Paying for surgery out of pocket

Hi everyone. Wow, things sure have changed on the website since i was here last... I think it's been since January. I was denied by Aetna for the lapband, so that was the end of that. Well, I've been going back and forth about paying out of pocket for the procedure. I called Dr.Fang and got the dollar amount as to how much it would be for a "cash" customer.  I wanted to know though, if anyone has gone this route and where did you get financial assistance, if you did. Since I'm just looking into it again, I wasn't really sure where to start and Coleen from the office actually told me to come here and get some information. So, here I am :). Thanks for the help and repies. Lisa

Lisa, I can't really answer your question. But the one thing that would keep me from being a self-pay is the thought that if I had complications I would have to pay for it MYSELF. I could probably scrape up the cash for the surgery, but could NOT pay for the complications, strictures, post-surgery issues keeping me in the hospital, etc. If the insurance tells me "no way, no how, never ever gone pay for that" then I will just have to stick around here, and do everything I can to diet without the tool to make it work. Having tried a zillion diets over the last twenty years, I am pessimistic that it will really work, but that is the route I will go if surgery is not an option.  When I went to the seminar, one of the papers they gave us included a financing-for-self-pays information... 602-239-5000.. (that's the good sam bariatric center) Says 4.99% APR (and up) with 12 - 24 month payback schedules, minimum monthly income $2000, and credit rating A-D. That's it in a nutshell. No down payment either. (just read that).

Hi Lithia, You may want to check out Dr. Eric Schlesinger.  He is building a new office suite and is giving introductory prices for all of his W. L. procedures.  The Lap Band is just $13,500 right now and that includes all office visits and adjustments for the first year.  The LapBAnd rarely has issues that would require more hospitalization so you could rest easy knowing that you'd have office visits covered.  I uinderstand your worries about not having things covered by insurance but it's very rare with Lap Band to have any complications.  The worst case is usually the need to have an x-ray in case of a slipage.  Those are generally covered by insurance if ordered by any physician. Good luck with your journey!  The wait for insurance approval is nerve racking!  .....  It's soooooo worth the effort though to gain a better quality of life!

Hi, I could probably afford that, but alas, everything I've read about the LapBand indicates it is least likely to be the tool I need. I need to lose 200 pounds, and I need something most likely to also cure my reflux quickly. losing the weight will take care of the reflux so any WLS that is successful will take care of that, but I believe that the RNY is the procedure most likely to eliminate the Reflux from the very beginning. If I don't get a curb on the reflux, I won't be able to teach after this year, and teaching is my life my true calling. Last school year I couldn't lecture for more than ten minutes each hour before my voice would start to go. I got creative and found ways around it, but it was terrifying. This school year, after not lecturing for 9 weeks, my voice is a little better, but I've already had three days where I got total laryngitis temporarily, and we've only been back in school two and a half weeks. So for me the Lap Band is not an option.  I also know that while my overall health is good, I do have trouble coming out of the anaesthesia, and that would most likely be considered a "complication". I don't doubt I will come out of it, it just takes a little more than usual. My mother is the same way.  I agree with you that this IS worth the effort. It is worth the time off from my students. When I feel my voice going or I'm too tired to stand in front of them and lecture, I find myself thinking about AFTER... when I will have more energy (eventually), will not lose my voice all the time, and will be thin enough to walk up and down the aisles and see what the kids are doing. With the surgery I will be better at my job, and healthier, and those things can only lead to being a happier person. (I'm already a very happy person though, so mostly I'll just be healthier). So even though I dislike seeing the doctor, and I hate paperwork and fighting for things, I'm going to do what it takes to get this surgery, and then use the surgery as a tool to get my life back!

As for aftercare for RNY for cash customers... from what I understand from people at support groups, anything that happens after the surgery, like strictures or any other problems are considered medical emergencies and your health insurance will cover it. I have had a few strictures and just had my gallbladder removed and had some repair work done to my RNY procedure and it's all billed as a medical emergency to the insurance company and nothing has been questioned. I would definately ask the billing people at the doctor's offices and they can give you better answers. ~Nicole

someone at the WLS seminar I went to asked about self-pay and complications. They said that insurance doesn't pick up those costs, and seemed pretty certain about their answer to this question. As self-pay is not an option (at least not until I've used up the insurance option) I didn't find the question or answer pertinent. But it did help cement for me that I can't risk it being self-pay. It would be nice to be rich, and have that kind of money and more sitting around, but alas, I am but a lowly teacher married to another lowly teacher!

Check with your insurance company yourself versus going off what people have experienced or even better check with your surgeon's billing office.  Everyone has different insurance and some insurance companies are strict and some aren't.  It all depends. I know there are members of this board that were self-pay and had some minor complications after surgery such as strictures and it was billed to their personal health insurance and covered.  As well as other people I know.  I just looked up all my claims and on the diagnosis/reason it says medical emergency and nothing about morbid obesity or anything related to the my initial surgery. 

At the seminar it was the lady from the billing office who answered the question about complications and who has to pay for them. Perhaps she was erring on the side of caution, but that's me too... erring on the side of caution.

Hey Lisa, Just me, the BERNESE LOVER.  I wrote you a note, but thought I'd post as well.  I am self-pay and was I worried about possible complications and having to out of pocket that, FOR SURE, but I also knew that not much does happen with the band and my personal Doc was willing to work with me as well, for instant, before surgery need to get all kinds of bloodwork and my personal Doc requsted that using I dont know a COVERED CODE, and the X-Rays or theres another test my personal Doc said he would work with me to make sure we use a COVERED CODE so that stuff is covered, so make sure you have a personal Doc willing to work with you and that will help!  As for the financing, I happen to have very good credit so what I did was called my credit cards and got one of them to give me the line of credit I needed at 0% for 18mths, so when thats up I'll need to do a balance transfer to another lender for I'm hoping another 0% and with some extra hard work hope to have this surgery paid off in a little over 2 years!  Not to bad, and I paid $16,500 and I know many people now going to the Doc JUDY mentioned, Doc S for $13,500 and they LOVE HIM!!!  Really if you think about it to help give you a "Better Quality Of Life" can we put a price on that!  We'll chat - Good Luck and dont hesitate to write me with questions!!  Take care.......

Hello Lisa, I was self pay also and was really concerned if there were to be any problems that too would come out of pocket. I paid on my american express and that needs to pay off in the month. That was fine but was scared to death if anything arose I would be in trouble. But nothing went wrong and am 3 weeks out. As Joyce said I did use Dr. Eric Schlesinger and I loved him. He is still finishing his office but we meet in the plastic surgeons office downstairs. He is doing ths great deal and he has a great aftercare program which was really important for me. I too was denied for insurance and tryed for a full year. They basically said I wasnt big enough for health risks but they never did see me or suffer the things I did. It is very scary being a cash customer because I didn't want to fail at this too because I have done every diet and landed here anyway. I have to say I have o regrets and I take every day as a new day.But as for Dr. Schlesinger I think I chose a great surgeon and am very happy with him and his staff ae very helpful I wish you only the best on this journey. If you have any questionshat I can help with feel free to leave me a message. I am only 3 weeks out and a newbie but feel great. Yo soon will be on your way!! Kelly