My insurance has an exclusion clause for WLS but will pay for the hiatal hernia operation, Can these surgeries both be done at the same time and the Surgeon work with a discount on the surgery I will be self pay for the actual WLS . Help

OMG I could have typed this message word for word! I wish there were replies, because I was wondering the exact same thing :-( Have you heard anything else? Please PM me if you do!!!

Hi ladies, I can answer apart of your question. I was banded on Monday and I had a hiatal hernia repaired at the time I received my band. I have insurance, so I will keep you posted how it pans out.

Any news yet whether insurance pays for lap band when going in for hiatal hernia repair?

You would probably get the best answer by calling your surgeon's office and discussing with them directly. If you don't have a surgeon in mind yet, then find a seminar in your area and attend. Once you've done that, touch base with that surgeon's staff and they can probably help you out.

If your insurance doesn't cover WLS, then they won't pay for the band, but you may still be able to get them to cover the pro-op stuff like endoscopy, ultrasounds, EKG, etc. Then I would think the surgeon's office would be able to bill as much of the procedure as possible as a hiatal hernia and hopefully they could leave you just paying for the actual price of the band, since anesthesia and other hospital costs could be hernia-related.

I'm guessing that you probably aren't the only person who's ever had this problem or question, so really, I would call them and just explain to them where you're at and see what they can do to work with you. They've probably been through it before and will do everything possible to help you out.

Thanks for the quick answer!

My initial consult is in 1 1/2 weeks and I guess I'll have a sit down with the insurance/financial admin. at that time. Obviously, I'm concerned about the money aspect, but I really don't want to be put to sleep a second time if I can get both procedures at the same time. I have severe sleep apnea as well and this puts me in a higher risk category (I'm told) with the anesthesia.

From what I hear, it's most common to fix a hernia at the same time they put the band in, so you shouldn't have much to worry about there. Good luck! :cursing: