dotofoz

Well, ordered Birks from Sierra Trading Post Clearance section, they look comfortable, so I'll give them whirl. My chiropractor agreed that they really should help!:rofl:

Hi. I have BCBS Ohio FEP and my aftercare and fills are covered. I'm still getting all my stuff together, so we'll see. Attached is the info I rec'd from them. Hope it helps. (oh, and hope it attaches OK too). :rofl: if you check out about mid way thru, the HCPS codes have something in there for fills. Now this is Ohio, you should call you ins and ask for something in writing like this... anthem lap band policy.pdf

Hi. I've had dogs all my life, but they've ALL been inside animals. My suggestion would be to do some research on the net and see what breeds exhibit what tendancies. I DO agree that mutts are better. The couple I've had were the smarter, heathier ones. Please DO NOT get one from a pet store! I worked for the federal agency that oversees the breeders, and it was horrible! Rescue groups are great, I did Carin Terrier (Toto dog) rescue in DC and most rescue folks do a thorough check on the applicants. My final tidbit would be to get a dog crate. The crate is their "den" and it is great for housebreaking and when you leave you KNOW there will be NO damage when you come home. When my first husband and I split (his doing, not mine), my dog was all I had for a very long while. She was about the best thing (besides the birth of my son) to ever happen to me. Good Luck, I'm sure you will enjoy having a dog! :clap2:

Hi. Anyone in Northeast Ohio (preferable Cleveland area) know of any psychriatists that deal w/lap band or bariatric patients? I had my psych eval and passed per the administering psychologist. My psychriatrist did NOT agree w/her recommendation to have the surgery (after in our 2 sessions we ever had said how great bariatric surgery was and how she had some patients doing so well). The clincher is that this a MAJOR negative mark for my insurance co to see! She gave NO reason and we did not speak before she wrote her very short negative statement. I got a copy of the letter Saturday and cried most of the day and have been up each nite so far worrying! Any info would be more than greatly appreciated!:help: :cry

GEMOM: what state are you in? Do you have PPO or HMO. From what I hear in Ohio, they're pretty good w/the Anthem bcbs fehb ppo approval. I have a feeling it varies state to state. And who says we don't need healthcare reform. Actually, I'm going to stop before I get on my soap box on that one! Alexandra has a GREAT post on convincing the ins co to cover band vs bypass. I saved it to a word file so I'd have easy access. Personally the whole thing sucks! lap band appeal ltr.doc

Ok I'm confused....what are "plastics"? I know the band is plastic.....

hmmmm MHBP.....How are they w/everything else?

Hi again.....Well hopefully it is state specific. Here's what Anthem voluntarily sent me. Yes, voluntarily! Did they specifically say the didn't cover the band? Now I'm wondering.....Will TRY to upload this pdf thing..... anthem lap band policy.pdf

Hi. I have Anthem FEP BCBS HMO (OH). Is that a whole different thing? According to a call made to them (by me 3 different times and surgeon's office once), they DO cover the band and ALL testing associated w/it. So far all the preliminary stuff has been paid and we are getting close to submitting to insuance for approval. BCBS actually sent me a fact sheet on what's covered as far as wls goes (will post if anyone wants to see, it's actually pretty good). Has anyone tried to go thru the appeal process (if denied by a Federal insurer) and contact their elected officials also? I used to work for a public affairs office in DC for a federal agency and found that seems to get a little more attention. I'm planning on going to my congressman, both senators, & OPM if I get turned down. I figure, bring out the big guns in the beginning so no more time is wasted. A good website is http://www.obesityhelp.com. I think it's Ohio based, but you can search other states too on different topics. Wish me luck, and good luck to everyone else!

Hi. I was doing some Googling this am on federal health benefits for bariatric surgery in general, and some decent hits came up pertaining to tricare. I don't have the EXACT websites, but you might wanna try that....It SOUNDED like for the RNY, all they had to do was contact pcp and surgery was actually done on base! Check out, http://www.obesityhelp.com that MIGHT have been where it was. When you open up the site, go to upper right corner, hit insurance, and pick "my insurer". It gives a map to select your state and procede from there. Personally it's a good site, but can be cumbersome to navigate thru. I learned alot and got alot of good info. If you've been turned down, have you tried writing to your senator (being that tricare is a federal based program)? I used to work for a federal public affairs office and that would at least get someone's attention. I already have that planned if I get turned down. I know you want the band, but it wouldn't hurt to check it out.....Good Luck! :eek:

Well, my bariatric center's "member ship fee" is tiered, and of course non refundable. It covers "providing support for the comprehensive services of the program (assisting in organizing necessary documents to complete assessment phase of program") whatever that means. You can pay $250 w/in 2 weeks of the first assessment, $300 @ surgeon consult, and $350 upon ins. approval. If you're self pay, you STILL have to pay the fee, go figure! Just like anything else, they know if you want it bad enough, you'll find the money. I also had to pay $250 for the psych eval upfront (even w/a participating provider). Someone at work had to do the same thing with that psychologist and it took an act of congress to get their $240 back from the same Dr AFTER battling w/ins co. Great. :faint:

All, thanks for the info! Hopefully when I report it to my Dr., they will include in letter to ins co and thus add ANOTHER reason to fully cover my surgery, showing another physical effect of me being overweight. Also, I was all worried about passing the psych eval and the administering Dr. reccommended me for surgery! Some of the questions were soooo off the wall! "Do you like to see small animals suffer?" What sicko would say yes....well, don't answer that one! I'm sure there's plenty of them out there!!!! :eek:

HI. I will be 36 in August. My highest is now (+-220, BMI 45.5, only about 5' tall). I weighed a little bit less when I gave birth 3 years ago!!!!!! I've done all the diets out there over the last 36 years, with no lasting results, obviously. I've been on marriage #2 for almost 6 years, (having #1 end NOT my idea) and have a 3 year old son (my son is the best thing that EVER happend to me). Per the Bariatric Center, my goal is like 125ish. I'll be thrilled if I can make it to 150 and stay there 'til I POSSIBLY have another child. I'm playing the insurance game now. Hope to submit package soon! I'm prepared for a denial, if it happens so I'll have all my ducks in a row for an appeal. Unfortunately I agree w/MoonGoddess, I'm too waiting for things to get going and want to eat everything in sight! Wrong, I know. Well, as far as people's reactions, most were positive. If I did get an attitude from someone, my response is always...." you have NO idea what's it's like (to be huge) until you've been there" . They usually shut up then. Hopefully get banded by end of October 2006 the latest. Pets, I have a dog and a cat. The cat has severe dominance issues (not too unusual from what I hear).

:clap2: HI. Try Dr. Ben-Meir in Cleveland. He's at St. Vincent Hospital (awarded to be a Center of Excellence in Bariatrics) and has a wonderful bedside manner. I'm playing the insurance game now, but the whole bariatric staff is MOREthan WONDERFUL! Wish me luck, and good luck to you!

ALCON: Well, looking at all your great posts are REALLY inspiring! I'm jumping thru hoops for the insurance co now. After looking/hearing of all your wonderful successes, it makes me want the band even more! Good luck to you all, you look GREAT, wish me luck! Will update you on band date....

Alexandra: Agree w/you 500%! I have a 3 year old that out ran me and ended up darting across the street at my sister's house. Luckly it wasn't a busy street, but that didn't mean a car couldn't have come racing down the road! I couldn't believe it that my soon could have been killed because of ME! I'm in the insurance approval process now (wish me luck). I'm 4'11", BMI 45, size 26WP. Not a good thing at all! My dh has worse habits than me and I DO NOT want him (or the "outlaws") raising our son! I promised myself that I'd be there for my son regardless what my husband wants to do w/his health. I've gotten to the point that if he doesn't want to see his son grow up, that's his choice. Kinda gruff, but sometimes the truth hurts! Oh also, someone at work asked me if "there wasn't something he didn't know" and looked at my belly.....No I'm just fat, not pregnant!:cry

Hi. My name is Kim, I'm 35 (pushing 36). I'm married and have a 3 yo son (otherwise known as "the boss"). Also a mom to a cairn terrier (toto dog) and a neurotic cat with serious dominance issues. I'm in the beginning stages of the insurance approval thing. I have federal employee insurance, so maybe they will be kind and approve me with no problem. Been on diets for the last 27 years, hopefully this will be the tool I've been looking for. My lowest adult weight was 113, when I was 22 (or I say "many many many pounds ago"). Currently tipping scales at 220, 5'0", goal of 125, but will be thankful to get to 150 and stay there, but MAYBE looking to have second and last child (depends if DH behaves). I know if I got pregnant now it would NOT be a good thing, financially or healthwise. The real bad part is THIS is how much I weighed when I gave birth to a full term baby over 3 years ago! Scarry! Any wisdom you all can provide that would be great...Oh, have psych eval Monday, wish me luck....:nervous

Well, I think it depends on what you're exactly looking for...Personally, I'm leaning towards the band (ins pays for both, but I'm praying for band approval). I'm 35 years old (bmi 45.5) and looking to POSSIBLY have one more child. The research I've seen on line stated that there's LESS likelyhood of a problem pregnancy w/the band since it can be adjusted for the nutritional needs of the mom and fetus. Also, since the weight loss isn't as fast as w/the bypass, I'm hoping less chance of loose skin too. I also know it's less envasive and less time I have to recover. I have 3 year old that I can't keep up with now, plus being out of commission for a 4-6 weeks +, I can't really have that. :preggers:

Ok, my ins requires a psych eval....What kinda questions are we looking at here?:help:

Ok, this is my FIRST forum, so I hope I don't sound too stupid....I'm Kim from Cleveland, went to seminar Monday and decided on "the band". Waiting to hear from Bariatric Center for them to verify insurance coverage, wish me luck!:clap2:

Well, I got verification that my ins pays 100%, so now it's just a matter of stating my case for them to approve me! Have appt w/bariatric ctr next Friday. I have to take all my prior weight loss info to them (maybe I should rent a uhaul or something). Well, I'm 35 and I've got over 18 years of yo yo dieting to detail.... :clap2:

Ok, sounds kewl, thanks for the response. I'll try not to make myself sick over this....:cool: