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The Long and Winding Road....

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jennay5180

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SO...I have unofficially begun the journey. I have taken steps to prove that I am serious about getting thin and being healthy. OK....so over the weekend, I did a lot of research on different doctors in the area who specialize in LAP-BAND®. In fact, I found a Weight Loss facility pretty near my house that ONLY does LAP-BAND® surgeries. I called my insurance first thing Monday morning and found out that indeed the LAP-BAND® surgery is covered, provided you fall into the "Medically Necessary" category (which I do, as I have a BMI of 41). I have to enroll in a program called iCanChange through Tufts Health Plan. I have to have my Primary Care Physician write a letter and be accepted into the program. SO...I then called my DR. and left a message to have her call me back. I am going to ask her to write a letter that will get me into this program. It is a 6 month program where you speak with a nutritionist on a weekly basis...so pretty much the 6 month diet. THEN....after 6 months, I can either re-register for the program or get the LAP-BAND®. However, it is possible that you could be denied. I'm a little bit bummed....b/c even if you are enrolled in the program, it isn't a guarantee that you'll even be qualified to get the surgery through insurance. I REALLY wanted to get the ball rolling faster than 6 months out from whenever I get enrolled....let's just say in a couple of weeks....so that was a bit of a downer for me.....BUT....I'm just going to believe that everything will work out. I also have enrolled for a free seminar at the place that I was speaking of at the beginning of my post. It is on February 9th at 7pm. I am really excited to meet my "future" surgeon! :P (PS...I'm thinking positively! :thumbup: hahaha)...

 

Anyway, that's all of the news that I have for now. I'll keep everyone posted if anything else changes. :)

 

Have a great night!!

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SO...I have unofficially begun the journey. I have taken steps to prove that I am serious about getting thin and being healthy. OK....so over the weekend, I did a lot of research on different doctors in the area who specialize in LAP-BAND®. In fact, I found a Weight Loss facility pretty near my house that ONLY does LAP-BAND® surgeries. I called my insurance first thing Monday morning and found out that indeed the LAP-BAND® surgery is covered, provided you fall into the "Medically Necessary" category (which I do, as I have a BMI of 41). I have to enroll in a program called iCanChange through Tufts Health Plan. I have to have my Primary Care Physician write a letter and be accepted into the program. SO...I then called my DR. and left a message to have her call me back. I am going to ask her to write a letter that will get me into this program. It is a 6 month program where you speak with a nutritionist on a weekly basis...so pretty much the 6 month diet. THEN....after 6 months, I can either re-register for the program or get the LAP-BAND®. However, it is possible that you could be denied. I'm a little bit bummed....b/c even if you are enrolled in the program, it isn't a guarantee that you'll even be qualified to get the surgery through insurance. I REALLY wanted to get the ball rolling faster than 6 months out from whenever I get enrolled....let's just say in a couple of weeks....so that was a bit of a downer for me.....BUT....I'm just going to believe that everything will work out. I also have enrolled for a free seminar at the place that I was speaking of at the beginning of my post. It is on February 9th at 7pm. I am really excited to meet my "future" surgeon! :blush: (PS...I'm thinking positively! :thumbup: hahaha)...

Anyway, that's all of the news that I have for now. I'll keep everyone posted if anything else changes. :)

Have a great night!!

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WELCOME to LBT and congrats on getting started! For most insurance co. you're expected to be a failure at the WL program (only lose 5-10 lbs., but do NOT gain), but ask the insurance expert at your surgeon's office as they deal with them all the time. Do NOT go below the 40 BMI until after approval. Best wishes ! -BG

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