Savedbygrace

It depends on your insurance's guidelines. Some want your past weight back 3 years, some want 5. Anything past that number of years shouldn't matter to them. From all insurances I've looked into, your BMI must be 40 or above ... or 35-39 with comorbids. Good luck!!

Congratulations!!

I looked at their website to see if I could find their medical policy - which usually tells you what you must do to be approved. Bad news is I couldn't find that but good news is that they have a brochure on there about WLS so that's a sign they DO cover it. Call and ask them what you need to do. Good luck!!

Congratulations!!!!!!!!!!

From my understanding, your start BMI, if you don't have the required number of co-morbs (ex: some require 3) must be 40 or above and stay above 40 the entire time. If you do have the required number, as long as the BMI is above the minimum (usually 35) you're fine. My guess is if you don't have more than the required, you will be denied based on the fact that you are below 40 on the BMI now.

It depends on the medical policy and your specific contract of your insurance company. Have you called them? What insurance do you have?

I've never heard of this insurance but I looked up their website to see if I could help you by finding their medical policy. Which plan do you have? HMO, PPO, POS, etc ?

Where did you find that? YOUR specific benefit booklet? Online? Is there a date on it? It's very possible that Regence covers the surgery, but your plan may have exclusions. If that's the case, my advice would be to talk to your human resource contact about seeing what they (the company you work for) can do about getting that removed. According to the policy I found, it says as of 1/07 the procedure is approved. About 1/3 down the page, it gives the criteria for coverage.

You're welcome. I battle insurance companies every day on the job so I try and do what I can to help anyone I can. They (insurances) can be a pain sometimes!!!

Regence's policy Surgery for Morbid Obesity Premea's policy https://www.premera.com/stellent/groups/public/documents/medicalpolicy/dynwat%3B5826_61536918_6140.pdf For some reason, I thought I read that you're from Washington... but I can't find what made me think that lol. Both websites have different states so they may have different policies. These are both for Washington. Let me know what state you're in and I'll see if they are different from these. Good luck!!

Your Regence BC is primary? ( because it's your employer) Do you have their website? If so, they should have medical policies on there that tell you exactly what you have to do to get it paid. That's assuming they DO cover lapband. I'll see if I can search for both ins. companies websites and see what I can help you with. All insurances are different.

I'm using Dr. Miles. 4/24/08 is the date! Can't wait!

Live in Fayetteville, TN - work in Huntsville, AL - B&R in Forest, Mississippi Got the south covered HAHA

April 24th for me! Dr. Miles, Birmingham, AL. Seems forever away but hopefully it'll be here before I know it!! I have quite a bit to do in April so it'll keep me busy! It's great to have a thread for those that are basically walking this journey around the same time. Wishing everyone the best and looking forward to knowing you all better. Mini Bio: I'm 30 yrs old (aww. I just typed 2 before I realized I'm not in the 20's anymore lol) Very Happily Married to a wonderfully supportive husband... with 2 step daughters and an angel in heaven. (we recently miscarried) BMI of 46, have been overweight my entire life, have PCOS and problems with infertility. Most importantly, born again believer in Jesus Christ!

LOL Angie! Amen! Thanks for the chuckle!! :-)

Sometimes I think it's almost a trick to see if they can deny it due to your BMI being below the 40. I don't really have an answer other than I was advised to loose some but that they WILL deny it if you loose below the required 40 BMI (or 35 with comorbids) Sounds terrible to say loose some.. but not alot.. but from my experience.. that's what works. I only lost 13 pounds in the 6 months and was approved. Good luck!

I'm in the loop too HAHA! MySpace.com - Wendy - 30 - Female - Fayetteville, Tennessee - www.myspace.com/wendybpalmer . Just let me know in the message that you're from LBT, as I, like all of you, get lots of bogus friend requests.

Thanks!! Date is set... April 24th. Seems like forever away.. but they are booked up until April and we are planning a weekend getaway that month also and I didn't want to be away and on liquids during vacation. I'm excited! Sure hope I don't gain back what little I lost before then. lol

I called the surgeons office last week and found out that I have been approved!! As some of you may know, I found out the first of Feb. (which was the last month of my 6 month diet) that I was pregnant. The entire month of Feb was spent in and out of my OB's office due to complications. Yesterday, I had my HCG tested for the millionth time and it is going down... which means I miscarried. It never got over 300 so it shouldn't take long for it to be back to normal non pregnant numbers and I can then proceed with the lapband. I'd much rather still be pregnant right now but God has given me lots of peace in KNOWING that I can get pregnant.. after being told for 5 yrs that I can't without treatment. So I'm calling the surgeons office again tomorrow to get it scheduled. I still have to go through an all day nutrition class required by the surgeon so it'll probably be a while before the actual surgery but i'm hoping for March. as far as the 6 month diet... i did stick to it to EXACTLY as directed. There was only one month I was concerned about and it was because I saw the nutritionist about 10 days before I should ( because she was going to be out on vacation the rest of the month) Obviously, that wasn't a problem. I only lost 13 pounds during that 6 months. I didn't focus on it at all in Feb. due to the pregnancy. I look forward to getting the surgery done, getting involved with a support group, getting serious about exercise, getting some weight off and getting pregnant again!!!!

I'm curious!!! How did the first support meeting go?? So sorry I couldn't be there!

I won't be able to make it due to other appointments that day but normally Tuesdays are ok with me. Hope y'all have a great time. Look forward to being there soon. Let me know how it goes!!!

For those of you have had both... pregnancy and band... looking back.. would you prefer going through the pregnancy before being banded or banded before pregnancy? And why? I'm torn about it. Next Monday is my final day of the 6 month diet. I haven't had AF in over 5 years without medication and have been told I can't get pregnant due to PCOS and not ovulating. Well last week, I find out, I'm pregnant. Praise God (without fertility meds!!!) This week, I find out, I'm loosing the baby due to low progesterone. So.... I'm debating on trying again or going ahead with the surgery first. Any suggestions?

Well...... I'm good with whatever. I too am not sure where to find a room that would provide privacy and the ability to hear. BUT to much surprise, after being told for 5 years that due to PCOS, I can't ovulate, I found out last week that I am pregnant. Of course, the last month of my six month physician led diet, I find out but that's ok. Still having some issues with my progesterone so right now, surgery has slipped off of my top to do list. I'll be glad to help in any way that I can though, as I do plan to have it someday. Keep me in your prayers during this time and let me know if theres anything I can do. I'll try to throw the idea around and see if I can find someone who knows a place we can get a room. It might be best to go ahead with the mall and go from there.. depending on how many show intrest.

I went to Madison Square this weekend. First time in years. I saw the group of seats (couches, chairs etc) set up in several places around the mall. I guess depending on which one we can get, the noise may be a factor. I personally would prefer more of a room type setting so we can hear better but we can always try it and IF it don't work out, find something then. 2 times a month is fine with me also.

Well we are getting there! Madison Square is fine with me. Is it rooms that they will allow us to use? I haven't been there in over a year so I dont really remember how it's set up. I've heard that theres a group that meets at the HSV library but was for the bypass. (I think) The mall area might be better for people in Madison too. Booking a location wasn't as big of a deal to me as basically being the spokesperson so to speak. Coming up with topics, hosting, whatever you want to call it. I guess because I haven't had the surgery yet, I didn't feel qualified to lead it but looks like the majority of us haven't. So... anyone know how to make a poll to se which day would be best, how many times a month, etc? Let's get it going :eek:.