my 25 yr old daughter had to have her lap band removed as an emergency surgery after 3 years...she had lost 120 lbs and has now regained 60. we are looking at the vertical sleeve; however the costs in the ny/nj area are cost prohibitive and there is no bariatric rider on her insurance. she has a hiatal hernia and was wondering if anyone can recommend a doctor in the ny/nj/pa area who might be willing to fix her hiatal hernia (which is covered) and then we would just need to self-pay the vsg..

any thoughts?

thanks,

sonja

I'm not in your area so I can't recommend a doctor. However, I wanted to tell you to be very careful with this. Hiatel hernia repair is an outpatient procedure unless there are complications from it. VSG usually requires an inpatient stay of 1 to 2 days. Those 1 to 2 hospital days plus the doctor, anesthesia, pathology and operating charges for the portion related to the VSG could end up costing your daughter more than cash pay would.

Hopefully, someone who did this will come along and post their experience. Good luck to your daughter.

My doctor says that about 50% of the US population has hiatal hernia. Obviously, they aren't all lining up for surgery. I believe a person needs to have problems related to the hernia before most insurance companies will pay for it.

yes, she has a severe issue with this....her hiatal hernia! so now, any answers to my query?

My sister had her hiatal hernia repaired while having her VSG procedure done....however, her insurance covered both. We live in NY and have a great surgeon. I am not sure the cost of VSG in NY or NJ =\

who was your sister's surgeon please?

you can reach me at njpetsitter at gmail dot com

who was your sister's surgeon please?

you can reach me at njpetsitter at gmail dot com

It's called Winthrop Surgical Associates and it is a Center of Excellence. The surgeon's name is Dr. Collin Brathwaite. He operates in Long Island and Queens. Check him out! He's amazing!

While my hiatal hernia was repaired during my VSG, prior to it, I was seeing an ENT for GERD and guess eventually he would have repaired the hernia if necessary or referred me to a surgeon.

Who removed her lapband? Can they not suggest a physician/surgeon, what about her primary care physician? It should not be so difficult to find someone but I'd imagine they are going to want to consult and treat her first.

It's not that it cannot be done together; I want insurance to cover at least half of it...there is no bariatric rider in the insurance whatsoever...

For those who had both a hernia repair and VSG, was your recovery time longer? People seem to suggest recovery is longer if you have both. I am having surgery Aug. 16.

For those who had both a hernia repair and VSG, was your recovery time longer? People seem to suggest recovery is longer if you have both. I am having surgery Aug. 16.

Not according to my doctor. He said most sleevers also have hiatal hernias and they are fixed at the time of sleeve surgery. I had one repaired when I was being sleeved and my recovery was short and uneventful.

Not according to my doctor. He said most sleevers also have hiatal hernias and they are fixed at the time of sleeve surgery. I had one repaired when I was being sleeved and my recovery was short and uneventful.

Well, that makes me feel better! Thanks!

my 25 yr old daughter had to have her lap band removed as an emergency surgery after 3 years...she had lost 120 lbs and has now regained 60. we are looking at the vertical sleeve; however the costs in the ny/nj area are cost prohibitive and there is no bariatric rider on her insurance. she has a hiatal hernia and was wondering if anyone can recommend a doctor in the ny/nj/pa area who might be willing to fix her hiatal hernia (which is covered) and then we would just need to self-pay the vsg..

any thoughts?

thanks,

sonja

Apparently no one can answer your question directly. Have you tried talking to the insurance specialists at several bariatric surgeons' offices? They ought to be able to answer the question. Give it a go. If you have already tried this, I am sorry I have no other ideas.

Apparently no one can answer your question directly. Have you tried talking to the insurance specialists at several bariatric surgeons' offices? They ought to be able to answer the question. Give it a go. If you have already tried this, I am sorry I have no other ideas.

No one can answer it directly because she, or more importantly her daughter, needs talk to the current doctors involved with her care. Who ever is treating her for these issues is probably the best person to answer her question and or direct her to local physicians.

Hello, I have United Health Care and my plan required I had a BMI >35 for 5 years with 2 co morbidities. My BMI was not quite over 35 for 2 out of the 5 years so I was denied. Dr. Gregg Jossart in San Francisco agreed to fix my hernia and let me self pay for the sleeve. I will sign a contract with the hospital where we agree I only have to pay $5,000. $2k to Dr. Jossart and $3k to hospital facility. My surgery is scheduled for Dec. 18th.

I had no idea Dr. Jossart would do that. He and Dr. Cirangle are my first choice if I have to self pay in the US. Can anyone elaborate on how to get hernia repair covered in the first place?