Cost

Donna, I think you're right to not go to that surgeon if his track record is so horrible. From what I've heard, some people do wonderful with a lap band (however, I know others who haven't). Either way though, if the surgeon and/or hospital doesn't provide quality care, you are best going somewhere else. As to insurance... Insurance companies have a cap on what they allow. When you are pre-approved through a surgeon's office, the surgeon's office is committing to accepting the payment that the insurance company deems appropriate. Same thing for the hospitals. So...for instance...a RNY procedure may cost total $60,000...BUT your insurance says 'nope, we allow a cap of $25,000'. Because the hospital & surgeon agreed to the pre-cert with that insurance company, $25,000 is all they are allowed to collect on. This would knock your 40% down from $24,000 to $10,000. For my last endo, $2146.55 was billed. $1018.79 is what was allowed & paid. A reduction of close to 53%. I agree with checking to see what your maximum out of pocket expense is also. That's 2 questions I would ask my insurance carrier...(1) What is their allowable amount for a WLS (RNY or Lap Band or whatever other type you desire), and (2) What is the maximum out of pocket expense per year (it may be a percentage of your income...just as it is with income tax in order to claim medical expenses as a deduction). I think you will find that you will have to pay far less than you are assuming. Best wishes! Keep in touch. Sherri

Thanks Sherri, I appreciate all the information. I will check into this more on Monday. I was amazed I was approved so quickly and then the cost just really let the air out of the balloon. lol lol But it will work out somehow. Thank for your support I appreciate it.

My total cost was under $35,000...I paid under $800 in co-pays. It weird that your insurance only pays for the adjustable lap-band....out of all the WLS surgeries, that one has the lowest over all precentage of weight loss and compliance (not due to the procedure-but rather due to not knowing before the surgery who is going to be able to maintain their diet or not). Of course...RNY and other by-pass patients can and do gain their weight back too. There isn't any fool proof surgery I guess ****sigh**** Good luck on your journey!!!