Revision surgery without insurance?

terrapin16
on 5/2/14 12:10 pm - CO

I had VSG in MX Jan 2012.

Am thinking of revision surgery and would LOVE to not have to go to MX.  But my primary doc said it could take up to a year with insurance in the states....and that's IF I get approved.

Anyone pay cash for revision surgery in the states?  If so, do you mind telling me how much it was?

Thanks in advance.

Ladytazz
on 5/3/14 12:26 am

You are looking at big bucks for WLS in the states.  The lowest I have seen for self pay is about $20,000 and that doesn't include complications.  You need to find out if your insurance would cover issues related to WLS or you may get into a lot of problems.

The best thing to do is decide which surgery you want to revise to.  The DS is the logical choice because you are half way there and depending on the state of your sleeve you may only need to intestinal portion.  Find surgeons that are near to you, and if that isn't possible then search for experienced surgeons.  DSfacts.com has a list.  Contact the surgeons and find out if they have a self pay rate.  Make sure that includes the hospital and all fees.  Some surgeons give special rates to self pay patients because it helps them cut out the hassle of billing the insurance company.  Many doctors have deals with insurance companies to take what they are willing to pay and write off the rest.  Some doctors will let you pay that amount or close to it.

Good luck and make sure you have a plan ready for follow up care because WLS with malabsorpiton will require lifetime lab work and it can get costly out of pocket but you should always factor in post op costs when you are looking at WLS, vitamins, supplements, lab work, tests such as DEXA are all part of being a post op.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

SuzinDallas
on 5/3/14 11:19 am

I saw three different Dr's for consultations in Dallas and Houston Texas while looking for my revision from Band to RNY. I got quotes ranging from $18,000-$28,000.

Additionally some Dr's required multiple surgeries-one to do the take down of the band, then one for the bypass.  Increasing the cost a good bit.

If there's a chance that your insurance will cover it, I would spend the year-or however long it would take to find out if they do unless you have a lot of money lying around.  

My insurance (Tricare) covered my revision (I wasn't on this policy when I started looking into it) covered my revision on the first submittal.  My consult with my Dr was 3/26.  I went to see the nutritionist the next day and we submitted everything to them-documented history with the band, documented problems and my original surgery information that day.  I got the call that I was approved in 3 business days and had the surgery yesterday-I could have had it last week actually but needed to coordinate schedules with my mother to take care of my daughter. So they don't all take a long time if it's covered.  You will likely need to prove medical need though so start gathering any records you may have.

But start with a phone call to your insurance company. Finding out if they have an outright exclusion for revision or weight loss surgery will be a good first step in deciding if you need to get other financing in place or start the process with insurance.

     

Revision from Lap-Band to RNY May 2014.  

Revision Consultation: 326   Day of Surgery: 310   Current: 250   Goal: 150

terrapin16
on 5/5/14 11:41 am - CO

Oh my goodness these prices are crazy!

Thanks for all the info.  

pineview01
on 5/8/14 5:30 am - Davison, MI

Personally I would find out if your insurance will pay for the second stage DS surgery.  If so find out what you need to do for it.  So may take a year and others are revised in a short period of time.  Doesn't cost to check this out first and will save tens of thousands.

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Holdenwhat
on 5/13/14 3:02 pm

I had a revision from RNY to DS 2 months ago. It was $37,000. 

terrapin16
on 5/13/14 10:29 pm - CO

Wow. Had no idea it was that expensive.

Thanks for the info.

How are you doing today?  

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