Alexandra

Maybe because I'm a mod I don't have the option. Oh well. (I wouldn't use it, anyway.) It's probably not technically feasible on a thread level, or I'm sure Alex would have done it that way. But this is a great measure that people can use from time to time if a forum is getting on their nerves. Thanks, Alex!!!

Welcome to LBT and good luck with your new doctor!!

That sounds like it will be perfect, but as of right now I can't see that option in my User CP.

Hi jeejee! Aetna does follow the medical guidelines for qualifying, which are what you mention above. You do have at least one weight-related comorbidity, the sleep apnea, and I'm sure your doctor was able to make the case that your other medical conditions are also affecting your health and need to be considered. If your plan covers bariatric surgery for medically qualified patients, AND you have met all their qualifying requirements (do they still require the six-month supervised diet?) and had all the tests, you should be OK. Your doctor is really the expert on this--or, at least, those people in his office who handle these things. If they thought it was worth submitting for pre-cert, you have a very good chance of success.

Sugarplum, PM me with a password and I will change it for you. Then you can change it again later.

You should call Cigna on Monday and see what their timeframe is for responding. Your doctor's office is correct, denials usually come fast. In most states the law calls for quick turnaround on requests for precertification; though 30 days is typically the max it shouldn't ever take nearly that long. Call! Make sure they have all the pieces they need to render a determination. The worst thing would be for them to call you or your doctor on the 21st or something just to say they don't have all the information they need. April 19th seems like too long ago for there to have been no response at all.

Kacee, there are types of insurance policies that work by reimbursing people after the fact, but those are the old-fashioned "indemnity" plans. If you have a managed-care plan (which most are, these days), it's highly unlikely that you would be reimbursed if you have surgery without preapproval. If you are denied and pay yourself, you can always continue your appeal process of course. But even if you manage to have the denial overturned, the coverage of surgery would be "in accordance with the terms of your contract" -- and almost all managed-care contracts require PREapproval for surgery. Ergo, they'd have yet another reason to deny coverage. The bottom line is that if you believe you have a shot at getting your insurance to cover it at all, you want to see the whole process through BEFORE paying for it yourself.

I'm a big believer in snacking, because for me the worst thing I can do is let myself get too hungry. If I am eating in response to actual hunger pangs I tend to bolt my food and take in WAY more than I need before I know it. So my strategy has always been to identify those times when that tends to happen (like when I get home, before dinner is ready and I haven't eaten since noon), and prepare myself with a snack (like a piece of cheese or some nuts before I leave the office). That way I have a semblance of control when it really is meal time. With my band snacking was by no means an everyday thing, but I felt no guilt at all about eating between meals if it seemed necessary. But without my band this strategy is more important than ever, since there's no impediment to eating as fast or as much as my warped brain tells me I want. So if I let myself get really, really hungry? Watch out.

Thinking of you and pulling for a good outcome. :hug:

Heathergirl, have you talked with your doctor about all these problems? There are usually other things to try before having the band removed altogether. But if you truly come to the decision that the band is making your life worse, not better, your doctor will NOT look at your as a failure. Your experience won't go down on his list of band successes, true, but that's not your concern. Your concern, and HIS concern, is YOUR HEALTH. Talk with him about your issues and you'll see what the next step is. Insurance should pay for the procedure if your doctor deems the removal to be medically necessary. That depends a lot on your symptoms and how your entire banding experience went. Also, is your insurer band-friendly? Was your initial banding surgery covered? If not, you might be up against a challenge getting them to pay for removal if it's not an emergency situation. First things first: call your doctor and discuss your symptoms and options. Then come back and let us know how you're doing!

My band was removed last month after 3.75 years, but I am eagerly awaiting a date for replacement surgery. Having the band removed is really relatively easy; the only downside to it is the cost. Medically speaking, it was a very simple procedure and I could have gone to work the next day. Removal is indeed a possibility, but to me that was one of the main attractions of the band. If something went wrong it didn't mean a lifetime of issues, malnutrition, major surgery, etc. The simple nature of the device and the fact that it doesn't permanently alter one's anatomy was, to me, the primary selling point. I'm going for it again, absolutely, because I need help keeping off the 120 lbs I lost. But right now I am 100% the same as I was before banding surgery in the first place, except for being 120 lbs lighter.

That was my first thought too when I saw that comment. Certainly there are more and more teens getting banded these days, but we've never made any pretensions about being "family-friendly." There's no profanity filter here, for example, which was a considered decision. Weight loss surgery is an adult issue, and I think we assume the reading audience fits that description in spirit, even if not literally.

I think it's a lot easier to subsist on a completely liquid diet than it is to just "watch what you eat." Complete avoidance of solid food is much easier than just having a little bit of something, or chewing very carefully. So the initial post-op diet is relatively easy, especially when you have healing to think about as a motivator. The really hard part comes when you're on solid food but have no restriction. It's extremely important to be gentle to your stomach by eating tiny bites and chewing carefully, but it's hard because you might be just as hungry as pre-surgery. It's hard, but if we made the decision to have banding surgery we have to be willing to TRY to observe the rules.

We probably all "struggled" with the decision at some point. But I think we know when the decision is right by when it stops being a struggle. There may always be second thoughts, nervousness, but when we are convinced to our very core that it is the right thing and the only option, those thoughts and nerves are less worrisome. If you are truly struggling with the decision, listen to your heart. Give it some time. Explore the options. The band will always be there for you when you're ready.

There IS a way to prevent the section from coming up in New Posts, as I described above. Just mark it "Read" before clicking on New Posts. Easy Peasy!! So though it's currently possible to prevent entire sections from appearing in New Posts, I'm hearing that people want a way to prevent specific threads from appearing. I'm not the techno brain behind this board, but I will ask the owner if that is possible. If it is, I don't see any problem. We certainly want to be responsive and I appreciate Neal's effort to make improvements. However, it seems obvious to me that the onus must be on those who would want to filter threads rather than our trying to devise a system-wide change that will make everyone happy. People just coming on to the site should see everything, so they get a full idea of what this place is about. For every person who might be offended or bemused by the R&R section, there may be another who is attracted to LBT specifically because we have a lively debate section here. Who can say? So I think it's absolutely preferable to allow registered members to change their own preferences, rather than our trying to make decisions for the masses. Personally, I'd be fine with the Top 5 threads being disabled, but PLEASE not the New Posts feature! Neal, by the way, the names of the moderators show on every forum listing page. I'm guessing you use New Posts almost exclusively, and don't see those?

It works! I just completely hid Canada from myself!! :biggrin1:

Something that I think will work now: If someone wants, for example, the entire R&R section to not show up when they click New Posts, mark the section "Read" before clicking on the New Posts button. Do that by double-clicking on the icon to the left of the forum title when you're on the main forum listing page. (Looks like a memo pad, or something.) It goes gray after you double-click it, which means there are no new-to-you posts in that entire section. Then it will be "safe" to click on New Posts and the sections you've tagged as read won't show up. I think.

How much clearer could the title of the R&R section be? What should it say?

Leatha, there have been no changes to the way this board is run. What are you referring to? The R&R section is only "shown off" because it's popular. The software isn't picking and choosing; it's only showing the threads with recent posts. Debates are more likely to have lots of posts, it seems, but it's not like anyone is highlighting them purposely. The "moderators" don't have an opinion, as far as I know. What are we in the minority on? ------------------ The off-topic sections thrive because people who find entertainment there stick around, and post a lot more often than they might do otherwise. That's just the nature of an online message board. The display responds to activity. So, get more active in the other areas, and other threads will pop to the top. Voila!

Perhaps there's a way for members to have, among their options, sections that are hidden or visible. When they log in and click New Posts, only the sections they have "allowed" will be shown. People might want to un-check all sorts of areas, like regional sections that don't apply, for example. That way each person can manage their sections and therefore their view, and those who want all sections available in the view can still have them.

Holy cow, this is the first I've heard of this! If my doctor had said anything about self-injected medications related to surgery, I'd have run for the hills. Thank goodness it was never mentioned to me!!

Melissa, thank you for sharing your experience. Who knows how many people you may have helped today? :hug:

Biggie, I think all they meant is that no one will go on record one way or the other with you until the request for preapproval is actually submitted and considered. The rep was probably telling you that the policy says it's not covered, but you won't know FOR SURE until and unless you submit a request and it is denied. Standard insurance-speak, I'm afraid.

Sigh... this is NOT uncommon and though I don't know the laws in Canada in the U.S. there's precious little one can do about it. I recently applied to increase the amount of life insurance I have on myself. I bought a policy years ago and just settled for what they'd give me at the time without a medical exam--since I was so young that wasn't a problem. Now, though I'm ten years older, I'm 100 lbs lighter and I figured I could buy "real" insurance even with medical questions. So I applied and the ball was rolling. A couple of days later I find out my band has to be removed, which meant surgery. Easy, simple, recovered immediately, no ill effects, but lo and behold my insurance application was ... well, let's say I decided the prudent thing to do would be to withdraw it. Now that I'm having replacement surgery in a month or so, I'm told I'll need to wait at least a year before applying again if I don't want to run the risk of being denied completely. SHEESH! It seems like there are no humans involved in the underwriting process anymore. They see surgery--especially weight-loss surgery--on a chart from less than 5 years ago and it's an immediate black mark. No matter that the surgery IMPROVES our health, makes it likely that we'll live LONGER. So you have my sympathy and I hope that you can prevail with an appeal. In my state, at least, I don't know of any appeal process for life insurance. All we can do is "shop around" and hope someone else takes a different view.

Honesty is never a bad thing, but I wanted to be sure everyone is observant of our terms of service. I'm not saying that every comment has to be all hearts and butterflies, but constructive criticism doesn't have to be presented in a negative way. Don't worry--MOST of the comments posted on this thread didn't even come near the line. But I could see where a thread like this might lead and thought a reminder was in order. Carry on...