Mateotete

I'm a 38 year old male living in Sacramento...I've been overweight for about 15+ years now...although I don't look it..I'm actually about 70-80 lbs overweight with a BMI of about 35-36. I've really thought hard about getting the lap band procedure and have recently just got off the couch long enough to start putting this desire into action. My insurance is Blue Shield of California and I've been told it's a coverable procedure BUT if my BMI is between 35-40 then I would need a co-morbidity to get pre-approved. Yet, I don't think I really have a co-morbidity that applies..I've got a good heart, no diabetes, no disorders, take no medications, have a good blood pressure...yet, I have a very strong family history of high blood pressure, heart problems, and severe diabetes...I'm nervous that I won't get pre-approved...is there anything I can do to increase my chances of getting approved for this procedure?

Okay, okay, I know there are a million skeptics out there..but while going to college in San Diego I couldn't afford American insurance and so I would get medical treatment in Mexico instead. I did this because, frankly, I couldn't afford American medical insurance or care AND because anything I needed as a young adult (common colds, dental work, flu, checkups, etc..) could be taken care of quite easily, quickly, and with better service than I typically received in the U.S. So fast forward 10 years, I'm a professional now that works with computers and have gained about 80 pounds of excess weight. My American insurance denied my lapband procedure although my doctor thinks its a great idea to get it...I make enough money to pay for the procedure but thought, why not save some money and get the procedure done in Mexico...after about 6 months of research, saving money, and working up enough courage, I finally made the jump and had the procedure done in Mexico at Jeruselem Hospital by Dr. Mario Almana Reyes. The result?? Well, I still have my liver!! Ha-ha, actually, I am extremely pleased with the service I got there...they were extremely professional and seemed to do a great job! Now don't get me wrong, it's only been 10 days and so far I've only lost 9 pounds...was hoping I'd lose a little more by this point but I haven't even had my first fill yet so I'm keeping my fingers crossed. But I will say that before the procedure they took lab work (blood), had a cardiologist run an EKG on me (not an RN or medical assistant...a real cardiologist), the primary physician, and an anesthesiologist...after surgury I spent two days at a guest house where doctors, nurses, and maids kept the house safe and checked up on me. Before leaving I was given a barium x-ray to make sure the Allergen product was working correctly, Allergen documents and serial number card so I can authenticate that the Allergen lapband was made and purchased in America (the only authorized dealer of lapbands), and all the medications I needed including pain medication and antibiotics. All in all, I was nervous, hell, who wouldn't be when going under the knife? But I was impressed, they did a very good job. Oh, and the price?? You couldn't beat the price...seriously.........$4,250 with lifetime free fills. So if your considering this procedure and Mexico, think of this facility, I'd vouch for them.:smile2:

Okay, here's the problem. 10+ months ago I began the lap-band approval process....problem is that I had previously lost 18 lbs of weight right before starting this process...since my weight started to inch back up I talked to a doctor to see if this procedure was for me or not. Because of this, I've only gained weight during my 10 months and haven't lost anything but a few pounds here or there. Currently, I weigh 264 pounds and have a BMI of about 38 but no co-morbidities..I'm certain I'll be rejected for the procedure and am bummed...however, if I gain 10 more pounds I'll be at the 40 BMI which alhtough I'm not really trying I might do anyway because I've been this weight previously. My question is this....if I happen to gain 10 pounds resulting in a BMI of 40, would my insurance likely deny the procedure simply because I've been gaining weight over the last 10+ months? Anyone have experience with this or something similar? [side note: I have only been seeing my primary doctor and I should get the referral to the lap-band surgeon within the next two weeks]

Actually, I do have VERY sore knees....I imagine partly because of being overweight and party because I have a torn ligament on my right knee. However, my doctor did an x-ray on it and said although there may be pain there is no indication of permanent damage. As for sleep apnea, I'm going to ask my doctor to check this but for now, I don't think I have this.

A website (obese solutions) for the lap-band procedure found on this site is offering a promotional $4,500 LAP-BAND procedure if done in Tijuana, Mexico. Price includes everything except airfare (including lifetime fills). I'm considering this because I imagine my insurance won't pay for the procedure and I've used Tijuana doctors several times when I was in college in San Diego. Has anyone done this procedure through this site or in Tijuana?