MelindaH

They will probably insist that you get one. For me, they said it is essential if you are on any meds. They do not like to do the pharmacy side of it. Med dosages change as you lose weight. But every situation is different and every insurance co has different requirements. All the best to you in your journey. Melinda

Hon, this is not normal. Go to a center of excellence even if you have to drive a bit. As far as I know there are no up front charges. This is a big red flag for me and I would almost question their ethics. Melinda

I don't want to discourage you from the band, but I have heard that Kaiser won't pay for it--only the RNY. You may already know this. Just check it out thoroughly. all the best to you. You will find that the folks who post here are very knowledgeable and supportive. Drop in often. Melinda

Hi, I would focus on choosing a surgeon. His or her office will gather the info for you but they will appreciate your help in telling them where it is. All the best to you! Melinda

I wouldn't worry about dropping below 40. They want to know that you can lose weight. I didn't even start at 40--37.4 but with co-morbidities. All the best to you, Melinda

I am on BCBS Fed Standard. I started the end of April with a seminar at a Center of Excellence here in Eugene, OR. You complete an 18 to 20 page questionnaire about your history of obesity and your medical history as a whole. Then they will call you for a consult appt. Mine was the end of May. Went really well. My BMI was 37.4 and I have several co-morbities. After the MD appt, I met with their insurance co-ordinator who informed me that BCBS requires the following: 1) a documented weight history showing obesity for two years 2) documentattion of any weight loss attempts you made within the previous calendar year before you met with the surgeon--just a brief statement 3) three months of consecutive nutritional counseling. 4) screening by a psychologist.. The MD may send you to various specialists ie: cardiologist depending on your age, gastroenterologist for endoscopy, visit with your primary care to establish their support, perhaps a sleep specialist to rule out sleep apnea, perhaps an orthopedic consult. The consults will vary from patient to patient. After you complete all of the above, they (surgeon's office) will send your records to BCBS (usually by fax). My ins lady said it takes one to two business weeks. If everything is in order, it is usually approved very quickly and then they will schedule you within that month. Oh, one last thing, the surgeon requires that you lose 5-10% of your weight. before pre-op. I hope this helps. Feel free to contact me if you have further questions. I have one more nutrion session then mine should be ready to go to BCBS. Hoping for surgery the end of Sept or so. Melinda

hi, are you BCBS Federal or regular BCBS. I can help you with the Federal plan if that is what you have. Melinda

Hi, I take Mirapex (it comes in generic) for my RLS. It has helped enormously. I wish you and your wife all the best, Melinda

I have a double hiatal hernia and am so looking forward to getting it fixed along with the band. Hopefully by end of Sept. I understnd the reflux thing. It is awful and getting worse. Thank heavens for nexium. All the best to you. Melinda

Rose, you are definately not too old. I am 54. At my informational seminar, I asked about age. My surgeon said they don't even look at age until you are 65 and then every case is considered on an individual basis. Do not listen to the naysayers, whether it be family, friends ins co or whatever. You are worth it. You are doing this only for yourself. Keep your chin up! Keep us posted. All the best to you, Melinda

Hi, I have horrible insomnia and if it wasn't for ambien I would never get the six continuous hours that one needs to even remotely function. My children mentioned to me that I snored so loud that it worke them up with both their doors and our doors closed. This was close to ten years ago. I mentioned it to my ENT and he suggested a pulse ox test at night. You put a little something around your finger and try to record it for at least six hours. My sats came back around 70%--not good for living. He sent me to a sleep specialist and I had the overnight studies done. They came in more than once and had me change positions because I wasn't breathing. I am claustrophobic, I didn't like the masks but I wanted to live to see my kids grow up and that was the motivation that moved me past the claustrophia. I use it all the time, whether at night or napping. I travel with it. They do discourage napping if you have insomnia.. I usually wake up feeling rested. When I didn't have it before, I was exhausted all the time. I look forward to losing weight with the hopes that I will no longer need the machine. Hopefully weight loss will cure my snoring also. But if I need the machine, I need it. Even with no insurance, there are places that will accept you such as teaching universities. Some doctors have a cash pay out plan or will discount their services. It sounds like apnea to me but I am not qualified to give advice. The finger pulse ox test should not be expensive and I know places here that will do it for free and even deliver and pick up the machine. Ask around. I wish you and your girlfriend the best. Melinda

Missy, I take Lyrica and it has helped me so much. You have to watch your diet but it is well worth it to me. Neurontin got to where all I was doing is gaining weight with no pain relief. All the best, Melinda

Great job! Awesome report. You give me a lot of hope! Melinda

You are amazing to undertake this by yourself. I am sure it will be a sweet surprise when your husband returns. All the best to you. Take good care of yourself. I love this forum. As the previous poster said, very compassionate and knowledgeable people. Drop in often. Also, many thanks to your husband and to you for serving our country. Melinda

I am covered under BCBS FEP Standard. I am planning on lap band surgery in late Sept, early Oct. and am in the process of jumping through their hoops. I have several co-morbities so I don't think it will be a big problem to be pre-approved. I also have Ehlers Danlos Syndrome which destroys the elasticity of the skin and I already have saggy skin most every where you can invision. I am sure that I will need at least an abdominoplasty after I lose weight. I have read the plan backward and forward and upside down and have talked to their cust svc several times over the years. I have been told that it is approved when medically necesary only. They suggested that I see my doctor anytime I have a skin infection so that it will be well documented. Personally, I do not look forward to any plastic surgery as I have heard it is really painful and most of it is done outpatient so they really can't use or give adequate pain control. I chose the lap band because the weight loss is slower and hopefully that might not make the connective tissue issue that much worse than it already is. Unless the plan were to approve any plastic surgery, it won't be an option for me. All the best to you. Hope this helps.

Hi Rox Welcome to our forum. You could be my daughter, I am 54! I wish you all the best in your journey to good health. Please feel free to fire any questions our way. I would encourage you to contact a Center of Excellence Bariatric Center and make an appt for an informationa seminar. It was very helpful to me. I am in the process of jumping through insurance and medical hoops and am hoping for surgery in late Sept to mid October. This forum has been extremely helpful and supportive. Again, drop in often. You are doing your surgery for the right reasons. Melinda

Hi, Karyn. All the best to you in your journey to good health. Is there a Dr. Rick Lindquist in this office? I am thinking this is the correct one. I worked with him in the emergency room several years ago. He also helped establish Monarch Medical Weight Loss here in Eugene. He is a wonderful man. Let us know how your surgery goes. Take good care! Melinda

I think what is being referred to here is the preop diet that most surgeons have you go on one to two weeks prior to your surgery.

I have BCBS Federal/ They will consider a BMI between 35 amd 40 if you have co-morbities. There are several hoops that you have to jump through. Have you been in contact with your insurance recently. I would appreciate any feedback. I am in the process of a work up for the lap band. Mine is 37.4 but I have been diagnosed with arthritis, DDD, GERD, HTN, am a pre diabetic and have sleep apnea. I have already had both knees replaced. I am hopeful for surgery in late Sept or early Oct. But I am nervous. My BMI is at 37.8. Keep us posted and all the best to you. Melinda

Hi, I am really sorry, hon. Do you have any co-morbities? I have heard that ***'s are the worse. I would not gain the six pounds. Has your doctor talked to them directly? You might consider filing an appeal with the insurance comission of your state. All the best to you, Melinda

How high is high? I wouldn't think it would delay surgery....but do not hold me to it. One of the benefits of the surgery is that diabetes is often improved. All the best to you in your journey to good health. Melinda

Hi, welcome to our forum. Congratulations on your weight loss! I have learned a lot and have received a lot from the group here. Hoping the same happens for you! Drop in often. I lived in Richardson for a few years in elementary school and have family and friends all over the Dallas area. Melinda

Will be thinking of you. Let us know how it goes. All the best , Melinda

Hon, I know you want more children but I would seriously encourage you to wait. The clinic I am using requires that you use contraception for two years. Since I am done having children that wasn't a concern for me. But I am certainly not qyalified to give you medical advice. Please work with your surgeon and your OB/GYN. They are the only ones qualified to give you medical advice. I sincerely wish you all the best. Please thank your husband for me for serving our country. HUGS Melinda