nursemommypaige

Okay, I always thought I was 5 8 1/2 but I just got measured in as 5'9 and I was trying hard not to stand up to my full height. SIGH! That puts my BMI to a 38 which SUCKS...however, I was sooooo nervous that my BP shot up and it was 152/72 and he also says I have some obesity related arthritis. Do you think those are comorbidities enough for insurance to cover me? I asked him, and he said that yes he thought so... so we shall see!

Oh my! Okay...so I posted before, that I really do not think that my insurance will cover me. I am 5'8 3/4 and about 250-255lbs. My BMI goes back and forth between a 37-39 and the only comorbidities I have are: sciatic nerve pain, knee pain, and acid reflux. Nothing life threatening anyway. So, I found a doctor that will do the surgery with my comorbidities....for 5000 down and $200/month for two years. This includes 90 days of fills for free, and afterwards the fills are only $50. Great deal right?? Well, to qualify for this special you have to have the surgery BY 12/30/10. I KNOW I Want this surgery..I have been thinking about it for years....and know several people who have had it. I have a three year old, and I want to be healthy for HIM.... Anyone made this decision in such a short period of time..... oh and how long does it usually take for the insurance to qualify or disqualify you?

Hey guys! Im Paige, 29 year old Mom of a three year old little boy! He is my life..and I love every second with him. Lately, its getting harder and harder to be active with him though. My knees hurt...my hips hurt.... So, I am really struggling here. My BMI is currently just over a 39 (only about 4lbs from a 40). Insurance will not yet cover me....because my comorbidies are not life threatening. I recently went to the doctor today...and started my "doctors supervised weight loss" Insurance requires me to do this for 6 months prior to getting the surgery..and ONLY if I am a 40 BMI. I know I need this surgery....I HURT ALL THE TIME. I have acid reflux and my hubby and I would love to have another child, but we know I am too heavy to get pregnant now...its just unhealthy. My doctor is not supportive. He once again put me on diet pills and told me to "step away from the table" ugh! I have found someone who will do the surgery...but its 10,000. I am concerned if something happens to the lap band, and I have to pay to fix it....10,000 is about the only money I have access to....and if something happened....I would be in trouble. So, do I wait and see if insurance will cover it? Has insurance ever turned anyone over 40 down that did all that they required? I mean...I guess I can deal for 6 months...but......I really just want this weight off now so I can get on with my life, and hubby and I can wait the year for another baby. My son is already over three...so I dont want them to be 10 years apart lol I realize I wrote a novel, and yall dont know me! I am just do torn!! :thumbup:

Lolly, your post makes me laugh. I mean, for real, you basically strip search people?? This is a business NOT a prision. I would not want a surgeon that is that lame to touch me..:rolleyes2:

Okay this is what my insurance says (roughly-it wont let me copy and paste): -has to be 18 or older -clinical records support BMI of 40 (or 35-40 with life threating comorbidies) for a period of six months -documentation showing that you have had failure to lower BMI (within the past 12 months) following a doctors supervised medical progrom of 6 months or greater. -if those are met, then they will only cover it if surgery is done in a hospital that is certified as "well qualified" by the Center for Medicare and Medicaid. Our insurance is GEHA, a federal insurance. Basically, I am taking this to mean if I am above a 40...and stay fat for six months (and do the doctors weight loss) they will not turn me down. Is that correct, or has someones insurance come back on them and not pay after meting all requirements?

Im looking into self pay options myself. Insurance MIGHT cover me...I just dont know yet. Good luck, and I do think it is sooo worth it even if you have to do self pay.

thanks for being supportive..I was kinda wondering if I might get bashed for saying what I said, but I am only 4lbs away, ya know?? AND I HURT...all the time. Sciatic nerve pain is KILLING me.

I really need this surgery. I hurt all the time. My joints kill me. I do not know if insurance will cover me at a 39 BMI and otherwise healthy. If need be, I can self pay 10,000 or under. I do not really want to go out of the US, or even too far away...because I know the fills need to be done. So does anyone know of anyone reasonable in this area? Thanks so much for you time! (I am actually in Gainesville Fl)

thank, I will check into that!

Hi! I am new here as well. I am looking into insurance paying, but I am not very hopeful. My BMI goes back and forth between a 38-40 (my weight has never been steady my whole adult life) but recently I am having a ton of joint pain (knees) sciatic nerve pain and acid reflux. I am only 29, and have a three year old. I need to get healthier to enjoy his life!! If insurance will not cover me, I will be going to self pay option as well. I am also in Florida. What part are you in?