LAP-BAND® cost of

blueashdj · 01-03-2008, 07:53 PM

Did anyone have to pay for the cost of the LAP-BAND® only, was told ins. may not cover it. Will everything else. :help:

kacee · 01-03-2008, 09:22 PM

That sounds very odd. If they are paying for the LAP-BAND®, they would pay for the procedure or they would not pay at all I'd think. I've never heard of insurance paying for a piece of the procedure. I would get with your insurance company and have them itemize what it is they will pay...the surgical fee, the hospital fee, the anesthesiologist fee, meds, tests...... get them to be specific.

princesstracey · 01-04-2008, 01:18 AM

Oh ok, so your insurance company wants you to put it in yourself? Great idea.

I would investigate more into that. I hate insurance!

DrWatkins · 01-04-2008, 06:57 AM

Quote:

Originally Posted by blueashdj

Did anyone have to pay for the cost of the LAP-BAND® only, was told ins. may not cover it. Will everything else. :help:

It is true that some insurance companies do not cover the cost of the band itself (approx $3,000). Isn't that outrageous?

It is true that some insurance companies do not cover band fills but they will pay for band surgery. Isn't that outrageous?

Leena · 01-04-2008, 07:34 AM

My insurance covered the anesthesiologist fee, and pre-op fees but not the LAP-BAND® or surgery fees or hospital fees. I guess they were willing to chip in and make sure that I was sedated, because you know anesthesiology must be medically required for surgery.

DrWatkins · 01-04-2008, 03:53 PM

Quote:

Originally Posted by Leena

My insurance covered the anesthesiologist fee, and pre-op fees but not the LAP-BAND® or surgery fees or hospital fees. I guess they were willing to chip in and make sure that I was sedated, because you know anesthesiology must be medically required for surgery.

Isn't that outrageous!?

shortgal · 01-04-2008, 05:15 PM

Totally outrageous!
I am NOT a universal health care advocate, but we must make insurance companies NON PROFIT organizations and put more decisions in the hands of Doctors.

Nancee · 01-04-2008, 06:39 PM

Very funny - I chucked out loud when I read your response!

Nancee · 01-04-2008, 06:39 PM

"chuckled"

juliegeraci · 01-04-2008, 06:45 PM

Check to see how much they cover first. Fills can be costly and I am battling with the insurance company right now to pay for my fills. I have spent between $2k and 3k the last 18 months! My fills are $200 each.

Ang1982 · 01-04-2008, 06:51 PM

Quote:

Originally Posted by juliegeraci

Check to see how much they cover first. Fills can be costly and I am battling with the insurance company right now to pay for my fills. I have spent between $2k and 3k the last 18 months! My fills are $200 each.

Holy cow! Am I ever glad my fills are covered by the original cost of my band (self pay $14,000)

Shalee04 · 01-04-2008, 06:57 PM

Quote:

Originally Posted by kacee

That sounds very odd. If they are paying for the LAP-BAND®, they would pay for the procedure or they would not pay at all I'd think. I've never heard of insurance paying for a piece of the procedure. I would get with your insurance company and have them itemize what it is they will pay...the surgical fee, the hospital fee, the anesthesiologist fee, meds, tests...... get them to be specific.

My bill shows they charged the insurance co $6390.00 for the band only.

I am actually disputing with my insurance company right now.

United Healthcare HRA plus. as they said I had the covereage, I have 3 letters stating that it will be covered. I will only have to pay 20 percent....
They covered thier portion of everything so far except the surgeon. They wont pay any of his fee's. He bills out of network and they are now trying to skip around and say my policy doesnt cover weight loss surgery. HELLO you paid the Hospital and the surgeon assistant and the aneisteciolgeost, and all other costs. But said no to main surgeon. Hmmm weird and ridiculeous I say. My policy states if my surgeon bills out of network I will have to pay 40 percent and insurance will pay 60% so I am disputing with them.

I will say that when just the hospital bill came it was for $32,003.71 :faint:for 1 nights stay. and by the time they reduced it for in network provider discounts my insurance ended up only paying $5,000. I paid $1,100 for my portion to them

I also paid my surgeon $3,500 up front. I go in for my first fill on Jan 8th.. I can't wait to see what that's going to cost me..

DrWatkins · 01-06-2008, 09:20 AM

Quote:

Originally Posted by shortgal

Totally outrageous!
I am NOT a universal health care advocate, but we must make insurance companies NON PROFIT organizations and put more decisions in the hands of Doctors.

Over the past 20 years the cost of health insurance premiums has gone way up.

Over the past 20 years the amount of money health insurance companies pay to doctors and hospitals has gone way down.

The difference, the margin, insurance companies are getting is at an all time high.

The problem with this is that patients and our healthcare system are suffering while the health insurance companies are making HUGE profits.

Insurance companies make more money by denying claims or not paying claims. Insurance companies have a very powerful lobby.

This is a really big problem.

Leena · 01-06-2008, 09:39 AM

$200 fills don't sound too bad. My fills are $250 and are done without fluero. Thankfully I had three months post-op inlcuded in my surgery price. It looks like the fills I had then will last me for a while, knock on wood.

I considered changing insurance companies during dh's open enrollment period at work, but couldn't find out if things would be covered or not. I'd only be willing to switch if fills were covered.

I figure my surgery was the price of a commuter car and will last longer and be more benificial in the long run. Hopefully I won't be trading it in within 4 years.

Yes I know the insurance company is a pain in the butt. Covering anesthesia only was a riot, my surgeon's office had never heard of it happening and even called on my behalf to ocnfirm it. Now they're having their self-pay patients submitt anestesia fees with this company just in case they pick them up again.

aussie jedi · 01-07-2008, 05:36 AM

The Australian system seems a little different to the US. (all figures are quoted in Australian Dollars. Roughly AU$1.00 = US$0.90)

If you have private health insurance (optional system, you choose to have it if you want it, and pay a fee to have it - approx $60-$140 a month) it may or may not cover it depending on your plan. (alot of plans exclude expensive stuff like hip replacements, pregnancy, cardiac intensive care, laser eye surgery etc).

If you dont have private cover, it costs about $12,000 out of pocket.

My private insurance covered it - which means they pay the hospital bill and the cost of the band itself. You are then out of pocket for the Surgeons bill ($3000) and the anaesthetist ($1000)

Australia's free public health system - Medicare, gives you a small refund on your out of pocket expenses - about $400.

Consults with the surgeon cost $50, and Medicare gives you $35 back.
Fills cost $125, and Medicare gives you $108 back. (so very little out of pocket cost)

You can choose to have your surgery done as a public patient, and get Medicare to cover it entirely, but there is waiting lists, and you will wait about 4-5 years. (cannot choose your doctor or hospital)

You can also claim a tax rebate - if you have medical expenses of any sort over $1500 per year, you can claim anything above this and get 20 cents in the dollar back for every dollar over $1500. (you can include dentist bills, chemist bills, doctors bills optometrist, etc)