Be sure to do your research. I had my surgery 4/07. I am lucky my insurance did pay for the procedure as well as for the follow up. I tolerated the procedure well and have had no problems to date. I am down 68 pounds and am very happy; but I have heard and read many horror stories from self pay individuals.

Examples:

1) Self pay patient had internal adhesions from other non related procedures. During the procedure they discover the adhesions. They had to remove the adhesions. This required additional medical care and follow up. The insurance company, which did not cover the procedure or related costs, stated everything stemed from the intial non approved procedure. That nearly doubled her cost.

2) Self pay patient developed pneumonia, insurance refused any costs associated with the pneumonia because it was associated with the non approved surgery.

3) Self pay patient developed stomach and esophagus ulcers, 1 year post. This required testing and draining the band 2 years post the procedure. Since her issues were the result of the banding the insurance company refused to cover any of the additional expenses stating it was all related to the initally unapproved procedure.

4) Number of follow up visits and fills. When you are self pay, many times you can negotiate your fills for the first year to be included in the cost of the procedure. If not what can you anticipate: each visit an estimated $100 and the fill another $150. How many fills have I had in 1 year? I had my first fill 6 weeks post the fill. I have had additional fills every 10-12 weeks. Then at the 1 year point you have bloodwork and an upper GI to ensure you do have not developed ulcers. I am told I will require the same bloodwork and upper GI at the 2 year point. I don't know about after that. After year 1 the fills will greatly decrease. After 2 years the fills are about every 6 months, just to tighten it up a little and make sure you are slipping back into old habits. Every person is different this is just my experience and what I have been told.

I am not discouraging anyone from having the procedure. I am simply stating you need to be aware.

Shoot, I wish I'd written it down now, but I just read somewhere else on this site that some states have laws which say that insurance must provide coverage from any ongoing medical issue no matter what the point of origin is. Basically, they might not pay for the lap band but they do need to pay for anything that arises from it. Whoever said this works for an insurance company. I believe that I read it in the "complications" forum and I'd go and find it again but that forum seems to be down at the moment...

I have to put my two cents in.... I started my journey january of 07. I researched and researched and went to differnet doctors. I CHOSE SELF PAY, one because I did not want to jump through the insurance hoops. I did not have to wait 9 months to have the surgery. I was very close to diabeties and was not willing to wait. Number two, I would have had to have the surgery at the hospital that I work at, and I really did not want everyone knowing my business. My Dr also performs surgery at New Hope Bariatrics. I had my surgery done out patient. No problems.

I dont think that self pay patients are at any more risk than insurance patients.

The Dr I chose is a leader in Lap Band surgerys in my area and has even TAUGHT other Drs to do the band. I was scheduled to have my band in Aug of 07. I had all of the medical testings done that a Insurance Patient would have. In those testings they found that my Calcium was way high and cancelled my surgery a few days before I was to have it. I WAS SELF PAY AND MY DR CANCELLED. I found out that I had Hyperparathyroidism. I would have been at a Huge risk "cardiac" during surgery. Thanks to god that my Dr CARED enough to cancel... was I mad.. hell yes. I had spent two weeks on a liquid diet. But the way I look at is that my Dr may have saved my life twice. 1st. during surgery, and 2nd. banding me so I can be healthy. I had my left lower pararthyroid removed on November 9th. I was cleared from my Lap band Dr to have surgery in Jan of 08.

I had my surgery on Jan 3rd of 08 and have lost 58 pounds.

You have to weigh the options, do your research.

I feel my Dr treats each patient the same, self pay or insurance.

I also have free fills and unfills for a year.. After that time.. I WILL BE MORE THAN HAPPY TO PAY OUT OF POCKET. I do not have diabeties and off of blood pressure meds. You cant put a price tag on that.

Good luck to everyone.... Research, Research, Research.....

Lois Holcomb

Lois,

Wow, what a story, that could've been scary. I had never heard of a parathyroid until a year ago and my dad through a blood test found out his calcium levels were out of whack and he had surgery to remove some of his parathyroid as well. Congrats on your progress and being healthy again!!!

It was scary, expecially when I found out what COULD have happened during surg. But all is well now. THANK GOD FOR MY LAP BAND DR. He was concerned about ME... not the money. I was self pay.

Good luck on your journey, please let me know if I can help you out in any way at all.

Lois