Self Pay Costs???

[ToddNYG 0]

I was banded in Nov of 2009 and have never felt better. My progress has encouraged my father possibly to have WLS now. His problem is he would only go to my surgeon and of course he doesn't take my Dad's insurance. So my question is (and I know it's a rather broad question) to the self payers, what was your ballpark out of pocket expenses for your surgery? He would probably be looking at a deductible and then another 80% of the rest of the cost. Any info would be very helpful and appreciated. Oh and this would be in NJ, not sure if regionally would make a difference or not.

[emjay 8]

Don't know if this will help you, but I was originally self-pay at $15,900 (2 years free fills, any surgeon fees during this time for revisions, dilations, etc). But after 2 rounds of appeals I ended up getting part of it paid for, but out of network. So all in all I ended up having to pay about $4700 out of pocket due to higher deductibles and out of pockets and over UCR amounts.

It's really hard to say how much your Dad may have to pay since plans can be all over the place in terms of coverages, deductibles, OOP's, limits, etc. And without a detailed list of charges complete with coding, I doubt any insurance company will tell you what his personal cost would be.

[JJLaw08 4]

I am in North Alabama, and mine was $11,800 but I got a $500 discount through the hospital because I paid in full early. So the total was $11,300 which included program fee, surgeon's fee, doctor who puts you to sleep fee (can't spell it :thumbup:), and up to ten fills the first year. I did have to pay some to get my ultrasound, blood work b/c I haven't met my deductible yet.

The first doctor I talked with about it was going to charge $15,900 I believe, but I heard the doctor who I went with was a good one and of course was cheaper so I went with him.

Hope this helps!

[jre1974 0]

I was a self pay because my insurance would have nothing to do with it... :thumbup:

My surgery cost $16,500, which included everything to do with the surgery as well as a years worth of follow ups and fills...

[Debster21 0]

Definitely depends on the region and on the surgeon/ clinic. I was self pay in Texas and it was 12,500.00 with a years worth of fills/ doc visits etc.

[Cingulus 0]

$16,600 for the entire process plus fill for the first year.

[timetobefree 5]

I was self-pay as well (WLS excluded under my insurance). Mine was in MI - $11,700 which included 3 fills. Fills are $150 each after that.

[Manda87 3]

I'm not self-pay, but on my surgeon's website it says that self-payers pay $12,000.

[Malisafos 0]

I had mine done with TLCedge.com here in Texas and the cost was 9,999.00

[Humming Bird 275]

Sorry, not in NJ ............

Dr. K in Denver has many out of state patients ....

$9,950 www.lapbandrockies.com

[jtreece 0]

I was self-pay and excluding the pre-op tests the following was my charges:

$11,300 hospital fee (includes the actual band $3,600)

$3,000 surgeon's fee

$2,400 anethesia

$500 program fee

Total: $17,200.

I did get insurance to pay about $7,700 of the hospital fee because I had a hiatal hernia and I went with the approach that I was getting the lapband while I was there for that. I only had to pay for the actual band. I argued after the fact and had to surgeon's office code the hiatal first then obesity surgery.

So I ended up paying $9,500. I had to get a sleep apnea test and was lucky that my insurance paid for that. It can be very expensive (I believe over $1,500)

[Momto4kids 0]

what was the sleep apnea test for? I have OSA and considering surgery, so that's one of my questions - can you have the surgery if you have sleep apnea?

[jtreece 0]

Yes, you can have the surgery but if you have it, they want you to bring your C-Pap machine so they can have it on you in recovery. I didn't have sleep apnea so I didn't have to do anything other than the test. My doctor required if you did get tested and needed the machine you'd have to have it for a couple weeks before the surgery to before he'd operate.

[Momto4kids 0]

jtreece Thanks for the answer.

The week after I was dx with moderate OSA, I had 3 heart procedures and didn't have to have a cpap - I don't use one because it causes me to have panic attacks and vtach episodes.

That will be one of my first questions to ask after I decided which dr to go to

[vow 0]

I was self pay (no insurance through work) and even if I did have insurance would probably have opted to self-pay since I did not want to wait out 7 months of diet before being allowed to schedule my surgery.

I chose to go with Medical Tourism to Mexico; Hospital Angeles in Tijuana with Dr. Lopez Corvala. He's an incredibly experienced surgeon who practiced in the US, has performed over 8000 bariatric procedures.

My final cost, including 3 days in Hospital Angeles, limo service from the San Diego Airport to the hospital (and return), surgeon fees, and free fills for the first year either at Hospital Angeles, or in a US sister medical facilty, psych eval, dietician class..etc was $5995.

They are efficient, the hospital was amazingly clean, the staff is friendly and attentive to the point that it puts US hospitals to shame. Anyone that cannot afford the 10-15k pricetag I would encourage to explore this option. It was quite frankly the best medical experience I have had in my nearly 39 years.

If I ever have any other surgery that is considered elective I will be returning to Hospital Angeles without hesitation.