Jump to content
×
Are you looking for the BariatricPal Store? Go now!
Sign in to follow this  
  • entry
    1
  • comments
    7
  • views
    490

So lost....

Sign in to follow this  
TaraR

334 views

:) So here I am....

I have absolutely no effing idea where to begin...and there are so many things I need to do before I can even begin "lap banding".

 

My to do list:

Find an insurance carrier

Find a doctor who accepts my insurance

Do all paper work for doctor among other things

Get insurance company to pay for procedure...am I wishing or what?

 

So my first thoughts today are, OMG! I look like a whale...

I went shopping and I fit into a large shirt and size 21 JEANS....this is ridiculous! I am an active person, I dont eat alot, but I know I dont eat right either. I weighed myself a minute ago and the scale pratically screamed "GET OFF ME!!!!!!!" To my dismay it also told me I weigh 230 lbs. And I am only 5'4". This is so sad. This time 2 years ago I weighed 180. And that was after I gave birth to my daughter. I started doing some research tonite and came across the lap band. I had heard about it before and have always been interested just never thought the day would come when I would actually NEED it. My BMI is 39.5, so I am a great candidate for the procedure, I just dont have the money to do it. I am trying to save money for a new house and money to pay for a wedding next year so I have absolutely no money for anything on the side. I live with my dad until i get married (house rules) so my dad helps me out alot financially. Being that I am in school and have a student loan for 10,000 and growing, and I have shitty credit, I dont think financing will be an option for me either. Unless I can sucker some bank into giving me a loan I think I have only one option left, INSURANCE. Which leads me to the question, what insurance company pays for the lap band?

 

SO if anyone is reading this...send me a message and let me know if you can help...give advice, guidance, anything!

 

 

Much Love to ALL:faint:

Sign in to follow this  


7 Comments


Recommended Comments

:o So here I am....

I have absolutely no effing idea where to begin...and there are so many things I need to do before I can even begin "lap banding".

My to do list:

Find an insurance carrier

Find a doctor who accepts my insurance

Do all paper work for doctor among other things

Get insurance company to pay for procedure...am I wishing or what?

So my first thoughts today are, OMG! I look like a whale...

I went shopping and I fit into a large shirt and size 21 JEANS....this is ridiculous! I am an active person, I dont eat alot, but I know I dont eat right either. I weighed myself a minute ago and the scale pratically screamed "GET OFF ME!!!!!!!" To my dismay it also told me I weigh 230 lbs. And I am only 5'4". This is so sad. This time 2 years ago I weighed 180. And that was after I gave birth to my daughter. I started doing some research tonite and came across the lap band. I had heard about it before and have always been interested just never thought the day would come when I would actually NEED it. My BMI is 39.5, so I am a great candidate for the procedure, I just dont have the money to do it. I am trying to save money for a new house and money to pay for a wedding next year so I have absolutely no money for anything on the side. I live with my dad until i get married (house rules) so my dad helps me out alot financially. Being that I am in school and have a student loan for 10,000 and growing, and I have shitty credit, I dont think financing will be an option for me either. Unless I can sucker some bank into giving me a loan I think I have only one option left, INSURANCE. Which leads me to the question, what insurance company pays for the lap band?

SO if anyone is reading this...send me a message and let me know if you can help...give advice, guidance, anything!

Much Love to ALL:faint:

Share this comment


Link to comment

Most insurance companies will pay, but they all have diffrent bennifits. Some pay more than others and others have some real stupid things that have to be done before surgery will be approved. I do have one piece of advice DO NOT go with Humana. That is who I haev and when we got Humana they had great benns, but they have changed my benns 3 times since Jan 1 08 and now they suck really bad. I am in the middle of getting everything done and all of a sudden I have to start a 6 month sup diet by my doctor. So I was going to have my surgery done like next month and now I am going to have to wait till Aug or Sept. Anyway it is BS so for your own sake dont go with them.

Share this comment


Link to comment

You can't go by which insurance company you have. If you are employed, they pick which parts and sections to allow for the benefits. I worked at a company that offered BCBS and it was not a covered item. Even though some policies for BCBS they are covered.

I was working for a company where I had Humana PPO. They did pay for it. I would start with your insurance. Call them. Ask them if you have the benefit and what you would need to do. Then find a dr that is willing to help you get the surgery. Mine was very helpful in working with me and the insurance company to get approved. I'm in Colorado and used Dr. Michael Johnell. Very satisfied. My insurance made me do the 6 month Dr Supervised weight loss. I did it. Saw the dr once a month for 6 months. Just show up. Don't get upset about having to loose weight b4 the surgery and don't give up.

The insurance feels like if you wont go every month for 6 months, then you won't follow the program after you get the surgery. And unfortunately they are right!

If you have to wait the 6 months, do it. It's still worth it. Once you do find a dr to perform surgery, they usually ask you to loose 10% of your weight anyway. It helps to have the liver shrink b4 they do surgery and makes surgery much easier for them.

Anyway, as I said I had Humana and I only ended up paying about $700 total for a $34k surgery.

So Call your Insurance and ask them if it's covered. Ask them what they require and find a dr that you trust. Ask around. People are glad to tell you which dr's were good and definitely which ones were bad!

Good Luck!

Share this comment


Link to comment

Hey It is a new requirment that any plan Humana offers, you must complete the 6 month diet. No matter what company it is through. That started January 26, 08. But the good news is that Humana has a bariatric department, they are one of the few insurance companies that have this. The bad news is that everyone of the employees that anwser the phones are dumb a$$es. But if you dont feel that what they are saying is wright ask to speak to a supervisor. They are great. The number to that department is 866-486-5295. You have to have your member number for them to look at your policy, so you will want to have your card right with you when you call. Also all of there policies require that you use a Center of Excellance, as of Jan 01. But they will be able to tell you all of the doctors available in your area. I really hope this helps and you are able to get everything figured out. Please let me know what you find out from them.

Share this comment


Link to comment

I have Humana and had to do the 6 month thing... it is not a 'new' requirement. A colleague of mine also had to do 6 months and her surgery was in 2005.

Share this comment


Link to comment

That is a new policy with Humana that ALL plans have to do the 6 month diet. Most of their plans have required it in the past, but as of 01-26-08 ALL of their plans now require it. My plan, through my husbands employer Brunswick, has not ever required it in the past. They said that there were about 30% of their plans that did not require the 6 month diet in the past. But they said that they felt as if it was unfair to require 70% to do the diet when the others didn't have to. Humana is making alot of changes this year. So be careful of what they tell you and what you get your hopes up about. Just since Jan 01, 08 they have made 3 changes to my plan, and I was told that they are changing alot right now on all of their plans. I wish you all of the luck!!!

Share this comment


Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

PatchAid Vitamin Patches

×