Mahoney

That is exactly what I found in my policy. Weight Loss Surgery is listed in the exclusion area, but is also listed in the coverage area for people with morbid obesity (I hate that term "morbid"!).

I'm just wondering if anyone has any insights on something I'm thinking about. What if I do get approved for surgery by my insurance, and at some point down the road I need surgery to fix something like a slippage problem at a point where I'm at what the insurance company considers a normal weight? Would they typically cover a repair of a lap-band even though I no longer met any of their BMI type requirements? Thanks! Bob

How about all of the NJ'ers that come aboard this board agree to meet in January 2005 to celebrate our successes? I'm thinking that 8 of us could probably go the TGIF or something and order 4 Quesadilla's appetizers for $4 each and be full Anyone game??

Well that is good! Another related scenario ran through my head today. I found a website about a very successful bander needing to have his band temporarily removed due to slippage, and then he had another one put back in a couple of months later (http://www.waynesmith.net/lapband/). I have a feeling that the insurance thing could get tricky at that point if one were already at goal weight. Alexandra - make me feel better again and tell me they would probably cover it! That being said, after I ran through all of my worst case scenarios (like the one above), and I couldn't be more excited about the band. Now if my insurance plan is as excited, we are in business. Bob

Hey Nancy, Great to hear it went so well (and reassuring). Now its time to let your body do its work and heal from the surgery. Thanks for the update! Please keep them coming so the rookies behind you can learn what to expect. Bob

I have a plan that I'm starting to realize is a little unusual these days. It is a self-funded plan by the company I work for (although there is a 3rd party claims administrator). I did a little more digging around today and weight loss surgery is listed in the coverage of benefits section for BMI of 40+, so I'm starting to feel pretty good about things.

Am I being covered?? To be determined It is not a network plan so I'm free to go to anyone I want. I've called my insurance 4 times to check coverage and twice I got the rep to read off the requirements and they said that 40 bmi (or 35 - 39 with serious comordalities) and letter stating medical necessity. We'll see...

Hey Alexandra, I'm in Morris county myself (Long Valley). I'm glad to hear that your surgery went well. I have an appointment with Dr. Trivedi (Hackensack) a week from tomorrow. BTW - Thanks for all of your great posts! See ya, Bob

That is great Alexandra. By now you should be awake and I hope everything went great. I look forward to reading your report.

Hello - I just felt like introducing myself. I just attended a seminar today by 2 bariatric surgeons in NJ, and I set up an initial appointment for September. Here we go. I probably have read more than 1/2 the posts on the board so far in the last 2 weeks, so thanks for the great info! Bob