Lap band insurance help!?

Question

My husband and I want to get the lap band surgery. He's looked into it significantly, and we know pretty much everything there is to know about it. We both have health insurance (under my name) that will pay 85% of the cost (up to $7500). However, I've been calling all over and there isn't anyone I can find that will allow little or no out of pocket cost. The cheapest one I found I would have to pay $3500 out of pocket! Is there anyone who has gotten this surgery with everything included for under $8000? We can't get any loans or use any credit cards at all. Any advice?

Answer 1

Sorry, there's no way around it that I know of . ..

Answer 2

No insurance company is going to allow you to get insurance from the for the sole purpose of having the surgery, especially with little or no out of pocket cost insurance companies are not Charity they are for profit if they pay it all for you were is there profit. stop eating cheese burgers it might be cheaper and healthier.

Answer 3

I'm supposed to be having lapband done in August and I had to pay full out of pocket of $16525 because my insurance wouldn't cover me since I don't meet certain criteria for coverage. I looked into another hospital and they were about $21000 out of pocket. Sooo, where ever you're looking sounds the cheapest. Good luck. I know what a pain in the *** it is to pay for this!

Answer 4

Go to the website of Obesityhelp.com and look up the surgeons and what insurance they take and you might find one that does that or they also have an insurance forum that could possibly help you.  Good Luck..

Answer 5

What no one here seems to have mentioned is that it appears your choice is for an elective surgery.

Health insurance generally does not cover a surgery without a medical need.

Don't forget the common exclusion for known pre-existing conditions.

It sounds like your best bet is to go with the company you already have. Especially, if they have already approved your need for the surgery.

Good luck

Answer 6

Nope...if you have 85% coverage under your surgical benefits, then you're going to have to pay the out of pocket cost if you want the surgery.

You should also keep in mind that if your insurer has a cap on bariatric coverage, complications from the surgery are generally lumped into the cap.

So, if your policy will pay a max of $7,500 for lap band surgery, keep in mind that its possible that you may have to pay 100% of the charges for any complications that arise.

If I were you, I would definitely verify with the insurance company first whether they would provide any coverage for complications from the surgery.  In the unfortunate event that you or your husband had major complications, the charges could easily run into the tens of thousands of dollars.  That $3,500 out of pocket charge could triple or quadruple in no time, if you were stuck paying for any complications that arose.

Definitely ask your insurer who would be liable for the cost of complications!