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Self Pay

I am pretty sure I'm going to have to do self pay, and I was wondering what the experience is like for others who have done the same? I have information on a few different finance companies but I havent called for preapproval because I am scared they will tell me no (silly, I know)

I have decent/good credit and a great job but I've only been at the job for a few months so I'm a little worried that will hinder me. I also have this fear that I will finance this and then something will go wrong... I wonder if insurance would pay if I had a complication, especially if it was something life threatening? Anyone have any experiences with something like that? I know if all else fails I can save up but it would prob take at least a year to save up that much money and I am ready to do it NOW haha

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I don't know if any of you having to self-pay have considered Mexico but I paid $5900 there. I went a few days early, had a wonderful vacation and then got banded and came home. It wa a great experience all the way around and all total, including my vacation, hotel, airfare and surgery was less than $7000

I was self pay and paid about $15,500 in total. $8,500 to surgery center and $7,000 to surgeon. 2 months later I get this explanation of benefits from Blueshield stating the surgery center charged my insurance co another $9,500 for Hiatal Hernia repair and my surgeon charged $0. Basically the surgery center is trying to charge a whole other surgery and double bill. I am disputing this claim. How can a surgery center charge for a complete surgery when the surgeon isnt even charging for it. It requires a couple of extra stitches and done at the same time same incision as LAP-BAND®. Bottom line is I have been hit with an additional $4,000 in insurance deductible and co pay for the Hernia that btw I didn't even know I had. Beware when you start handing out your insurance card. Stupid billing people at surgery center answer "we global bill" which means it doesn't matter if you are already under anesthesia, with a paid OR and same incision, you are billed for every procedure you have at full price!:confused:

mlsf, Do you have some insurance coverage, just not for bariatric surgery? I will need to talk to the staff at my surgeons about this, since testing confirmed a hiatal hernia. My insurance does cover that, so in my case I thought it was good that it is billed as a separate surgery. Otherwise the 3500 extra that the surgeon changes to sew up the hernia would be out-of-pocket for me. (if included in the lap-band surgery)

Yes I have insurance, but does not cover Bariatric Surgery for my low BMI. It's not the fact that I had a hernia repair that I am upset about, It's the fact that they charged a complete surgery in the amount of $9,500 just for the Hernia in addition to the $15,000 lapband surgery.

  • 3 weeks later...
Yes I have insurance, but does not cover Bariatric Surgery for my low BMI. It's not the fact that I had a hernia repair that I am upset about, It's the fact that they charged a complete surgery in the amount of $9,500 just for the Hernia in addition to the $15,000 LAP-BAND® surgery.

I understand why you are upset, however, thats perfectly legal and something that does happen. I work in the insurance industry (on the doctor's side collecting money from insurance companies). Anytime you go in for surgery theres the possibility that more (or sometimes less) will be done when the doctor actually gets inside and sees whats going on- that's why surgical procedures are always done on an 'estimated cost' basis. Hernia repair and lapband are two different procedures that require more anesthesia, more hospital time and room usage. I wouldnt be thrilled at all to be getting hit with a deductible fee from insurance either, but someone has to pay for the extra time and expertise done to fix your hernia. I highly doubt that disputing the claim will do anything other than cause you more stress.

I don't know if any of you having to self-pay have considered Mexico but I paid $5900 there. I went a few days early, had a wonderful vacation and then got banded and came home. It wa a great experience all the way around and all total, including my vacation, hotel, airfare and surgery was less than $7000

Who was your Doc in Mexico and what hospital did you go to??? I'm going to Mexico come Aug 26th will be banded by Dr. Jose Rodriguez at the INT hospital in Tijuana... I am self pay as well and was wondering if something happens (complications need band removal in future) will my insurance pay for it. the wont pay for the lap band at all.

My doctor was Dr. Sergio Verbooten in Cancun. I don't know about your insurance, you would need to check with your insurance company. Make sure you google the doctors name and make sure there are not a lot of complaints.

I have Aetna POS and so I was told they had a clause in their contract where they wouldn't pay for my surgery. I had a feeling...I'm a lower BMI and no comorbidities so knowing my luck I was going to have to pay. It was $13000 total (7k to the hospital, 600 to the anesthesiologist and the rest to the surgeon). I was interested to hear that one of you said that any complications were covered through Aetna once it was installed. I have worried about that and thought of changing my insurance at the New Year just because I want to have the coverage, but maybe I won't have to after all. I was told that my money only paid for 3 fills after surgery so I am going to call them up and do a little bartering now that I have your info. Either way I will end up with this surgeon and this hospital because I am comfortable with their combined experience.

It's funny when you are selfpay. I definitely feel like I am shopping...which is so weird when it comes to your health :unsure: However, I like being in the control seat on this one and I am happy that I am almost to the banding part! ONE MORE WEEK!

Hope this info helped...

I also was a self-pay. I went with "True Results". Out of pocket for me was $9995.00. My insurance picked up all Pre-Op test. The $9995.00 covers one year followup/ fills. Every month so far, (banded April 13) I go to the center for check-up with PA and may or may not get fill and then drive across town to see my surgeon. I am totally pleased and have lost 62 lbs as of today. Dr. Fox and his crew in Richardson TX are the best!!!

I will be doing self-pay in Seoul. It will be between $6,400 and $6,800 when all is said and done. (After the pre-tests, initial consultation - which impressed me. I never expected a surgeon to spend more than an hour with me - explaining everything and answering all of my questions!)

My fills will be $25 per visit.

  • 4 months later...

My doctor was Dr. Sergio Verbooten in Cancun. I don't know about your insurance, you would need to check with your insurance company. Make sure you google the doctors name and make sure there are not a lot of complaints.

He was my doctor as well - I have been very pleased with him - are you happy as well?

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