jean
Banded 2-21-07
330H/323S/253C/199 next goal(Onederland!!)150G  |
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