Question:
Cost Estimate
I am looking at getting surgery. I have to wait a few months for a dr to come into town. Currently we do not have a regular surgeon. I just had a question. Did anyone have surgery and pay out of pocket? I have spoken to my insurance and in my guidelines, they do not cover wls. It is discouraging, but I would rather try and pay it to be healthy. Anyone have any info or ideas? — joey6965 (posted on February 20, 2006)
February 20, 2006
I didn't pay out of pocket but I would say it would cost anywhere from
$20,000-25,000 for total expenses and more if you are going to have it
open. Goodluck and I hope everything works out. I'm 7 months post op and
down 120 pounds and I would do it again in a heartbeat. Don't give up.
— jjeanniespets1
February 20, 2006
this is a complicated surgery, fortunatly you are close to mexico,and there
are some of the worlds best bariacric doctors doiing the most complex
proceedure, and for some of us the most prefered proceedure of the three
the DS, for about 13k , it is hard to get approval in the us for the ds so
going to mexico or brazil is common, come to the DS forum and ask about the
surgery there and self pay. a lot of people will help you.
http://www.obesityhelp.com/forums/DS/posts/
— walter A.
February 20, 2006
You CAN negotiate the charges with the hospital. Try and negotiate a set
charge with the physician and the hospital so you know going in how much
everything will cost. Otherwise, as a self-pay you won't get an insurance
discount (think of going to the pharmacy). Good luck on your quest.
— needstoclean
February 20, 2006
Hello, I am 5 yrs Post-op. My insurance too had WLS as an exclusion. MOST
do. That is just part of the process of getting your documentation ready
and in the right order for your surgeon to submit. Most insurances if you
follow there guidlines will over turn there exclusion and approve for the
WLS. Most Barriatrics Surgeon are familiar with these procedures and know
what to do. My suggestion is to have a consultation with the surgeon of
your choice and ask them what are The insurance apprval procedures. If they
dont know then they are a surgeon that is not up to date on the WLS and I
would look elswhere. Most WLS surgeons offices have a department in them
just for Insurance issues. My Suggestion if you have one in your area Is a
Barx Clinic. They not only have a long history of doing the WLS they
basically founded the procedure plus they have special department in there
offices just for the purpose of batteling insurances to gain approval for
patients. WLS was an exclusion in my insurance also but I followed there
guidlines and was approved after first submission. Hope this helps. Your
WLS friend Jo Michalko
— Jo_Michalko
February 20, 2006
Please don't accept a no by speaking to your insurance's customer service.
Half the time they have no idea what they are talking about, or are just
quoting a general policy-not yours. Also, you do not have to see a local
surgeon, mine was 4 hours away, we didn't have one locally either. As for
costs, in 2001 in St. Louis total costs for my surgery came to 44 thousand
dollars. Costs will vary widely. Good luck.
— RebeccaP
February 20, 2006
I had to pay out of pocket. I found this great company that schedules the
surgeries in Europe. Even with the flight there, it cost me just under
10k. It was great and affordable! Feel free to email me if you want to
know more. [email protected]
— Katpts
February 20, 2006
I ended up having mine done in Mexico as I was denied by my insurance. I
paid 12000.00 for LAP RNY and that included my airfare and hotel after to
heal for 5 days. If you have any questions, just email me.
[email protected]
Leanne
LAP RNY - Dec 16/05
Dr Joya - PV Mexico
274/247/197/140
— lmsmith
February 21, 2006
My surgery total cost around $42000.00. But, fortunately my insurance
covered all but about $500.00 of it.
— Tom
February 21, 2006
I just had Adjustable Lap band performed by Dr. Hamn in Plano, Texas. My
surgery was not covered by the insurance so my husband and I made the
choice to pay for it ourselves. For self pay it cost 14, 500. This
included the surgeon, one night hospital stay, anethesia, radiology
procedure next day, and a year worth of fills. The office helped us find a
company who financed it at a low rate 10%. It's cheaper than the price of
a car and lasts a lot longer! What wasn't covered was the pre testing:
psych evaluation, sleep study, pre-op blood work, upper gi, and xray. My
pcp worked with me to order the blood work, upper gi, and x ray so it
wasn't covered on an out of network basis. Good luck.
— djbevill
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