Mvpo8961

Is there a way to change jobs to a hospital that does offer it? M

I haven't seen the law but I live in TX and my surgeons office manager told me the insurance co has up to 30 days to send back an answer. M

Oh wow. COBRA insurance is expensive. We did that about five years ago for a while and the premiums cost an arm and a leg for sure. I hope you can find an individual policy soon. M:omg:

:faint: My worst CIGNA nightmare came true today. After repeatedly talking to our HR benefits coordinator and calling CIGNA's benefits coordinator for our healthplan I found bariatric surgery is EXCLUDED on our plan. Then my almost bestest dream came true.:clap2: Today was the LAST day to switch insurance at my husbands job. The best part it is United and it states in the benefits hand book that bariatric surgery IS a benefit. So tomorrow they are supposed to mailout our new insurance cards. My current PCP and LapBand Doc are approved providers so I won't have to switch docs. So I think I dodged a bullet on this one. My husband said if I hadn't been a bulldog about digging, digging, digging we would have never known and would have paid for it ourselves. Now before anybody gets up in arms I will stay with this insurance as long as it is offered thru his job. :Banane41: :Banane20: :Banane31: :Banane18: :Banane28: :Banane48: :Banane04: :Banane47: :Banane05: :Banane35: :Banane03: :Banane21: :Banane43: :Banane32: :xena_banana:

Well that is a long story. I currently have CIGNA. They now require a six month weight loss attempt documented monthly by your PCP before they will approve WLS. I am 4 1/2 months into the 6 months. I have not been able to get a straight answer from my HR benefits coordinator or CIGNA if LapBand is an included benefit of my CIGNA plan. So I have funding in place to go the selfpay route if necessary. I am going to finish the six months submit to CIGNA possibly do one appeal if I am denied and then proceed to selfpay. UNLESS I get something in writing from CIGNA in the next few weeks where LapBand is an exclusion. Then of course I would go ahead and selfpay and just get it done. As far as the fills go my surgeon has a local surgery center do them. You know one of those free standing day surgery kinda places. Where do you live? Is it around DFW? I believe it is sometimes hard to find a doc to do fills if you are no longer close to your original doc. M

I have not been banded yet but my surgeon told me if the fills are done under flouro then it is considered an xray and billable to CIGNA.

Ouch that is a tough one. I would hope since that is her job she would send the correct info to CIGNA. I have already told my PCP that I want my entire chart of almost ten years copied and I will personally take it to the surgeons office. I also have my own copies of the nutritionist and psych evaluation. I plan to make a cover letter of MINE to go along with the medical necessity letters for CIGNA. I am going to staple it to a copy of THEIR bariatric policy. Then I plan to highlight everything in my chart and write out where it is located so there will be no coming back and saying we didn't have this or that. I am going to send it certified return receipt overnight mail so I have a receipt saying it made it into their possession. This may be overkill but when dealing with CIGNA I think it is best not to take chances. Also my HR person told me again today that LapBand is NOT excluded from my insurance and that she had personally talked to the CIGNA coordinator in October when I started this process. So she is going to contact that coordinator again and have them email to her, which she will forward to me, where it is not excluded in my policy. That way I will have something written straight from CIGNA also. I tell you it will be a fight to the end for one or the other of us. M

:faint: Found out from CIGNA today the LB is excluded on my policy. Oh well guess I will have to selfpay after all. Let me know how yours goes. M:)

:faint: Last Wednesday I went to the dentist. For about 15 years I have beenasking for all 19 of my remaining adult teeth to be pulled and to get dentures. Well my dentist has finally agreed that it would be a good thing. However I have to selfpay for them. So I am going to hold off on my LapBand and try to get CIGNA to cover it. So to make a long story short I haven't been banded and I have about 7 weeks left to go in my MD directed WLP. I will let you know when I submit and hear something. Thanks for remembering. M:Banane36: :girl_hug: This is what I think all dentists need.

Wonderful news:Banane10: :Banane10: :confused: :Banane10: :confused: :Banane10: :Banane21: :Banane10: :Banane21: YOU GO GIRL. I'm ROOTING FOR YA. M Where ya going? If it's down here towards Dallas let me know!!

:thankyou: If this has be going on for only two weeks I think I would look into taking a pregnancy test. I know uncontrollable sleeping was my first sign. M

:faint: Thanks GC. I have had developments today. Went to the dentist and I need to have ALL of my 19 teeth pulled. Yep I have SEVEN whole teeth that haven't had a root canal, crown or cavity in addition to the rampant gum disease. They want to put in implanted dentures (been asking for dentures for about 15 years. I have dental pain EVERY SINGLE DAY OF MY LIFE.). Due to my age (44) this will keep me from have as much bone loss in my face. However I have to make a choice between teeth or lapband as I can't afford to selfpay for both. So I am going to fight my ins co for them to cover the LB and selfpay for my teeth. Oh by the way I got to look through a SMILE CATALOG and pick out what I want my teeth to look like. Isn't that too cool? But darn I am going to look GOOD in about 18 months. Now if I can just save up for a BOOB job. HHHMMMMMM!!!!!! :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2:

I am going to self pay as my insurance is notorious for denials. Trying to get them to do it is like:deadhorse: M

:clap2: Hi GC I am getting banded the same day in Texas. Where ya from? I have started getting together my surgery "stuff". Like chicken broth and Koolaid and things like that. Do a search of presurgery lists and you can find things that others recommend to make the first few days easier. Good Luck, M. :) :Banane52: :Banane45: :Banane13:

The 1983 Metropolitan Life Insurance Company Weight Charts for female, large framed, 5'10" gives a range of 152 - 173 lbs. These are listed as the "desirable" weight range that indicates people with the lowest mortality rate. M:faint: :confused: To determine frame size measure wrist. For height over 5'5" use this table Small - Wrist size less that 6.25 inches Medium - Wrist size 6.25 - 6.50 inches Larger - Wrist size over 6.50 inches. :) :confused:

Go to www.room42.com and input your info in the basal metabolism calc and it will give calories and other info. M:clap2:

I will have fingers and toes and everything in between crossed for ya. M:Banane10: :Banane34: :rose: :rose: :rose: :rose: :rose:

Will you let me know how it goes. I have CIGNA ins but I am going to go the selfpay route. But I have a couple of weeks until my surgery so I could still change my mind. I have done four months of supervised diet so far. I just hear how difficult CIGNA is to get an approval. Even with comorbidites. I am diabetic with high lipids also. So I am very interested in what happens and wish you the best of LUCK. M:Banane45: :Banane34: :rose:

Fingers crossed and waiting to hear how it went. M

My doc lists Propel on his handouts as fine to drink. M:clap2:

ReneBean I have mine scheduled for Jan 25 with Dr. Fox at SCOR.

Thumbs up!!!!!!!!!!!!!!! Are you still going to use Dr. Fox? M

Hi Holly I'm not banded yet but I wanted to congratulate you on your upcoming banding. M

I can totally relate. Sixteen years ago I lost weight and got into a size 14. Well so happens I meet my husband and got married in two weeks time. Then (this is really corny) I got PREGNANT on the HONEYMOON. Had my only child 9 months 4 days after getting married. Well I bought a slinkly little black lace dress when we first got married but I NEVER got to wear it. I have been dragging this dress around 16 years with the tags still on it no less. I am going to be banded in two weeks and I have told my husband for my one year band anniversary I want to fit into that little black lace dress and go out for a night on the town. I am keeping my fingers crossed. So you go girl. M

I'll keep my fingers and toes crossed for ya. M