I had started looking into the LapBand in 2010. A friend and I went to an informational seminar about the procedure. Our first question was "How Much?", but of course we had to listen to the whole dog-and-pony show before they would discuss finances. And then we learned why. The procedure cost $15,000 and our insurance did not cover it. Yikes! That was a whole lotta clams. I really was convinced that LapBand was the solution for me, but I simply could not justify that expense. My friend was in the same boat.
Fast-forward to 2012, when I'm sitting in my car and the radio commercial says, "Even if you've been told your insurance doesn't cover it, come and talk to our expert case managers at True Results..." I was intrigued (not to mention 20lbs heavier than my 2010 self), so I wasted no time in giving them a call.
My insurance still did not cover the LapBand procedure, so I was quoted an initial price of $9888, with offers of in-house financing and/or external credit plans. I had already agreed to that amount, but the amazing Patient Advocate says, "Wait right here..." She went to check on my insurance benefits, and came back and laid out a pretty clever plan. She explained that if I was found to have a hiatal hernia, my insurance WOULD pay for surgical repair of that. And during the procedure, all I had to do was pony up a measly $5500 and they would slip on a LapBand!
"What if I don't have a hiatal hernia?" I said. "You have a hiatal hernia,"she said confidently. "How on earth do you know that?" I asked. She explained that my history of reflux/heartburn was highly indicative of a hernia. Plus, she said, "about 90 percent of obese people have hiatal hernias." I like those odds.
So I had an EGD done (paid my share of $120 for the test) and EUREKA! Hiatal hernia was found. I had never been so happy to have been diagnosed with an ailment in all my life! I promptly hosted a "Hernia Party", complete with TUMS and AlkaSeltzer hors d'oeuvres. That darn little bulge just saved me over four grand!
The experience also ingratiated me to my Patient Adovocate. I had already agreed to the $9880. I was not waffling. I feel she went out of her way to make the process as *painless* (in the wallet) as possible. I will always be thankful to her for this.