TracyinKS

I would check with your HR/Benefits person, ask her what your SPD says... for instance ours say BMI over 40, OR BMI of 35 and two comorbidities........ also you could call BCBS and ask them what your SPD says... (they should have it loaded to their system for refernence)

wooooooooooooohooooooooooooo!

I would try and call your company EAP plan first..(it is free).

and the grits may be too sticky for you to eat........ don't know, just a guess

From an HR standpoint...(my job).... Yes, they will look at you like your crazy, because changing policy is for the most part a pain in the butt and most likely something that is discussed on a Benefits Committee... (at your corporate level) This is what I suggest........ start seeing a doc OR start a supervised 6 month diet plan SOMEWHERE.. keep all documentation.....When your benefits kick in THEN talk to your HR department and ask them what the process is for a medical appeal, if they don't know ask them to contact corporate and find out what the procedure is.... (NOTE: you don't have to disclose to the people in HR what you want done.. that falls under HIPPA) Just say that you will be needing a procedure that is most likely not covered and you want to know the appeal process......... Then you might call your company EAP (employee assistance plan) and make an appointment for a counseling session....... talk about your struggles with weight.. Company EAP's are offered everywhere..... Usually a company break room or bulletin board has a poster with an 800 number on it.. what most don't realize that these services are FREE to employees, and you can talk about everything from domestic abuse to Credit counseling... OUR plan is good for the employee AND all their family members... 6 FREE sessions PER incident.... (Meaning that one month you could call for your credit problems, and the next month your teenage daughter might run away) My point being.......... call the EAP, talk about your weight, GET DOCUMENTATION FROM THE MEETING... (this may satisfy the phyc eval) Lets face it....... if this is excluded under your policy you are going to have to jump through hoops to win an appeal....... If all this fails...... appeal with the state insuarance board.... (KEEP MULTIPLE COPIES OF ALL your documentation) and GOOD LUCK!~

Hi Ya folks... I have no idea who besides me will ever read this,but I have to put my thoughts down on something..... I decided to get the band after I found out it was covered on my insurance.... well not entirely true....... I had been thinking, debating, pondering, calculating the cost for over a year now. I have two very close friends who had the RNY.. one going on 4 years post op, and one going on 2 years post op... BOTH Have done wonderful, both have lost over 100 lbs. ONE of them has regained 25% of her weight back,but is still happy with her decision........ BOTH say that it is THE best thing they ever did for themselves...... that said.. IT is not for me....... I chose the band for many reasons....... A simple week of PTO off from work and no one.... will even know... No one but my Sig Other, My mom and now as of today my sis! I have already been emailing my insurance company, the program coordinator at my surgeons office, and today... I just found out that I have my first consult with the doc on 1/08/2007..... I am HOPING/Praying that I might possibly have my band by the end of January or beginning of February......... a PIPE DREAM.. maybe... but maybee not. Today I weigh: 263 give or take a few christmas pounds... this is my top weight except when I delivered my son. Stay Tuned

UPDATE: I just got off the phone with the program coordinator at the surgeons office..... I am scheduled for the seminar on 1/6/2007, and she went ahead and scheduled my consult with the doc on 1/8/2007!!!!!!! wooooohooooooooo!!!!

WELCOME!!!!! I'm an atkins fan too... but like you it always comes back when I start eating trigger foods.... I'm hoping to get banded in January!

Woooooooooohoooooooooooooo!!!!!! How exciting!

From what people have said on this forum... WORK THE BAND and it will WORK FOR YOU!

First is to find out what your self pay options are close to you., then weigh that against going out of state (Like Colorado, Utah, Mexico) where I've seen packages listed for around 10K. ON Capitol Ones website, you can click the calculator to find out what your payements would be...... Do a search on this site for other medical financing companies... or heck even go out on google and search. GOOD LUCK!

I am so excited to join everyone in bandland.........I'm crossing my fingers for a quick insurance process!

WOW!!!!!!!! all the way to Hungary! Did I read that right? Thanks for posting.. and I LOVE the pic of your doc!

WELCOME to the boards! I have yet to get into bandland, but I am hoping for January or February. I think the pain you are talking about is caused from post fill swelling. This place is so great.. just read, read, read.... and post, post, post!

Thanks ladies... I can barely contain myself...... I have to go to a seminar before scheduling a consult with the surgeon... and I'm hoping to just blow them away with all my paperwork. I upped my Flex Spending Account to make up for my outta pocket max... if this doesn't go through, I'm going to be buying A TON OF OVER THE COUNTER MEDS! LOL

WELCOME! This place is so great... read on

Wooooooooohoooooooooooo!

WOW!!!!!!!! the stories on here are soooooooo telling. My mom (who is also big) is the hardest on my self esteem..... even when I'm down to a 12 see will say.. hurtfull things... I don't think she means too, but she does.

CONGRATS!!!!!!!!! My son, who is now 3 was an Atkins baby... (meaning that I have PCOS) and a low carb diet straightened up my cycles and allowed my body ot ovulate.... ANYWHOO it was a wonderful suprise.... I was 33 when I had him.... My advice is to ENJOY every bit of your condition.... knowing that you are creating a life it pretty amazing....... I took it as my one chance to do every thing motherly........ drink your Water, and do everything to keep the little belly bean safe and secure! again CONGRATULATIONS!

ahhhemmmm: that is bs...... my good friend who had the bypass is holding firm at the 200 mark, and she is in a size 10 because she is so dang tall... 5'10".... she just went in for an estiment on the work.......... boobs, arms, tt.... 12K. the most important thing her doc said was that the maintenence of the weight loss is key........ she thinks if she had it all done she would lose another 10-15 lbs. Your sis is just trying to rain on your weight loss parade......... don't let her!

Hey I would say go for it and see if he will throw in a year of free fills for compensation!!!!!

marjon... hey its a fact of life... just like the time I was surprised to see a BALD guy walk through the door when in his post he appeared to have hair! LOL ... that was ME being superficial and I had to get over it...... People are people... I can't help it if SOME PEOPLE (men and women alike) judge by that first gut impulse on what someone looks like.. and yes it is superficial.. just like the guy mentioned in my post.... he was fine.. and when he finally started asking what I weighed I knew he was a superficial guy... and when we exchanged full body pics (clothes ON) he said I was too big, and that he was interested in someone who looked good when on his arm.... I call that being insecure and yes SUPERFICIAL, oh and I should mention that he kept dropping names of various celebrities because he was a friend of a promoter... blah, blah, blah... we had a pretty frank discussion in the end.. and he admitted that because he was fairly short, (which he didn't disclose til later) that he could only date women who were under 5'4" and top the scale at 115 lbs.......... This was the worst one I encountered......... during my year of online dating craziness.. I met nice guys, and guys with issues all their own, I was never what most would consider skinny.. because if my sister ever had to wear a size 12 she would be so depressed... where as me... I am ONE HOT MAMMA in a size 12, and I will shake my size 12 levis at anyone who says otherwise! LOL........... (unfortunately those same levis are gathering dust in my closet waiting for me to get into them)

way to go!!!!!!!!!!

Hello there I don't know if I can answer all that you need to, because I myself am just starting the insurance approval mode... I will tell you that the best way to learn is to read ALL the sections of this great site. I have learned so much. The basics, as a rule you need to be 100 or more pounds overweight with a BMI over 40, or if Under 40 you need to have some comorbidities (conditions like sleep apnea) there are TONS of others. I think Medicare has approved the procedure but the requirements vary from state to state, and some doctors are still in the process of becoming a center of excellence.. again.. read, read, read this site. A lot on here have been self pay, and a bunch have had to jump through insurance hurdles..... good luck with your research and your journey!

OK.. so I skipped alot of what has been said before me, because I wanted to give you my advice... and I met my fdh ONLINE, and I had a year of various online dating experiences before him. I went online because I live in a small town and the gene pool had been picked over or they are someones ex... ANYWHOOOO.... I STARTED my online journey when I weighed 230 size 16/18.... during the time I was lowcarbing and ended up down at a size 12....but I had a lot of fun in the meantime.. it is mainly about YOUR self awareness..... I did post pics and one guy did end our communication because of my size, but really there are plenty of people around that are not that superficial... NOW I did get suprised myself on a couple, and one guy who I just didn't click with at all.... I had the best matches on Eharmony, but in the end I (ON A WHIM) joined yahoo personals.... that was where I met my current guy... and that was nearly two years ago....... I was a size 10/12 when I met him, and now I'm ALLLLLLL THE WAY BACK UP! He thought LowCarbing was crazy, and all the women in his family are large so to him that was normal.. Anyway.... I would meet him in a public place, just in case it doesn't work for YOU! and also realize for a lot of guys its mainly about sex.. so the nicest guy on the phone and on email... could just want to get some and move on..... Mainly remember to relax and HAVE FUN! YOU ARE WORTH IT! P.S... I just went back and read that your date went AWESOMELY! I LOVE IT! Just like your sig says... Watch OUT WORLD HERE YOU COME! :clap2: