Lap Band Fills - Cost and Insurance Coverage
One of the benefits of the Lap Band is that it can be adjusted to optimize satiety (feeling of fullness after a meal) and maximize weight loss for each patient on an individual basis. Adjustments made to tighten the band are often referred to as Lap Band Fills, a term which describes the process of adding fluid to the band in order to further restrict digestion of solid foods.
When the Lap Band is implanted into the body, the inner saline tube is usually left unfilled. This allows the body time to heal from surgery and become adjusted to the band before the first fill is done. The first fill is usually scheduled for approximately 4 to 6 weeks after surgery, depending on how healing is progressing. After the first fill, additional adjustments are scheduled by the doctor as deemed necessary, often at 4 to 6 week intervals.
Lap Band Fill Factors
After surgery, follow-up visits are usually scheduled for every 6 weeks during the first year and then every three months for the next two years. During the appointment, the doctor will monitor your health and rate of weight loss as well as adjust the Lap Band if necessary.
There are several factors which help determine whether or not an adjustment is needed:
- degree of hunger
- amount of restriction
- amount of weight loss
It takes time to find just the right fill amount, and even that level can change based on many fluctuating elements, such as weight loss, hydration, foods eaten, eating habits, and metabolism. Lap Band adjustments should be made slowly and gradually and not too much at one time. A good fill will satisfy your hunger for about 3 to 4 hours after eating a meal consisting of solid foods.
Cost of Lap Band Fills
The cost of lap band fills depends on many factors: the surgeon, the facility, if the fill is done under an x-ray fluoroscope, if you are going to the doctor who performed the surgery or another provider, and insurance coverage.
An average fill cost is $100, when you go to the surgeon who performed your surgery. Many surgeons will include your first fill in the cost of surgery or provide the first year of fills at no additional cost when you have them perform the lap band surgery. If the fill is done under an X-ray fluoroscope there is usually an additional cost of $100 - $200.
Finding a Lap Band Fill Provider
If your surgery was performed out of country or you want to switch doctors, you should be aware that it may be difficult to find a doctor who will take you on as a patient. Many doctors choose not to assume responsibility for a surgery they did not perform. Also, you will most likely pay more for your fills from another provider than if you went to the doctor who performed the surgery.
For patients who had Lap Band Surgery outside of the United States, it is also a matter of the doctor not knowing whether or not the surgery was performed to the standards set in the US for patient safety. The doctor can be in trouble with the licensing board if you have a gastric band that is not approved for use in the United States. If you choose to have your surgery in Mexico or another country, make sure you work out fill arrangements before you have the surgery, unless you will be traveling back to the same bariatric surgeon for your adjustments and exams.
If you find a doctor to accept you as a fill patient, it is common for them to charge you an initial consultation fee and a one-time program fee in addition to the cost of the fill. The first appointment and fill with a doctor could cost about $1000, and then about $100 to $300 a fill on subsequent visits. Another option is going to a lap band fill center such as Fill Centers, USA.
Insurance Coverage for Lap Band Fills
Some insurance companies may not cover fills even if they covered the surgery, but some insurance companies and medicare will cover fills as long as they are billed correctly. You may still be responsible for your portion of the co-pay amount.
How is the Lap Band adjusted?
During Lap Band Surgery, an access port is placed beneath the abdominal wall which is connected to the gastric band by a thin tube. This access port is used to add or remove saline from the balloon reservoirs which line the inner circle of the gastric band. The adjustments are made by the doctor using a thin needle, often under the guidance of an X-ray fluoroscope in order to view the level of restriction in the band and to check for any potential issues of concern.
The adjustment process is used to either inflate or deflate the band, depending on whether fluid is added or removed. Saline is added if the amount of weight loss is too low and the band is too loose. Saline can be removed if the band is too tight and causing too much pain or difficulty eating. Any issues of concern should be addressed with your doctor in order to arrive at the safest and most productive level of Lap Band fill.
Preparing for a Lap Band Fill
There are several steps you can do to increase the likelihood of a good fill outcome:
- Make sure you are properly hydrated on the day of your fill (you should be drinking water every day, but especially important in the 2 to 3 days before a fill)
- Do not eat a big, late night dinner the night before a fill (it sometimes takes 12 hours for all food to move through the stomach pouch)
- Do not eat any solid foods for at least 6 hours before the fill (the stomach pouch should be completely empty for a fill)
- Avoid COLD fluids for an hour before the fill (cold can temporarily shrink the stoma)
- Avoid getting a fill either during or a few days before your menstrual period (fluid retention affects fill level)
- If possible, hang around the doctor’s office for a few hours after a fill to make sure you feel okay with the adjustment
- If traveling from out of town, plan on staying in the area at least overnight, just in case there is a problem with the amount of fill
- After a fill, limit eating to a full liquid diet for 24 hours, then to soft foods for a day, before resuming a solid food diet (to help the stoma rest and heal)
The above guidelines are some of the recommendations that will help achieve a good fluoroscopy and good fill level. Make sure you talk to your doctor about any other specific preparations you should make before a fill appointment. If you are having any trouble with the Lap Band, it may be best not to get a fill at this time.
During your exam, it is also important to talk about any concerns or problems you may have in regards to the Lap Band, including eating habits, diet and nutrition, physical activity, and other health issues.