is your aftercare covered under your insurance

ronniesnana
on 4/17/12 12:43 pm
My maximum coverage for bariatric surgery will be at its max when i have surgery. Does anyones insurance cover revisions or any problems related to your lapband? My insurance company says after surgery if anything goes wrong I am not covered so my surgery date is May 4th and am wondering now what will happen if i need any after care.
MARIA F.
on 4/17/12 2:41 pm - Athens, GA

Ok this isn't going to go over well at all either. It seems whenever I post somethinng "negative" about the band.............it ****** someone off.

I see from your next post that you are concerned about the cost of fills. Really?! Fills??? That's going to run you anywhere from a few hundred to a few thousand to get your fills. That should be the least of your concerns. I know you have seen posts I have made on here warning about all the complications and re-operations. THAT is what's going to cost you. How many bandsters do you know with a band that's made it 5 years? If you are active in the WLS community, I'm guessing you can count maybe a handfull if that many. And of those few........how many have had 2nd and 3rd operations? Get the picture?

One lady emailed me that she paid cash for her band. Then had to have another surgery or 2 and had complications from it. Her expenses AFTER her band surgery-$50,000! Now that was in addition to the 20,000 that she had already paid for her band............because $20,000 for WLS to get healthy............good investment right? Well not if it's the band! So how "successful" was she? At the time she sent me the email I think she was 3 or 4 years out. She was down about 35 pounds (from being sick). So after $70,000 she was still MO and had a non-working band. And what does that mean??? Well it means yet ANOTHER surgery to have the band removed!

Now just last wk. there was a post on the failed band forum from a lady that has had $90,000 in medical since she got the band. I don't think that included the cost of the origional band either.

I would suggest you start a new thread asking how much complications will cost you instead of fills!

 

   FormerlyFluffy.com

 

minnie_cat
on 4/17/12 2:49 pm
if this maximum is forever, you need to be able to afford a repair or revision surgery. It may not be needed but you don't want to be in a place where you need it and you can't afford it. Discuss this with your doctor. Any chance your insurance will change?

    
Hislady
on 4/17/12 3:33 pm - Vancouver, WA
I would never suggest the band to someone who has to self pay! Mine was covered by the insurance I had at the time but you never know when that will change. I had my band for a year then the insurance changed and I have NO coverage for anything bariatric. That includes if my band erodes into my stomach or I end up in the ER with intense pain, it all will have to be out of my pocket!!!!! Right now my band is empty at my request to hopefully avoid any serious problems but if there are it's ALL at my expense! So think long and hard about whether you can afford to take this risk!!!
MARIA F.
on 4/17/12 3:43 pm - Athens, GA
On April 17, 2012 at 10:33 PM Pacific Time, Hislady wrote:
I would never suggest the band to someone who has to self pay! Mine was covered by the insurance I had at the time but you never know when that will change. I had my band for a year then the insurance changed and I have NO coverage for anything bariatric. That includes if my band erodes into my stomach or I end up in the ER with intense pain, it all will have to be out of my pocket!!!!! Right now my band is empty at my request to hopefully avoid any serious problems but if there are it's ALL at my expense! So think long and hard about whether you can afford to take this risk!!!
~So think long and hard about whether you can afford to take this risk!!!~

I hope she does! So often we post things like this and bandsters/pre-bandsters act like we are making this **** up...............until it happens to them! :-(

 

   FormerlyFluffy.com

 

MARIA F.
on 4/18/12 2:44 am - Athens, GA

Not that anyone on here believes it when I post anything "negative" on here about the band. Either b/c they think I'm lying, or that it only happens to "other people".............you know............the ones that are non-complicant.

Anyway here is what one of the failed band posted on here about her med bills from the band:

Yes, over 90k in medical bills for the emergency removal and partial gastrectomy due to the damage. However, the medical expenses are NOT the worst part, the permanent damage is....
  .I had lost 80 pounds at first too with 60 to go, then had hiatal hernia and all fluid removed. Never had another fill, still had problems with the band. At that point I had the insurance to remove it, however, I listened to my doctor saying that it would be fine and my hernia would heal on its own. Never did, ended up slipping, didn't have insurance by that time and it killed over half of my stomach, did permanent damage to my esophagus...
You may be able to find a revision surgeon a lot cheaper than it ending up in an emergency....
Good luck!!!

 

   FormerlyFluffy.com

 

(deactivated member)
on 4/18/12 3:28 am - Califreakinfornia , CA
On April 17, 2012 at 7:43 PM Pacific Time, ronniesnana wrote:
My maximum coverage for bariatric surgery will be at its max when i have surgery. Does anyones insurance cover revisions or any problems related to your lapband? My insurance company says after surgery if anything goes wrong I am not covered so my surgery date is May 4th and am wondering now what will happen if i need any after care.
I would say that ALL weight loss surgeries would be a bad idea for you unless you have a sizable savings account. This is not something that should be entered into lightly. Most likely you will be exchanging one set of problems for another set.

Wait for a time when you are better insured, so in the event of post WLS complications...you will have coverage.
(deactivated member)
on 4/18/12 6:16 am - Califreakinfornia , CA
Nope....not a good idea,

Lap-band patient released despite 'alarming' vitals

Updated March 5, 2012, 7:47 pm

[image]

An inquest into the death of a 26-year-old lap band patient in Tasmania has been told her vital signs were not stable when she was released from hospital the day before her death.

Joanne York died on January 31, 2010 - 10 days after the initial surgery.

The mother of two was readmitted to the Hobart Private Hospital four days after the operation, and surgeon Stephen Wilkinson and the treating doctor Sonia Peters treated her for a chest infection.

The inquest in Hobart heard Ms York spent five more days in the hospital, and the night before her second discharge her pulse rate was twice that of a healthy adult.

Forensic pathologist Donald Ritchey described Ms York's vital signs at the time as "alarming" and an indication she was not stable.

Ms York's mother, Christine Caudwell, wept as she told the inquest her daughter could not walk by herself and was breathless on the morning of her second discharge from the Hobart Private Hospital.

The inquest heard Dr Wilkinson had given his approval for the discharge over the phone.

Ms Caudwell says she vomited when she realised that a doctor had not discharged her daughter in person.

That night Ms York was taken to the Royal Hobart Hospital for emergency surgery and died of multiple organ failure caused by a stomach infection.

The emergency surgery revealed a widespread infection and a perforation on the wall of her stomach.

Dr Ritchey told the inquest it was his opinion it was likely that the perforation was the cause of the infection which led to her death.
The inquest was told a video of the lap band operation shows no apparent complications or traumas.

http://au.news.yahoo.com/latest/a/-/late....-inquest-hears/
   
  ---------------------------------------------------------------------------------------------------------------------------------------------------
Surgeon appears at inquest into lap band death

Updated March 08, 2012 21:45:55

The surgeon who performed lap band surgery on a woman who later died has told a coronial inquest he made an error of judgement in releasing her from hospital.

Joanne York died of multiple organ failure caused by a stomach infection 10 days after her lap band surgery in January 2010.

Surgeon Stephen Wilkinson gave evidence on the fourth day of the inquest into the 26-year-old's death.

He said Ms York was re-admitted to the Hobart Private Hospital four days after her surgery and he began working on a diagnosis of chest infection.

She was released from hospital five days later.

Dr Wilkinson told the inquest he was reluctant to send Ms York home as he had not reviewed her condition, but he buckled under pressure from the patient and discharged her over the phone.

The surgeon rejected suggestions he perforated Ms York's bowel, saying he had never perforated an organ in 16,000 operations.

Earlier, weight loss surgery specialist George Hopkins gave evidence, appearing at the Magistrates Court in Hobart via video link.

Dr Hopkins told the inquiry that when Ms York was re-admitted to hospital, he would have performed a laparoscopy.

He said it was likely that procedure would have diagnosed the problem and it was also likely the patient would not have died.

Dr Hopkins told the inquest he would not have discharged Ms York from the hospital because her heart rate was too high and was rising.

The inquest has been adjourned until May.

http://www.abc.net.au/news/2012-03-08/la....944?section=tas
   

 
Tarris
on 4/18/12 6:40 am
My aftercare is 100% covered, as would be any complication or additional surgery.  I probably would not have had WL sugery  if it hadn't been.  I have at least one friend who has had each type of surgery and every single surgery type required expensive follow-up (some due to complications, some just because follow-up is part of the treatment).  Unless money is not an object, I think self-pay could be financially catastrophic.

However, if my weight had been at a point that it could have been imminently deadly...it might have been willing to take the risk.  It's just such a personal decision based on your personal level of tolerance for potential risk (either financila or health.)     

But know that all WLS requires pretty expensive follow-up...the LB even more so because of the fills.
        
-Mari-
on 4/18/12 8:29 am
With the lap band there is after care, you will have to go in for fills, and maybe a few slight un-fills, these can be expensive visits, some people pay up to $250. (Mine are around $150, but my insurance pays all but $10). Fills go on for years and possibly a lifetime. I believe most lap band surgeries include the first 3 visits, but after that it is extra.  Your WLS office should have all the details of what is covered and not covered and can go over it all for you and what you will be required to pay after that.
 Mari  Nothing tastes as good as being thin feels!
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