BabyGirl127

Hi All, I'm genuinely heartbroken this evening. I just got the call from Dr. Enochs' office that I am NOT covered under Aetna for Lap Band surgery. Apparently, my policy excludes weight loss surgery all together. I really feel defeated here...I don't have $23K to drop for the surgery, but I genuinely need it. My BMI is at 47.6. I don't have any other health issue, but under Aetna a BMI of 40 and higher was all I needed. I've submitted a letter to my HR dept. I'm not sure if that will help, but I don't think it could hurt. I know open enrollment is coming up soon. I inquired about whether they were looking to move to another carrier, and if so will they be excluding weight loss surgery again. I'm open to advice and suggestions. All My Best, BabyGirl 127:frown:

Hi CKelly37, Your employer offered multiple insurance carriers? My company usually picks 1 carrier but offers two plans HMO & PPO. I know I have to stay positive. Back in 2007 I remember calling Aetna member services and they told me about the exclusion, but a friend who had Gastric Bypass suggested I pursue via a surgeon. I don't think she fully understood my issue. There is a difference from being denied and NOT being covered. Thanks for your reply.

Hi Babe, I'm beginning to research Surgeons in Mexico now. I want to see if my company moves to a new carrier and if they will exclude under the new plan. If I hit another brickwall, then I will go for plan B - Mexico. I'm really nervous about having my surgery in Mexico. I wonder about how I will manage getting my fills? If something goes wrong or if I run into complications, will Aetna or my new insurance company pay? Too much to handle now. I will cancel my Psychologist visit scheduled for 11/6. That wasn't covered & I would've had to pay out of pocket. I'm truly going to need to pull on a higher force for strength to get through this rough period. Normally I would eat to not have to feel this pain and disappointment. But I refuse to slide back into that abyss...I want NEW LIFE! May be this is a test to see if I can shake my old habits of using food to deal with adversity. I'm really sad. I feel like my hope is dying. I probably just need a really good cry, and I pick myself up in the morning. Have a good evening! ...This too shall pass:frown:

bigpapa2, Don't focus on the scale alone. You MUST focus on the other positive changes you've made in your life. You have lost a lot of weight in a short amount of time...and your body needs some time to adjust. As others have said...STICK TO IT! Each day jot down all the GREAT things you are doing or make a spreadsheet with all those items listed...each day check off all the items you accomplished. This way you are putting your energy towards the positive and not the negative. The scale going down will be the "icing" on the cake. I would also suggest that you take your measurements. Measure your chest, waist, hips, thigh, upper arm, and neck once a month. This way you have another means of charting your success. You are doing a GREAT job!

I'm in the early stages of prep work: Seminar with Dr. Enochs 10/14/08 PCP Appt. 10/17/08 Nutritionist Appt. 10/23/08 Psychologist Appt. 11/06/08 Goal: To be banded on or before Jan. 19, 2009 I'm anxious and excited all at the same time. The anxiety reminds me of what I went through to purchase my home... 1. We need your last 2-yr tax returns - We need 5 years of weight history. 2. We need you to attend a new homeowner seminar - We need you to attend a Weight Loss Surgery Seminar. 3. We need you to meet with a loan officer, inspector, and the selling agent - We need you to meet with a psychologist, nutritionist, and your PCP. You can't talk to everyone about it...because you may not get approved and need to come up with a plan B...or others may not be praying for you, but against you. But we are blessed to have the discussion boards...where other try to uplift you and advise you in the right direction. Thank you all...and be blessed!