Newbie Here!

maile5278 · December 2, 2007

Hi all, I just found this site a few days ago and have been reading a few threads here and there. I've just started my research on Lap Band and I'm liking what I'm learning. I have been overweight for as long as I can remember and I've been on just about every diet out there. I just need a little more control than those diets can offer. So I thought I'd look into surgery. Of course Gastric Bypass was my first thought but that was a really scary thought for me. I have a few friends that went that route and are doing great but I just didn't think it was for me. But in researching that I found Lap Band. I've only had one surgery ever and that was having my Gallbladder removed. So surgery is still kinda scary to me but remaining overweight for the rest of my short life is scarier. So here I am. I am still a little leery of doing this because of some of my reading but I'm not ruling it out. One of the biggest obstacles keeping me from doing it is money. and that leads me to my biggest question for all of you. How much does it cost (on average)? and how did you all pay for it (if that's not too nosy)? I have insurance BC/BS but I've heard that they don't want to pay for WLS. Any info you can give me would be greatly appreciated.

So sorry for the long post but once I start I have a hard time stopping. LOL

Thanks in advance for the advice.

Maile

kacee · December 2, 2007

Costs can vary significantly depending on where you are in the States (assuming you are in the USA). Prices if done in Mexico (and yes, there are very well qualified GOOD doctors in Mexico if the logistics allows you to go there) can be anywhere from about $6000-$10000. In the states it goes up from there. I was a self-pay and mine was $12,900, which I consider a good price. Prices can go up to the low 20's, though I have no idea why anyone would knowingly pay that much. As far as how to pay for it...I took a 401K loan, many people borrow against retirement,borrow from family members, take loans on their houses, or there are institutions that make loans for medical procedures. Yes, it is an investment. But you probably sink anywhere from $8,000-$25,000 in a new car every decade or so and that's something that wears out and has to be replaced! This is not a "temporary fix" so as far as I am cocerned you definitely get your money's worth in the life change.

maile5278 · December 3, 2007

Thanks for your reply. If I could get to Mexico I'd probably get it done there cause those are some nice prices. I live in Alabama and I think I know a doctor that does the surgeries. He shares an office with the laser center that I go to and I'll be there next Tuesday I'm planning to ask his receptionist about it. I really want to do this and and determined to make a way for it to happen within the next year.

Thanks again for the information.

mrskrzyz · December 4, 2007

Not sure where you live but I have BCBS of Western New York and they approved me three days after my doc submitted!!!! Good luck!!!

lachica39 · December 4, 2007

I have BlueCross in Cali, and I aslo was approved in days.All you have to do, is contact number on back of card and ask if they pay for WLS and get approved Dr.s info

SC

surgery date 12/26/07

December 4, 2007

I wasn't approved due to credit issues, but you can apply at Plastic Surgery financing & Cosmetic Surgery financing Nationwide. It was a very simple process to apply, you can do it on line in just a few minutes. Then they will contact you within the following days to let you know if you can be approved based on your own information or will offer to re-run your application if you can provide a co-signer who would be qualified. My friend got this information from a reputable LapBand clinic in the area where we live. They provide loans for all medical services-not just weight loss surgery.

As for the coverage through your medical insurance.... it sounded like you had already been told that your plan doesn't cover it. If you have a benefit booklet you should look through the list of plan exclusions, or call Customer Service and they can tell you. If your plan excludes obesity treatment then regardless of medical necessity you will most likely not be approved. I worked in Customer Service for a BCBS plan for years and I was the one struggling with obesity myself having to tell people that it wouldn't be covered when they called crying... that was always hard. Only in the most extreme cases did I ever see them approve the surgery outside of the contract. Also, just because you're dealing with a BCBS plan doesn't mean that it will be covered because others are telling you that it was for them. These are independent licensee's of the BCBS Association and they all have their own rules, often times based on mandates required by the state where they are located.

One thing you might consider is finding out which employers in your area cover bariatric surgery through their medical plan and seek employment with them... these will be larger groups that make their own medical benefits. Also, it seems like more and more insurance carriers are choosing not to flat out exclude obesity treatment, so you might also check around with insurance carriers, call customer service and ask if, as a general rule, their community groups and individual plans exclude obesity treatment.... if they don't exclude you could look into getting individual coverage or see if you could find an employer insured with them to work for. Be careful of waiting periods for pre-existing conditions.... and there will almost certainly be some requirements for proving you are worthy of getting coverage for the surgery. If you are with BCBS and you do get approved there is a chance that they will require you to go with a Blue Distinction provider. You can find out who the Blue Distinction providers in your area are by going to Blue Cross Blue Shield Association - Better knowledge for healthier lives.

My own surgery is scheduled for Jan. 3, 2008. My employer covers it after proving medical necessity, but unfortunately the benefit is 50%. In my area it is pretty typical for the surgery to run around $16,000 and I had to do a lot of work on my credit before I could get the financing for the $8000 that I will have to pay. You might want to start on that first if you are going to try to get financing. Check out your credit report if you haven't already and make sure there aren't any surprises on there and make sure anything unpaid gets paid if possible. That will only be to your benefit. I was declined by surgery loans, and Wells Fargo before finally getting my credit report cleaned up and getting approved the middle of October (I started the process in July).

I wish you luck!

maile5278 · December 5, 2007

Thank you all for your input. 010308, thank you for all that info. I like to be well inform and you have given me alot to research and think about. My credit is a little less than perfect and I have a few credit cards that need paying off. So for now if insurance doesn't pay all or most of the surgery then I'll be waiting untill those cards are paid off and I'll be using CareCredit to pay for whatever insurance doesn't. I have a good bit of credit with them. I used them some treatments I'm having done. Anyway, thanks again. Wish me luck!