Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Question for lap-band self-pay patients.



Recommended Posts

My daughter's insurance has denied coverage for wls. She is looking at lap-band with plication. I've had it done and it's the best thing I've every done for myself, but I had 100% insurance coverage, so my feelings may be skewed a little bit. In fact, I most likely would not have even considered wls if I hadn't had insurance coverage.

I know the majority of people on this site say it's the best thing they've ever done, also. I'm just wondering about the perspective of those that have paid $12,000 to $16,000 (or more) and if they, too, think it was worth the cost.

My daughter is 25 and has a bmi of 43. She does not currently have any co-morbidities, but having visited her lately and hearing her snore, she could probably use a sleep study and CPAP. However, with my history of high blood pressure and both sides of the family having history of diabetes, I feel like it's just a matter of time.

Share this post


Link to post
Share on other sites

Absolutely the best $12k ever spent! I did find out shortly after my surgery that the clinic I use reduced the cost of the sleeve to $7,500, which was a bummer but I'm still happy with my band.

Share this post


Link to post
Share on other sites

The clinic I went to and want my daughter to go to reduces the band from 16K to 12K if you're self-pay. Unfortunately, the sleeve is twice that! She really wants the sleeve, but just can't afford it and won't accept help from her parents...

Share this post


Link to post
Share on other sites

It may be worth traveling to Cincinnati for the sleeve.

Share this post


Link to post
Share on other sites

Because I was also found to have a hiatal hernia, my insurance will cover the cost to repair the hernia (think anesthesia, hospital fees, etc) so my surgeon is placing the band then. I am paying $5,500 out of pocket for the band because of this slight "loophole".

Sent from my iPad using LapBandTalk

Share this post


Link to post
Share on other sites

My daughter's insurance has denied coverage for wls. Have they denied her or is it stated that their is NO coverage for WLS? Because an appeal can be done ;)

She is looking at lap-band with plication. I've had it done and it's the best thing I've every done for myself, but I had 100% insurance coverage, so my feelings may be skewed a little bit. In fact, I most likely would not have even considered wls if I hadn't had insurance coverage. Your probaly not alone I'm pretty sure allot of people with insurance coverage felt more inclined to have WLS surgery because of the coverage. I mean realistically WHO can just say HEY, I'll pay out 12-16 K for surgery NOT ME! :blink: Which I firmly believe is why allot of Ins. companies are going to WLS per lifetime in their policies. :(

I know the majority of people on this site say it's the best thing they've ever done, also. ​Yes, reducing or eliminating Co-Morbidities and being Healthier is an awesome motivator :rolleyes: I'm just wondering about the perspective of those that have paid $12,000 to $16,000 (or more) and if they, too, think it was worth the cost. NO, If I had to have paid all out of pocket I would have personally gone with the sleeve. My reasons are this: I'm a realist and even though I'm not having problems now, I keep an eye on complications, especially since they first said the band was permanent and now they say it's not. :( I don't believe any WLS surgery is without risks but I'm not looking forward to another one so I pray I won't need it. Surgery to me is a BIG DEAL, any surgery to me is invasive. JMO~

My daughter is 25 and has a bmi of 43. She does not currently have any co-morbidities, but having visited her lately and hearing her snore, she could probably use a sleep study and CPAP. Which is probably a great idea PRIOR to her decision for WLS. So many people have the belief that sleep apnea is just snoring and an inconvenience BUT it is and can be much more than that and is connected to Health issues long term. However, with my history of high blood pressure and both sides of the family having history of diabetes. Mine too, Genetic Stinks!! your such an awesome MOM for helping her thorough this :rolleyes: I think with your Help she will make a Great decision!! keep us posted!

.

Share this post


Link to post
Share on other sites

I'm a self-payer too. Best "investment" ever!!! Think of all the money she'll be saving on medications and possible diseases in the future had she not do it. I just keep tasking myself, how much is my health and happiness worth? Best of luck!!

Share this post


Link to post
Share on other sites

11K here out of pocket, and I would do it again in a heartbeat. My quality of life is vastly improved over 6 months ago.

Share this post


Link to post
Share on other sites

I paid 10k and have one year of follow up care included. Almost eight months and very happy. I would do it again in a heartbeat.

Share this post


Link to post
Share on other sites

Was the $7500 just the surgeon's fee or the all-inclusive?? I can't imagine it being the hospital and anesthesia... that would definitely be worth the drive!

Share this post


Link to post
Share on other sites

I was completely self-pay. Locally they wanted $18k but I was able to travel to Dallas TX to have it done for $10k. It includes 1 year of after care as often as you need or want to go but I probably won't be using that because the cost of travel and time off is equivalent to an office visit/fill here at the local place.

Anyway...best 10k I have ever spent. I am only 2.5 months out but this has propelled me into a weightloss mission like no other! :) I don't have much fill in my band and don't feel restriction but I am eating great and recently started exercising. I really feel like the fact that I paid so much money for a tool is helping me to be successful.

Share this post


Link to post
Share on other sites

I'm probably going to get bashed for this but she might consider going to Mexico. $5500 with Dr. Kuri. I have also heard Dr. Ortiz is good. You may hear they use the "old" 4cc band that was banned in the US but they are still being manufactured by Allergan and used in Europe as well. Both of these doctors have done thousands of band surgeries and are well qualified. Just thought I would throw that option out there for her.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • vsg.with.sharon

      Hey everyone!
      I’m new here! Looking for some friends! 🥰
      · 0 replies
      1. This update has no replies.
    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 3 replies
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×