Lisa07

Last Friday I went to my primary physician to begin my six month dietary program overseen by a dr. I was shocked to find out he would not support my decision to get the LapBand because he doesn't think it works but that he would support me getting the gastro. This is coming from a man who in the past has told me to start taking my dog for a walk and to join WW. I really like him as my primary physician, I've gone to him for the past ten years. I don't need a referal so I don't have to take his recommendation but if I want to continue seeing him, it might be in my best interest. I am attending my free consultation with a bariatric dr. this Friday so I'm going to go in with an open mind and listen and ask questions about both surgeries. I had my head set on the LapBand because it's less evasive and recoop time is shorter. I understand it is only a tool and not a miracle. I am afraid of the side effects of the gastro and to me it seems like it's to risky, you have to take meds for the remainder of your life which is one reason I want to loose weight is to get off the meds I'm on now. Any advice on making the decision? I'm 5'5, 300 lbs with high blood pressure and arthritic knees. Even with the weight I'm still able to get around fine (with knee pain) I can keep up with my skinny friends, I just pay for it in the evening when I sit down! :crying:

I attended a seminar today and learned that if your insurance requires a six month consecutive dietary program, it has to be by a physician, it can't be NutriSystem because you are doing it unsupervised. Some insurance doesn't even allow WW or Jenny Craig because you aren't being seen by an actual physician. My insurance wants six months but it can be 2 three month dietary programs, I have one but I need to make three appointments with my primary doctor and each month there is a list of things he needs to discuss and document in order for the insurance to accept it. Record weight and vital signs Discuss nutrition Discuss excersie, the type you are doing and the amount of time you are doing it Discuss current medications Discuss changes in medications Discuss changes in comobitity Discuss additional conditions due to your weight (such as bad knees) Discuss good eating habits. If your doctor doesn't document all of this for each visit, the insurance could turn you down and you start all over! I also learned there are alot of out of pocket expenses but I would rather pay those then for the entire surgery! Plus you are going to save money when you eat less after surgery! I think the easiest insurance to get approved by is BCBS, one guy had that and she said he could probably have his surgery w/in the next month or two...lucky duck!:grouphug: Hope this helps, good luck on your journey, Lisa

Wow, what a difference and you're only at your half way mark! I'm excited for you. Today was my seminar so I'm only just starting my journey. Keep up the good work, you give others, like me, something to look forward to!

Congrats to you! What insurance do you have? I start this process tomorrow by going to the seminar and making my consultation appointment. Best of luck to you!

Has anyone had surgery by Dr. Cynthia Long in Silver Spring, MD? Thanks, Lisa

Thank you both for your replies, I ended up taking the names of each of the Lap Band doctors in our area and searched for them on the CareFirst Blue Choice website, I originally put gastro as the specialist but I was only able to find the doctors if I leave the specialist blank. I'm going to post another message to see if anyone has been to Cynthia Long in Silver Spring, MD. I live all the way down in Lexington Park, MD but drive up to New Carollton every day for work and Silver Spring would be close enough that I could probably get my fills while I'm up in that area during the week. We'll see. Another doctor that was recommended and is on the CareFirst list is Dr. Tran in Woodbridge, no convenient but like I said before, I want to go to someone that is recommended. Thanks again for your posts and good luck on your journey, I hope to join you before long!

Hi, I'm looking for a recommendation of a Bariatric -Lap Band doctor in MD, VA or DC. Getting information from Insurance is difficult, I have CareFirst Blue Choice (FED) and the list of Gastro physicians within the network is huge and I don't know how to make a selection. Do all Gastro physicians do Bariatric Surgery? I've spoken to several people that have had the procedure in my area but none of the doctors are within my network. Any advise is really appreciated! I just want to get started.

Hi, I'm looking for a recommendation of a Bariatric -Lap Band doctor in MD, VA or DC. Getting information from Insurance is difficult, I have CareFirst Blue Choice (FED) and the list of Gastro physicians within the network is huge and I don't know how to make a selection. Do all Gastro physicians do Bariatric Surgery? I've spoken to several people that have had the procedure in my area but none of the doctors are within my network. Any advise is really appreciated! I just want to get started.

Do you know if Care First Blue Choice FED is the same or equivilant to BCBS? I'm over a 40 BMI but they told me today that I needed the six month diet plan or two three month consecutively. I have 3 months on NutriSystem but it all has to be in a 2 year time period so I need another 3 months...that would be great if I could get that waved.

Sounds like everyone is battling their insurance agencies for this surgery! I just posed a blog that my insurance Care First Blue Cross wants you to have two 3-month structured diet programs as one of the criteria, I have one, I tried Nutrisystem last year for four months and I lost a little but immediately gained it all back. I've done WW several times but not within the two year timeframe they are looking for. I guess i could start WW online and pay for it for three months right? Any other suggestions for me?

Sorry to hear you were denied, that really stinks, I would also appeal. I had my hopes up and now I'm deflated! I have Care First Blue Cross. I was just told I have to follow 2 three month diet structured programs as one of the criteria for having the surgery, d0 other insurances make you do that? Haven't most of us already tried Weight Watcher several time (just not with the two year timeframe they want) and I did Nutrisystem for 4 months last year. Sorry, don't mean to whine but insurance makes everything so darn hard! I wouldn't have any other problem meeting the criteria..... I'm really bummed!