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Part insirance part self pay. HELP



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I am having my lapband removed and revision to sleeve. Insurance deemed lapband removal was medically necessary so they are covering that but wont cover the sleeve revision. Surgeons ofc is charging me the usual amt for sleeve which is 14500. Surgery is being dine at the same time. Shouldnt some of the self pay be reduced since they cant double charge? I understand sleeve requires two night stay in hospital so i totally inderstand that. But anesthesiologist cant double charge right? And some of the same instruments, equiptment etc, surgery room, portion of facility charge shouldnt that be discounted on self pay and ins pick up some of it? My surgeons ofc acts like they have never run into this issue and cant understand why i wont just do 100% self pay for sleeve and they not charge for lapband removal and that it would be cheaper. I cant wrap my head around it. HELP. someone give me some ammunition. And something concrete to argue so i can save some of my cash. We pay so much a month in ins premiums i want ins to pay for as much as possible. My defuctible is already met and ins covers 80% so im responsible for 20%.

Sent from my iPhone using the BariatricPal App

Edited by kgarrettsatx

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If I were in your situation, I would get the insurance funded lapband removal, wait 6 - 8 weeks, then head to Mexico for my sleeve. You can get sleeved by a reputable Mexican surgeon for $4500 - 6000.

I do think it's shady that your surgeon isn't giving any discount on the surgery. I've never heard of that before.

If you don't want to go to Mexico, maybe shop around with local bariatric surgeons who take your insurance and see if you can get a better deal with someone you are comfortable with.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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