Dr. Garber - Insurance or Not???

Hi all, I know Dr. Garber is Out-Of-Network for most insurance. He said he accepts 70% as full payment (assuming your Out-Of-Network pays 70% or more). Well...mine pays only 50% for Out-Of-Network. Has anyone else had a situation like this, and....if I may ask...how much out of pocket the additional 20% ended up costing? Thanks...this is a pretty urgent issue for me. -Karen

Karen, If Dr. Garber doesn't accept your insurance or is out-of-network, why are you so determined to have him perform your surgery when thre are other just as qualified surgeons on Long Island and even closer to you geographically that WILL accept your insurance in network? From what I understand this surgery can cost anywhere from $15-20,000!! So 50% out of pocket is about 7500-10000. Why pay that when you can have it done for no out of pocket if you go to someone in network. What are your fears? Trish

Hi Trish, After doing 2+ years of research I truly believe Dr. Garber is the best WLS, especially for LAP RNY. I have a sister and a Mom who are RN's and did the Consult rounds with me...and he has by far the best and most experience with LAPs. However: I am going to see yet another Doctor on Aug. 8th. The problem with some of the other doctors suggested to me is not so much that the Doctors themselves may not be EXCELLENT....but one has to factor in the Hospital and Post-Op care as well. And, as I said, having a Mom and sister who are RN's, I know which hospitals I wouldn't go to for a hangnail! I hope that better explains why I seem "hung up" on Dr. Garber. -Karen

Ok Karen, I accept your decision. But are you trying to tell me that Mather Memorial is not a qualified hospital? Because Dr. Ahmad claims that he is the FIRST surgeon in Suffolk County to perform lap bypass AND he has had ZERO deaths/fatalities from the surgery. There are no guarantees and with any surgeon you have to accept the risks. Just because Dr. Garber learned from a surgeon who performed this on someone famous, does not make him the only expert. Just trying to get you to be a little open minded in case cost is a major concern. As for me being single and financially strapped at the moment, cost is everything to me or I would not consider it. My insurance will pick up the tab so that is why I am trying to get this done before I move on to a new job. That being said, you may want to consider Dr. Adaniel in West Islip who performs out of North Shore LIJ in Bayshore or Good Sam in West Babylon. Lap is important to me too but I understand that Dr. Cooperstone is also well qualified and I have heard nothing but good reports from his post-op patients. Dr. Garber was the first surgeon's office to email me after signing up on this website. However, he is too long distance for me to have a "forever" kind of doctor/patient relationship in the long run so I am trying to choose someone more geographically desirable. All surgery is a risk no matter who performs it. I wish you luck and contentment with whatever choice you do make. But please stay away from Dr. Brathwaite as he is a butcher and I heard he nicked someone's liver not too long ago during the process. He also came highly recommended to me but after my experience with his staff, I would not send my dog to his office.

Hi Karen- Im one of Dr G's patients, and used him out of network. People who are not familiar with Drs Garber & Holover don't understand why we TRUST them, and want them.I had interviewed several LI doctors before I chose him. PLUS while other patients have only ONE surgeon, we have the benefit of TWO qualified surgeons to run to postop. What some people DON'T know is that Dr Garber was trained by Dr Wittgrove, who not only originated this surgery- but also did Carnie Wilson's surgery. And he is experienced at this surgery 10 yrs, whereas some docs have 4yrs or less experience. And I have heard routine complications by patients, like gall bladder problems, and strictures,post surgey, where I haven't heard that from other Garber/Holover patients. It has a LOT to do with their surgical expertise. Ok! That being said... Number 1- I know Dr Holover accepts insurance. I love him to death. I have consulted both with him & Dr G on several things since surgery ( I am anemic since before surgery) and just things that have come up- and I trust them both. Dr Garber did my surgery and Dr Holover assisted. If I couldn't use Dr G, I would def have Dr Holover, no doubts here. #2- I know Dr G accepted what my carrier- Aetna paid him directly. My out of pocket expenses was maybe$1500/$1700. And I will say Farrah works with you to budget your monthly payments. I am not sure what my carrier covered- but it was 80%. All these carriers don't want to pay and find ways to make the patient pay more. #3- Another consideration- Are you married? Have you looked into putting it under your husbands carrier? I've seen where that works to someone's benefit. I'm single and could not do that. If that is an option, look into it- all your testing is still relevant- and if it costs you less money- but a little longer wait- its still benefits you. I hope that helps you. When they say out of network- they are talking about maybe office visits, routine stuff. Call your carrier - Ive never heard of a carrier not covering 100% of In Hospital care- like surgery/ anesthesiology/2day care. All your hospital fees should be covered. Look into that and I wish you the best. Donna 325/210/150

I used Dr. Garber and it was the BEST DECISION OF MY LIFE! I believe my insurance covered about 80%. I remember when my insurance sent an invoice, i think the total cost of surgery was something like $40,000. But as Donna said (HEY DONNA!) Farrah will certainly work with you. Those of us who are Garber/Holover patients know why you are so interested in him--he's the best by far! Good luck to you on this journey. Erin