Gigi001

Has anyone had lap-band covered by Aetna? I'd welcome any info on what your process with them was.

Oh Boy. First go online and search for their "Obesity bulletin". Then follow it to the letter. in other words: 1. Make sure you have documentation - doctor notes, bills from Weight Watchers, whatever to demonstrate for at least 2 years you've tried to lose weight. 2.Get on any doctor supervised program for the next 3 months or more (I forget what it says for time). Make sure you have it all documented. 3. For surgery make sure you meet the BMI AND comorbidity criteria and this is big because I have high cholesterol, but not necessarily coronary heart disease...and my doctors assumed it did, but it did not. 4. AND even if you have the right BMI and comorbidity, they will only use lap band if you have a series of other condition they list which are not so common. So yeah they cover the procedure, but but but but... I am getting assistance right now with an appeal, but it is not looking likely. To counter point 4, I am arguing that I have issues that would have made the malabsorption under regular gastric bypass too much for me. Borderline anemia, wheat allergy, and B1 deficiency... So it is a very difficult thing. I know Alex on these chat rooms had better luck.

My insurer (Aetna) denied my claim for surgery - even though it IS covered under my group plan. So I need to mount an appeal. I'd appreciate hearing from anyone who has done an appeal that has been successful...what you had to do, did you need legal advice, etc.? Thanks G

How'd'ya get through 10 days of preop liquid diet?? Coz I feel like a raving lunatic. If I could've eaten 1000 cals of liquid diet, I wouldn't be getting the darn band next week would I? But seriously - I'm not whining, I honestly am curious to know about how long others followed a pre-operation liquid diet. I am also curious to find out how to add one of those cool tickers to my signature...since I'll be on here a lot :-) Thanx.

Yep. Got the band on 3/1. Feel fabulous. 30 minutes of surgery, and three hours later was doing laps around the hospital itching to go home. The worst part was pre-surgery. All that gunk you drink to 'empty' yourself dehydrated the daylights out of me and I was nauseous, headache, and generally wanted off the world. Even the bruising on my stomach isn't bad. And I could lift my little toddler on Day 3. So...yipee. And it seems I've lost 10 lbs in the last week (is that possible?)

You are absolutely right. The only time i ever got any respite from the things in my head was working 12 steps with Overeaters Anonymous in Boston -- and sadly I moved from there and did not think it was the same program in my new city. I used to get together with up to 40 women on a Monday to talk about body image/fat thin issues, etc. It was absolutley funny, sad, heartwarming and uplifting all at the same time. Anorxics, bulimics, and the compulsive overeaters. It helped me a great deal, and I still do some of the things I learned in the 12 Steps. OA is not for everyone, but for me it as full of sanity. But for me being banded isn't the magic bullet, it's just a part of the bullet. Coz the rest has to come from inside me.

Both UW Hospital and Dean/St Mary's in Madison to the Lap Band. Dean has a very thorough program and two great surgeons -- Sunby and Huepenbecker.

Now there is piece of news, I didn't realize there were different SIZES of bands. I thought it was one size fits all then fills. This forum always has such good info.

Hmm. I had thought surely a sip, but it seems not. This carbonation thing is really sad. But I guess I will live. Years ago I never thought I would have life without wheat, but on one of my fierce dieting attempts in Overeaters Anonymous I went wheat-free for 4 months and when i ate it again, voila, I was deathly allergic and now can't go near it. So I had to give up all bread/pasta products...forever. They don't call to me anymore, mostly (and when they do I have wheat-free pasta). So it surprises me what I can give up and not miss...I'll take that view going into no-carb land.

I'm a neophyte. What's a PB? It sounds painful and something I don't want. I get banded on Tuesday 3/1.

Guess What? I am due for surgery on March 1 and when the hospital called for precert (otherwise I'm handing them a check of course) they got the word that band IS covered at 80% after deductible up to $xx and then 100% after that -(i.e, the way anything is covered in my plan). So I didn't really believe this, and I called myself, got someone else on the phone who after a pause said YES it is covered procedure, yadda yadda same details. It is funny coz my surgeon wrote this long, beautiful note to the Medical Reveiw Bd at Aetna but we might not need it. But that was independent confirmation with 2 reps. YIPEE. So I should know for sure this week whether I, in particular, am getting it covered.

I'm having the band on March 1. Here's my big concern that they can't really tell me about in my town because I'm one of the first four to get it done: I'm a single Mom of a busy 21-month old little girl. The surgeon said I'll of course be able to lift her up "Uppie Mama" right after surgery (i.e., next day) but I wanted to hear from others who had had the surgery to find out how they have tolerated it and what the first few days after were like. Can you move? Work? Is there pain? How much? Thanks! GG

There are a whole host of people in Madison who are doing lap band now -- the UW hospital and the Dean Clinics (where I am getting mine done on March 1). THey have people doing fills...

Thank you all so much. This sounds like I had better try and find someone to stay with me. It's almost impossible not to lift her out of her crib, in and out of the car for daycare etc. And I'm very short in the whole "support" department generally -- but that's a whole other story.... Thanks again.

Hi. i get my band on March 1. I start a two wk liquid thing on 2/16 before that, which i am dreading because if I could have tolerated two weeks of liquid anything I might not be getting a lapband, if that makes sense. I have two fears: One the totally irrational fear or "grief" that I will not be getting to overeat again. Seriously. I had a panic over this????!! But two: that rather than be able to eat all foods in moderation, even if enforced, I'll not be eating all foods, and thus restricted. Not freedom from food at all.

can't say what to do first, but I hear that with so many insurance companies you have to keep pushing them and pushing them. I'm in WI and "between" insurance companies and thinking of signing with BCBS here because I heard that they have paid for lap band in WI already. So once they pay for it, it's sort of the thin end of the wedge. I'm not having surgery til the end of the month, but I can't wait. I'm so tired of fighting not to gain another 10 lbs, never mind lose 100.