JDUB0414

we luckly found one. He went to the knee doctor one year and a clinic another year. so hopefully it will work. He has an appt on wednesday. which will give our pcp with a record of 2006/2007 and now 2008. do you think they will take the current 2008 one?

bigunc, I'm a newbie also. I just got approved Friday. When I did the six month dr. supervised visits, all my dr. did was put on their that I did a 15 min treadmail workout three times a week. Hopes this helps.

I Got Approved!!!! 1/4/08

:Dafter six long weeks of waiting, I finally got approved. My husband on the other hand didn't because he only had three years of weight history. does anyone have any suggestions with regards to what we can do for his appeal?:help:

I still havent heard anything...this sucks!!!

Congrats Poopsie!!! I am so happy for you. Maybe mine will soon follow.

As of today, I am still waiting. I called this morning and was told it was being reviewed by doctors and they sent that over to the doctors on 12/21. They said it usually takes 7-10 days after that to hear something. This is driving me crazy!!

Tomecia, Thanks, I hope so. I'm glad your feeling great. What's a bodybugg? I spoke with the insurance company yesterday she said the file will go to the director today, so to check with them on Wednesday because of the holiday.

Congrats on your approval. Maybe I'm right behind you. I found out by surgeons office gave them a surgery date of 12/30/07, so maybe that will speed them up. Speical K, you may want to check on that. I was told they wouldn't cover either, but they did cover two visits. I had to pay a small fee, but it wasnt' over $40.

Thanks Tomecia!! I see you've just had your surgery, how do you feel? Special K, I would definately stay on them. I think it's ridiculous that you have to pay $50 to get you file. If they went to computer based, they should've been able to get all the info needed to compile a letter for you. I left my last PCP because of ignorant stuff like that and because her staff was so damn rude. I've always had pretty good insurance, so there wasn't a reason for them to be so rude. I know some doctors may treat you based on the type of insurance you have. Ughhh!!! Anyway, today, I finally got through to the department that makes the actually decisions and the lady called and told me personally that they received the five year history for me and three years for my husband. She said that there is one man that gives the final decision, so I should know soon because he has a deadline before the end of the year. I'm praying that they approve my husband with the info they have.

Well today they finally faxed it to the weight loss center. The nurse at the center has faxed it over to the insurance company today. Hopefully, we'll hear something soon.

Shell, why did they deny you the first time and how did you get it reversed?

thanks. I did call them about my records and that's what they said would take a week to get back. I called back and told them, something needs to happen because tomorrow will be 30 days and expressed how ridiculous this was. I received a voicemail today from the nurse stating that the doctor was coming in to type up my husband and I letter and we can pick them up tomorrow. My husband will go to pick them up and stand there until they fax it over to the weight loss center. I will also have him get the copies of our medical records, just in case the insurance company needs something else. During our six month visits, she seemed as if she was very supportive of the surgery and said she wanted to make sure she provided us with everything they needed. I am hopeful that they will approve us. I will let you all know tomorrow what happens.

Congrats Melissa, I'm happy for your approval. They've had my paperwork for two and a half weeks. I just received a letter today stating they needed the five year weight history for both my husband and myself. I am so upset, because I thought my doctor sent that info to the weight loss center. They said they will fax it over ASAP. I'm not worried about getting the history for myself, but I am for my husband. He hasn't been to the doctor like that. We are trying to figure out something. Do you know if they will just deny him, or will they look at the file and determine with what they have?

I talk to the insurance company on 11/29/07. They said they have all of our paper work and the file is still being reviewed. I am hopeful that we will have an answer soon. Please pray for both my husband and I to get approved:help:

wsb, I totally agree with what your saying. I actually clicked on section, Life After, because I wanted to know what it feels like to be at goal and living a life we are all waiting for. To find this this thread...it kind of took me for suprise. I've been reading and not posting so much since I started my process in May. I've researched and read all I think that I can about getting a Lapband, but that's just like having a baby...you can read everything about pregnancy and having a baby, but it will probably be different from what you've read. Talking to people about experiences is the greatest thing...it gives you hope. I'm a teacher, a high school teacher at that, so it's hard for me to get frustrated at people when they ask me the same question, or what I fell may be a simple minded questions. I learned a long time ago, that people may just not know what's going on, so they have to ask quesitons to get that information needed. There is no such thing as a silly question. I agree with people following the rules of their doctors, but, we all have been told by our PCP at some point in our overweight lives, that we should eat heathy, and exercise, so we can loose weight and feel better. Did we do this??? Probably not since we have gotten the band or will be getting the band. We all make mistakes...it's about fighting an addiction also.

thanks you so much. I will definately let you know what the outcome is. Where are you at with your surgery date?

My husband and I just completed the six month dr. supervised diet plan this month. I have all the requirements they asked for. My husband on the other hand doesn't have a continuous 5 year history proof because he hasn't been going to the doctor. They submitted our paperwork to the insurance company Friday 11/16, I am anxious and nervous about getting approved. I'll let you know how it comes out.. BTW: I have Aetna PPO

thanks for both your feedback. swstacey1977, i have everything that you have with a higher bmi though...so i'm hopeful that i get approved that fast. My husband on the other hand has everything but a ongoing 5 year history, that's only because he hadn't been to a doctor continuously like i have, so I'm worried about his. I will call them on Monday and let you know how it goes.

Congrats on your approval. I talked to my doctors' office and they will be sumbitting my husband and my paper work this week. How long does it take to get approval?

Pookie, I'm just starting my 6 month weight loss plan for insurance purposes....I know it will be a long a dragged out situation, but I'm excited. It seems like you will be fine once you get those two things in. Were you able to make the sleep apnea test earlier? Good luck!!!

I too have Aetna, but my requirements are 6 months of a PCP supervised diet or 3 months of a multidisciplanary plan at a hospital setting. I cant do the 3 months because its way too expensive and most are Meal Replacement plans. My question is do you think If my dr. submits my weight history and a letter explaining why she thinks I'm a good candidate for the lapband, along with my 3 months of visits with the recommended nutritionist will work? thanks, Jo

Hi All, I am also a newbie and so far have went to the first of six visits to my PCP which is required by my insurance company. My PCP has referred me to a nutritionist. My insurance will only pay for 2 visits for my lifetime!! That didnt make sense to me. Anyway, I've went to a HMR at the weight loss center at the hospital I'm having the surgery at but it's too expensive. The insurance says if I do that then I can get approved in 3 months versus 6 if I go to my PCP. I wish all of you luck and pray that well all get approved and become bandsters one day!!!

Thanks for your comments. My main concern is what will happen since I want to have more children. Yes I want the best results and I know I have to be committed to whatever I decide to do, but I want to do what will be good for me and my unborn child if I were to get pregnant.

Hi All, I'm new here from IL. For weeks now I've been researching weight loss options and have fell in love with the lap-band. Mainly becausing I want more children in the future and this allows that. Lately though I've been reading about the Gastric Y (I think that's what it's called) and have wondered about it also. I weigh 345 lbs and want to be around 170 one day. I would appreciate some suggestions on which would be good for the amount of weight loss I need and want. Also I'm in the process of starting my requirements of 6 month visits with my PCP or 3 months with a supervised hospital program. Does anyone have any experiences they could share regarding the hospital programs that are offered? Thanks..