TRN87

So today I had my psychiatric evaluation. Everything went well besides the fact that I had to answer about 1000 psychological questions on the compter and paper tests, literally. After 3 hours finally I met with the psychologist and he immediately questioned my weight. He said he loves numbers and it jumped out at him..(he was a weirdo)..well he compared my weight which is 262 with my height to the bmi chart and said "well im not sure that you are obese enough, your definitely obese but your insurance is probably not going to approve you". What the crap...not obese enough! That cracks me up and pisses me off at the same time! Obese is freakin obese!! First of all when I began my 6 mos weight loss I weighed 294 and have lost the TEN PERCENT Cigna "would like you to lose before the surgery" but it puts me under the 40 bmi mark and unfortunately (how sad is that... it has become an unfortunate circumstance to not have any life threatening sicknesses) I have no co morbidies. Second of all the insurance associate at the Lab Band doctor said I could get down to 256 and still be okay, and at the moment I am 262 so if they dont approve me because of this reason this is all her fault and I think she should pay for my surgery (haha not really). And third, How the heck can they request you to lose 10 percent of your current weight in the beggining of your 6mos diet and then if it puts you under a 40 bmi not approve you, oh right because all insurance companies are shady a holes! I have no doubt that I can lose weight. I have done it over and over again throughout my life and after recently puting almost 3/4 of the 120 pounds i lost in 2005 it is obvious to me that I need more than a diet. I am not someone who just sits around and eats potato chips every day, I am a very active person and after 21 years it is clear that my body will not allow me to stay at a healthy weight without starving myself. I need something that is going to change my lifestyle forever. And yes I understand that the Lap Band will not be an easy thing, and it will require a lot of hard work, but I know it is what I need to take control of my life and my health and that is why I am taking these steps. So after my rant....I spoke with the insurance lady at my Lap Band doctors office and she said we would submit anyways and see what happens. Hopefully none of you run into this situation. Hopefully I will be one of those lucky people who has no problems, but im thinking thats not going to happen. Life sucks sometimes but you just have to put on a helmet and keep on fighting. Cignas not going to win this one. :crying:

I havent called them. We are going to go ahead and submit and see what happens and then we will fight if we have to! Thats good info to know though! Thanks!

Thanks for all of the encouragement. I have my nutritionist appt next friday and then I will submit everything! I am SO excited/nervous/scared!! Wish me luck!!

I started my 6mos wls diet with my doctor in March. I went every month until June and then made a decision that I wanted to try and lose it myself rather than surgery and stopped going to the Dr. However, I got a personal trainer in June and he asked me all about my diet plans and documented my weight and diet program. Then I started going to weight watchers in July, and I know insurance companies now accept weight watchers meetings. So basically I have all 6 months of my weight documented and what diet program I followed. I have lost 32 pounds but I know that I need the band to help me continue my weight loss, and to finally maintain it for the rest of my life. I have been on diets since I was five years old and up and down my whole life and I am ready to end that demeaning process. So basically my question is, do you think that my insurance might deny me because I have weights from different places? I should have just finished it out at the Dr. but I guess we don't always make the best decisions. Im just nervous, back and forth on what I should do about the surgery, and second guessing myself. I know that the band is what I need, but I guess I just need some encouraging words from someone who has felt the same way. Help!!

I started my 6mos wls diet with my doctor in March. I went every month until June and then made a decision that I wanted to try and lose it myself rather than surgery and stopped going to the Dr. However, I got a personal trainer in June and he asked me all about my diet plans and documented my weight and diet program. Then I started going to weight watchers in July, and I know insurance companies now accept weight watchers meetings. So basically I have all 6 months of my weight documented and what diet program I followed. I have lost 32 pounds but I know that I need the band to help me continue my weight loss, and to finally maintain it for the rest of my life. I have been on diets since I was five years old and up and down my whole life and I am ready to end that demeaning process. So basically my question is, do you think that my insurance might deny me because I have weights from different places? I should have just finished it out at the Dr. but I guess we don't always make the best decisions. Im just nervous, back and forth on what I should do about the surgery, and second guessing myself. I know that the band is what I need, but I guess I just need some encouraging words from someone who has felt the same way. Help!!

Hey guys! I was wondering if any one paid for the surgery themselves? I am hoping to get my insurance to pay for my surgery, but if not I am going to take out a student loan to cover it. Also I would like to hear about your experiences with the band, good and bad. Cant wait to hear from you guys! Congrats on all of the success. Roxy

thanks to everyone! I had my consultation on thursday, and now the insurance game begins. Hopefully I will not have to pay out of pocket, but if so I know it will be worth it.

Thanks for all of the responses, it makes me feel a lot better!

Hello All! My consultation is tomorrow and I am trying to work up a list of questions to hit him with tomorrow. I was wondering what kind of questions I should ask him? What questions do you wish you would have asked your doctor? I would really appreciate all of your help! Thanks! Roxy

Thanks for the info. I have a question...do you have to have at least a 40 BMI for 5 years or just be "overweight"? I have my consultation in 2 weeks, but just am worried I will not get approved for this! I have a BMI of 42, but no co morbidities and my weight has been up and down for years, so I have not had a steady BMI of at least 40 for 5 years. Im so worried this wont work out...

I am a bit confused about what Cigna requires to cover the surgery. I spoke with a woman from my insurance company about a month ago and she told me that all Cigna required was that you have a BMI of 40 or more for at least a year. However, I heard that they also require 6 months diet with a nutritionist from someone recently. Can anyone help me out and let me know what all Cigna requires? I am a little bummed because I was hoping I could have my surgery by the end of the summer but if I have to do the diet it will be at least next October or later. I am just being impatient I guess? Thanks. Roxy:sad_smile:

I am pre-banded but would also love a cook book. I do not have any recipes though, im sorry that I cannot help in that area! Where should I send the money to?

I am going to my first day of "monitored dieting" today. I could only loose about 3 pounds to stay within the 40 BMI range and do not have any co morbidity's. Does anyone know what exactly the insurance company will look for? I know I can loose weight, but I can never keep it off. I am afraid if I get under the 40 BMI they will not cover it. What should I do to make sure my insurance will cover my surgery? Thanks for the help!! Roxy:confused_smile:

Good Luck Mary!

Thanks so much everyone! You all have been a great help!

When I weighed in I had a heavy jacket on, heavy wallet, keys, cell phone and shoes on, and I had also just eaten a big lunch with a lot of liquids. All of that added up to 12 pounds more than I weighed at my house before I went to the doctor! So if I loose some weight it will be okay. My real weight is also right on the line of 40, so I knew I was goin to need a little bit of help!!

So yesterday I began my monitored diet with my personal doctor. I have been overweight my whole life, and have tried every diet out there. I actually went on my first diet when I was five!! I have been successful before when dieting, but my problem is that I cant ever keep it off. My question is what do the insurance companies look for? I know I have to stay within my 40 BMI for them to cover it, but I only could loose about 5 lbs to stay within that range. If I do not loose weight, will they still cover it. I am just wondering what they look for?!? Thanks for your help!!

I have cigna as well. What happens if you go below the required BMI? Will they still cover it?

Thanks for the info. I have my consultation April 4th and I know my doctor will give me more information, but I have my heart set on this surgery and I am so nervous that it is not going to work out! I know that if it is meant to be, it will happen.

I also have Cigna. I have my consultation on April 4th and am very excited. I didn't know Cigna required 6 months of dieting with a nutritionist. I spoke with a lady from my insurance company and she said that I had to have my BMI for at least a year and that was all. What all does Cigna require because obviously she didn't give me all the info. Thanks:huh2:

Hello everyone!!! :thumbdown: Well, to get straight to the point I am thinking about having the lap band surgery. I have been doing a lot of research on the surgery, and everyone seems to rave about how great it is. However, I feel like I may be missing the hard things that I will have to go through. Basically, I would just like to hear your experiences, good and bad, just so I will know what to expect. Cant wait to hear all about it!! Roxy

Thanks for your reply! I have my seminar this Thursday and cant wait!!