deemarie

I Have UHC-EPO. I too was frustrated because my plan stated it did not cover gastric surgery. But then, I received by 2008-2009 Benefit Options Plan Description book in the mail and it stated under Article 9 Exclusions and general limitations that : "Medical and surgical services intended primarily for treatment or control of obesity which are not Medically Appropriate. Services for the purpose of diet control and weight identified condition of disease etiology. Services included but not limited to: gastric surgery, intra oral wiring, gastric balloons, stomach stapling, jejunal bypass, dietary formulae, hypnosis, cosmetics, and health and beauty aids are not covered unless all the following items are met: Documentation of 5 years history of severe obesity With a year immediately preceding the planned surgery documentation of 6 consecutive months participation in physician-supervised weight loss program...Must include all of the following" · Psychiatric assessment and approval · Medical assessment and approval · Nutritional Counseling · Exercise Counseling · Psychological Counseling · Support Group Meeting My personal doctor wasn't very helpful at first. I told him up front I was interested in Lap Band. I had been going to him for a year. He suggested calorie counting and exercise. I would lose only to gain it back when company visited or vacation time etc. I finally got depressed, mad, you name it. He read my insurance book and wasn't sure Lap Band surgery was covered by my UHC policy. He gave me a name of a surgeon out of town. They are working with me to meet the insurance requirements prior to submitting the claims. The necessary tests are covered by my insurance because they are submitted as diagnosing and treatment for "GERD" and acid reflux. Sorry this post was so lengthy but I hope it helps. I have my first appointment on July 27 to see the Bariatrician, Dietician, and to have a GI study (Manometry Study). I live in the Phoenix area and am traveling to Flagstaff (2.42hrs away) to start the program. I made the above appointments so there is less time from work. I will travel to Flagstaff once a month for the next 6 mos. to get this done!

I looking for affordable Lap Band surgery. Not sure yet if my insurance will approve. If I have to self pay I would like to know what to expect for cost?

I am still looking for affordable Lap Band surgery in Arizona. I live in Buckeye, just west of Phoenix. I was quoted $18,000 from a clinic in Tempe. Not sure if my insurance will cover the procedure. I can't afford this and am totally depressed:frown: Visited my family doctor today and he mentioned Flagstaff Surgical Assoc., Dr. Robert Berger, M.D. Is anyone familar with him and the cost of the surgery?

:sad:I am 54 years old, 5'2", weigh 235++ lbs. and have a BMI of 42. I have been overweight for the past 21 years, trying to do it on my own but with no sucess. My husband and I moved to our current address fall of 2007 and I began seeing my current doctor for help with weight loss Spring of 2008. I mentioned to him I was interested in trying the LapBand. He wanted to try other methods before resorting to it. It's been a year. I've taken it upon myself to attend the seminar and get the details but the cost is too much for me ($18,000++) and my insurance UNITED HEALTHCARE EPO does not cover the procedure. I've seen other posts stating that others with UHC eventually got approved. Please tell me how I can get them to approve surgery.