kari_berry

Thanks so much New Hope & Slenderella - I want so bad to pick up the phone right now and call my insurance company - but unfortunatly I am at work during the day, and I share a large cubical with my co-worker. Though there is a small divider to divide our space - there really is no privacy on the phone. She is the last person that I would want to know about this. I will have to do it on Monday while she is at lunch. No biggie. I am just going to keep praying that this is covered. Slenderella - I am in S.E. Michigan - just about 2 or so miles south of Detroit. I *think* I've heard of those apple orchards before. My fiance' wants to go out there this fall.

Hello New Hope - I think I might call my insurance provider and find out. I am a little nervous about calling though. I just feel like they might tell me "no" when really it might possibly be covered. Thanks again for the advice. I may call them tomorrow ~ Kari ~

Hello - thanks for the reply again I did manage to talk to my aunt about it on our lunch. I told her a little bit about the procedure, ect...and asked her if she could find out if our insurance covers it. She infomed me that on our company website - there is a complete copy of our benefit plan. She told me to look through it and see what I can find. I've read through some things that I felt were important, via the table of contents. There was a section called "What Is Not Covered Under the Medical Benefit Plan?" In that section - the only two things that stuck out to me were the following... Services or supplies which are not medically necessary. and Charges for services or supplies which do not conform with generally accepted medical practices. There was also a section titled "Pre-existing Condition Limitation (For Medical Benefits Only)" And the one thing that stood out there was the following: A pre-existing condition is any physical or psychoneurological condition regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the six month period ending on the enrollment date. There were no sections in the table on contents titled "Exclusions". I guess the thing that worries me is the "Not Medically Necessary" part. All the insurance co. has to say is - is that this is not medically necessary. All of this insurance stuff is foreign to me...lol. I haven't had insurance since I was 19 years old, and now that I have it...I have no idea what most of it means...lol. I guess now is the time to learn. As far as I know - we do not have an off the wall insurance provider. I work for a very large advertising firm. I know my insurance card says - "NGS American". I went to their website - and this below is what I found: (I'm not sure if this will help you identify what type of insurance I have or not). "Since our founding, NGS has specialized in the administration of self-funded group health plans for companies whose business needs require significant flexibility. This diverse group has included employers in manufacturing, retail, private and public corporations, partnerships, governmental entities and foundations. Each group has presented individual challenges in both implementation and administration." I hope that helps out a little bit. I still have some reading to do though. Well - Thanks again so much for helping me out. This is a start I suppose! ~ Kari ~

Hello all. I posted my first introductory message on the Introduction board. I do have a question though, and I'm sure someone here can answer this for me. After the surgery - you have to go for a "fill". Well - do you get the "fills" from a local doctor - or the doctor that did your surgery? I thought I read in a post somewhere that someone had to travel to get a "fill". Also - how often do you have to go for a "fill" or to have some removed? Please help clear this up for me. Thanks so much! ~ Kari ~

Thanks so much for the replies. I am glad to know that there might "possibly" be other places to get the fills. I am still in my research phase right now, and I'm also trying to find out if my insurance company even covers this procedure. Once I find out if they do, I will do more indepth research on the banding, and the fills. Like most of you, I am also very very cautious about things. I am not one to just jump in and do something. Doing the research is very important to having this done sucessfully. Thanks again for the replies. I will keep everyone updated as to what is going on! Thanks again! ~ Kari ~

Thank you all so much for the replies! First off - I'm not really sure if my insurance covers this surgery - or resitricts any type of surgery like this. I need to find this out soon. I'd hate to do ALL the research, and then find out that this is not possible. My aunt and I work for the same company, and she works in HR dealing with all of this information, so she should be able to let me know. I just hate to ask her, because I have a feeling she might judge me, or try to talk me out of it. As far as my health goes - I did have high blood pressure at one time, but lately it has been normal. I do have chest pains daily - the kind that are sharp, and take my breath away. I found out back in July that I have high cholesterol. I also have shortness of breath ALL the time, except when sitting. Just walking down the hall makes me out of breath. In the past I have also suffered from depression, and have gone to therapists. Mostly dealing with my weight issues. (I'm not sure if these records are attainable, as these offices are no longer around.) There is a history of health problems with my family. My father has type II diabetes, and his father also had this too. My father has had two heart attacks, and high cholesterol / blood pressure. He also has another heart condition, but I cannot think of what it is called. (Starts with an A). My mother is Hypoglycemic (sp?), and there is a large history of cancer amongst her side, and my father's side. Unfortunatly - I have not really seen a doctor since I was about 19 years old - due to no health insurance. But there are records from before then. I have tried many diets. No carbs, cabbage Soup diet, sugar busters, L.A. Weight Loss Clinic, and the Meical Weight Loss Clinic TWO times. Once when I was about 14 years old, and once again when I was 20 years old. I have also been on Xenical with no success. (Those who have used it probably know how yucky it can be!) Nothing has been able to help me. Lately I just feel as if I've been doomed to be fat. But on a lighter note - I am SO HAPPY that everyone here has had such a great success with their bands! I am praying constantly that my insurance accepts this. This could mean a new, healthy life for me! Once again - I thank you all for your replies. You are all VERY helpful, and supportive! I look forward to getting to know each and every one of you! I promise to keep everyone updated when I find out about my insurance! Keep your fingers crossed for me! Thanks again! ~ Kari ~