Another New person with a million ???

Good Morning, I just don't know where to start. I am new to Puget Sound and I do not have a family practice Droctor on this side of the mountian. I also have new insurance Regence BlueShield select through Boeing. Please is anyone has the time to help me walk through this. Thank you so very much. Diane

Hi Diane and welcome! Couple of things...have you found a surgeon that you would like to use?  If so they might have a PCP they can recommend to you.  Otherwise I use the University of Washington neighborhood clinics.  They have them everywhere and it's fairly easy to get an appointment.  The nice part is that if you move and start going to a different clinic all of your history is immediately accessable to any clinic in the state due to their computerization. As for insurance the best thing to do is call your insurance company and ask them if your particular plan covers weight loss surgery.  If they do (and be prepared for them not to cover it...not many Washington state plans do) you need to ask them what kind of documentation they require to get pre approval.  Once you do that you'll have an idea of what you'll need to do.  Some have requirements of a six month physician supervised diet, psyc evals, documentation of comorbitities etc.  Once you choose a surgeon they should be perfectly willing to help you out with the process and if they aren't, find a different surgeon.  Understand this, even if your plan covers surgery insurance companies often like to play a little trick of denying coverage for some stupid small thing with the hope that you will give up and not make them pay for it.  So you can't give up if you get a denial letter right off the bat.  Unless they have a specific clause against covering any treatment of obesity (which mine did) it's worth it to fight.  If they have a clause against it you have no case and will not get covered no matter how much you might need it. Hopefully that helps answer a few of your questions and good luck!! Corinna

Thank you so very much Corinna, I did call Aetna today and she said they cover it if it is deemed medically nessisary. So were you able to work with your insurance?

nope...my insurance had a clause against any kind of treatment for obesity.  So I went self pay.  It was about $22,000.

eeeeeeks! I sure hope the ins will come through for me.

Wow! I am self pay also and mine is going to be $30,000. I'm wondering what kind of deal I got? I have already paid for all of the testing and consults so I can't afford to change. I have insurance from both my job and my husbands but both have exclusions. I am scheduled for Oct 12th and we are taking money out of retirement. Which will really be a huge gouge out of it. Leaving me feeling guilty. Oh, well...  Thanks for listening and good luck and take care to you Diane. Cheryl

Cheryl, Just so you know, your tests should all be transferable to any other surgeon you might use.  They all require the same kinds of tests usually.   But I will say that I think my surgeon gives a really good cash deal.  All of the other surgeon's I looked into charged $30-$35k.  He's just building his practice and I think it's not all about the money for him.   Good luck to you...your date is coming up soon!! Corinna

Thanks, Corinna, I believe this is a package that he has worked out with the hospital or that they have worked out with him. That is the cash price! My surgeon is from Nevada and just came to town this past year, as far as I've been able to tell, he has really good references. When his office first opened, I think he may have lost a few patients' business as the office staff were not very professional and didn't know what was what. I have noticed since I have been working with him and his office there has been much improvement. He seems to really be in it for the patient but I have to say I thought when I first started with him several months ago, he quoted $27,000. This is a new package with this hospital so I'm not sure what all was involved. I will for sure talk about it with him at my next visit. He is very open about all of this. I have thought about another surgeon but so far I think he is excellent. I haven't paid any of the $30,000 yet so I do still have some options. I really appreciate your info and feel free to share more if you have any.  Thanks again! Cheryl

I was a self-pay through Dr. Oh and St. Francis Hospital in Federal Way... the surgery itself was 12,800 for surgeon, his assistant, hospital and anesthesiologist. In addition I had all the preop work done for about 3,500. My Lap-band was successful Sept 6, 2007

Hi Amber, I am having the RNY so that is prob why my cost is higher.  The price for your Lap-band is about the same as what my surgeion charges with hospital etc also included. I am so happy for you that your surgery was successful...here's to many more successful days and years to you!!!!! Cheryl