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The day that changed my life...

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Shavona

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It all started about 2 years ago when I had to set up an appointment with Dr. Clare in Lincoln, Nebraska. He is a Orthopedic Surgeon about my knees. He looked at my MRI and told me that I had old knees and I need to have a knee replacement in both of my knees. I was crushed. I never thought that I would ever hear those words. He looked at me all serious and ask me if I had ever thought about having the LapBand Surgery. He gave me a referrel to Dr. Hung in Lincoln. After leaving the appointment I broke down for the first time in a long time. I knew that I was overweight but to hear a doctor tell me that my weight is causing my knees to fail me. I was 24 at the time. Dr. Clare told me that he would not touch my knees until I was at least 35. What was I to do. So I made the appointment to see Dr. Hung. I met with him, he was very nice, talked a little fast, but I did retain a lot of information. Because of my surgery with Cigna I had to do a whole list of things, 6 months diet, psych eval, pulmonary test, sleep study and so on. I started the 6 months eval, waiting for everything else till the end. As the months went on my husband and I had talked about having a baby. So we decided to wait to have the surgery until after I had the baby. So we tried for a number of months. I decided maybe this isn't the right time to have a baby and I should get back into getting everything done for the insurance. So we fast forward 6 months and I have set up all the appointments, by this time it is November. My husband calls me one day to inform me that the company he works for is no longer going to have Cigna as insurance. I was crushed all this hard work for nothing. Jan of 2010 we change to Anthem Blue Cross and Blue Shield.

 

So going with a new insurance company, I called the number and was asking about what was covered, they said yes lapband was covered but that is all that they would tell me. Things came up and shoved it in the back of my mind. I was so busy with moving and and being a mom to my daughter I didn't think much about it. The whole year went by..... Starting a new year, I started reseaching the lapband again and getting my heart and mind ready to get it done. The day that really set me in motion was the day my daughter came up to me and called me fat and told me I had a big belly. I was hurt that my 3 year old can see what I have become. So I decided that I was going to call the insurance and make sure I didn't hang up the phone till the tell me everything that I want to know. I called and got the worst news, that the insurance did not cover any weight loss surgeries. I was crushed. So I started researching how much it would be out of pocket. My husband and I were willing to do anything to get this done. As I was researching I came across Dr. Ortiz in Mexico cost was $6000. I thought get, we can get a loan and I can have my surgery. I was excited. I called my mother-in-law and told her of the news, she was floored and made me promise that I would call the insurance again. She was scared because of all the news of the drug wars and what not. She is a firm believer that United States has the best medicine. Well keeping to my promise I tried calling. Being it was to late at night to get a hold of anyone, I decided I would call first thing in the morning. I was surfing the next and an ad caught my attention. A doctor here in Denver would do a insurance check for FREE. It would be Dr. Brown's office. So I filled out the little questionare. Being early the next morning I call the insurance and take to a guy ask him everything I wanted to know and he told me that nothing was covered. So I left it at that. An hour later I was getting ready to call my mother-in-law and I get a phone call from Amy, Dr. Brown's Insurance lady. And she informs me that the insurance will cover the surgery and that I only have to have a psych eval and talk to the dietician. I told her of what had happen an hour earlier. But she told me that she gave them all the codes and everything is covered 80 percent. I was thrilled, shocked and excited.

 

We set up an appointment for April 27, 2011 and I meet with everyone and get all my pre things done including the psych eval and speaking with the dietician. I meet with the doctor and his PA. Everyone was really nice and they really showed they cared and listen to me. Answered all my questions that I had. After meeting with Dr. Brown I went to see Amy to fill out some more paperwork. As I was sitting there I was waiting to hear that there would be something else that I would have to do. She looks at me and says "Ok, I have everything that I need, when do you want to set up your surgery date." I was totally shocked. I said WHAT??? She repeated her self with a little laugh. I said ASAP. We set my surgery for the 27th of May, at 8am. I was moved to tears, I couldn't believe that this is all that I had to do. It was by far the best day of my life and one I will never forget.

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