Question:
SELF-PAY...has anyone out there self-payed?
I'm considering paying for WLS because I'm having such a problem with my insurance company. I've been looking into getting a loan... Could anyone out there tell me of their Self-pay experience? Thanks! — pamela1 (posted on November 11, 2002)
November 11, 2002
There are lots of people who end of being self pay. Individual policies
that cover WLS are almost impossible to get, policies through employers are
more & more likely to have exclusions in order to cut costs. I know a
mother & daughter who both self payed to have their surgeries done in
California at Fresno (I believe it was). They had no post op complications
and did fine. People look at it as buying a "new car" expense
wise when they take out a loan or put it on credit cards in order to get it
done. From what I understand there are surgeons who have an "all
inclusive" package which would give you one guaranteed price for
everything involved in your surgery. Or if you're comfortable with it you
can look into surgery out of the states to help cut costs. Personally I'd
wait on the insurance to possibly cover it because of how really pricey
this is. But if they won't its not the end of the world and there's a lot
of us out here whose only option is self pay. You wouldn't be alone.
— Shelly S.
November 11, 2002
Oh, yes. I self paid. Surgeons fee, $6,000. Hospital fee (only because
my surgeon has a "deal" worked out with them, $8,000.
Anesthesiologist & other pre-op testing not covered by my insurance,
roughly $3,000. Tax deductible, thank God! My total so far, including all
of the above, plus travel, gas, hotel, etc. is about $20,000. I think it
depends a lot on where you have it done. I had to go 2 1/2 hours away to
have it done at a reasonable price. The one surgeon in the city I live in
wanted between $30 - $60,000 to do a lap RNY. I just about fell out of my
seat! Insurance companies are just evil, evil things, if you want my
opinion. Cosmetic my @ss!
— KelBurt
November 11, 2002
I am self pay because of insurance troubles and I am having surgery
December 4TH!! I don't know how far you are willing to travel, but my
surgeon is in Little Rock and is awesome. His name Dr Rex luttrell. There
is a discount for self pay patients: Total for everything is $12,100.00.
That includes surgeon fee, up to 7 day stay in hospital, pre op test(day
before) and anstegiologists(?spelling?) There is also Dr Baker with the
same price and Dr gibbs in Little Rock. They all charge $3,600 surgeon
fee, $1,500 for ansteg. and $7,000 for Baptist Hospital( they have a
special price for self pay and write the rest off). Anyway that was for
open rny, for lap rny was about $17,500 for everything. I hope this helps.
— Monette L.
November 11, 2002
I chose to self pay since BCBS of Kansas refuses to pay for WLS. The
program I went through here, Liv-Lite requires a $19,000 down payment.
$15,000 to the hospital, $3000 to the surgeons and $1000 to anethesia. As
for the actual costs... My pre-op tests ended up being about $5000 which
were mostly hospital charges for blood work, x-rays, ultrasounds, OR and
recovery room charges for my endoscopy, etc. My hospital bill was $32,000
for 5 days. My surgeon's fees were about $7000. Anesthesia was around
$3500. I owe Radiology about $500. Was it worth it? You better believe
it! I worried aout having to be readmitted for complications or something.
I was told by a doctor that if I had to go back to be dialated or anything
that my insurance would have to pay because it would be medically necessary
then. My insurance did end up paying for a little bit of my surgery costs.
Since I had gallstones they paid my surgeons to take my gallbladder out.
They paid some radiology and anesthesia for the gallbladder. They didn't
pay any of my hospital bill because "there is no way to know what was
used to take out your gall bladder and what was used for your RNY".
As far as blood tests for after care (who knew blood tests were so
expensive?) my surgeon's nurse is really good about asking if I have
fatigue or hair loss or something that she can code the tests as so that
insurance will pay for them. As far as coming up with the money to do it
my family was going to take out a loan but ended up selling stocks instead.
I know people that put it on credit cards and then keep transferring
balances to zero interest ones. Another lady I know took a second mortgage
on her house. In my opinion it was well worth it. My family has said they
would do it again in a heartbeat because of the difference it has made in
me.
— Tanya B.
November 11, 2002
I went to Brazil for a DS. The care was wonderful, the Dr. was even
better, and it was only $8000.00 + airfare and hotel. It cost my husband
and I about $10,000 for the whole kit and Kaboodle. I am six weeks out and
down 35lbs. No dumping, can eat what I want, just not as much, and I am
very happy with the rusults. The DS has a much better quality of life than
the RNY, or Lap Band. My opinion only. If you have any questions.. email
me. Check out the groups on Yahoo... Dr. Marchesini! He rocks, and will
make you feel like one of his family memebers! you can email him direct @
[email protected] Good luck to you! Jackie
— Jacklyn C.
November 11, 2002
I got a denial from insurance, and am going the self pay route. I want to
LIVE the rest of my life, and I am not willing to wait, beg and plead,
provide mountains of paperwork, only to possible be denied anyway. I also
am having BPD not RNY, and it's not covered as often, even though there's a
better long term success rate. I'm grateful I have the $$, and my surgeon
will take private pay - some won't.
Best of luck to you on your journey.
Diane
— Diane M.
November 11, 2002
I am 8 weeks out from an open RNY. Cost to this point is $45,678.42. I
live in the midwest. This is the best money I have ever spent. Good luck.
— barbara A.
November 13, 2002
There are 2 costs, the doctors portion and the hospital portion. I live in
Miami,Florida and the Dr's portion was $6,000 and the hospital portion was
$12,500.00, you need to speak with the hospital first and get what they
call a global package which means that everything is covered.
— Emily R.
April 18, 2003
I had Open-RNY with Dr.Aguirre in Ensenada,Mexico on 3-27-03 and my total
cost was $6,500.00 plus travel. Please see my profile for complete details.
— latrishanickle
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