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Need advice from self-pay patients re: choosing surgeon



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Hello,

I am a newbie here. I have been researching Lap Band surgery for quite awhile now and have decided it's the right choice for me. I'm a self-pay patient and live in Nashville, TN. I'm trying to decide between Baptist and Centennial Hospitals to have the procedure done. I have researched them both, met surgeons at both places and feel very good about the quality of both choices.

I'm pretty risk-averse and as a self-pay patient, I feel pretty strongly that I would want to buy BLIS insurance to cover myself if things go wrong (erosion, slippage, port issues - plus problems stemming from the lapband that insurance may not pay for because they excluded the original procedure).

Here in Nashville Baptist has a lower self-pay price ($12,000) but does not offer the option of buying additional insurance. Centennial is more expensive right off the bat ($14,500) but offers the option of BLIS insurance. The insurance is definitely expensive, which is of course a bummer. Centennial offers BLIS in 6,12 and 18 month increments. You have to buy separate coverage for each category (i.e. slippage, erosion). So, I could buy 12 months of erosion insurance, 18 months of slippage, etc.

Can people please give me opinions about this? I know it all comes down to my own comfort zone, but I would really appreciate any input. Is it better to choose the lower cash price but no BLIS option? Or, the higher cash price but BLiS option (which also adds a lot of expense)?

Thank you so much in advance for your input!!

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Personally, I'd choose the lower out of pocket cost (and I want to come to TN! my lowest here is $16,400). I'm optimistic my surgery will work :-) and if something does happen you have that extra $ you saved in the first place to help pay for any isues. Also, I tend to think erosion is over time, so probably wouldn't happen in the first 6, 12, 18 months anyways...

Remember, the purpose of an insurance company is to make money (not to pay for services) :D

Good luck!

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I would not worry about the bliss insurance. I have worked for numerous insurance companies as a nurse consultant, if a surgery or procedure is medically necessary your insurance will cover it. It has nothing to do with the fact the original surgery was not covered.

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I'm having surgery this Fri. Cash pay 12000 and I didn't buy the ins. Actually, this is the first I've even heard of it. My surgeon hadn't offered it and this group has been doing lap band since the first band came out.

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Trac75

Do you have medical insurance? If yes, that why you were not offered the bliss insurance. If you don't have medical insurance you may want to inquire about the bliss insurance. Your medical insurance will cover any surgery or procedure that is considered medically necessary. It has nothing to do with if your lap band was covered or not. There is no gray area if you have complications from your lap band. The lap band itself is a gray area, that's why there is criteria (because it can be considered for cosmetic reasons). If you have band erosion, slippage, etc., nothing about that is cosmetic. You may have to enlighten your doctor office on billing with the correct diagnosis and procedure code if you develop complications.

The risk for complication is low with lap banding. Anything is possible (even for simple dental surgery) but try to stay positive.

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Darkkmocha,

Yes I do have medical insurance. Maybe thats why they didn't offer it.

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Trac75

Good Luck & I wish you the best. Keep us informed. I am hoping to be able to get a surgery date for the first week of Nov.

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Thank you! I am self pay and have wondered if my insurance would pay if I, God forbid, needed surgery to fix something.

I would not worry about the bliss insurance. I have worked for numerous insurance companies as a nurse consultant, if a surgery or procedure is medically necessary your insurance will cover it. It has nothing to do with the fact the original surgery was not covered.

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