I'MREADY

Yesterday at my pcp appointment my bmi was 38. I'm 5'4" and 216.5 I convinced my pcp to get me the letter of med neccesary and then I called the surgeon office to sign up for the semminar she said my insurance wouldn't cover me and won't even let me attend the semminar. I called my insurance and they told me to have my pcp send for a prior authorization and send his letter to the insurance co. It takes 48-72 hours to get approved or turned down. I'm at a brick wall now. If my insurance won't cover it, no way can I be a self pay. I'm really upset now. I was really counting on this. It's not like I have gained 20 lbs and want to lose it. I have been overweight all my life with a 40 yr history of loss and gain diets. I don't want to wait until I get so overweight that the surgery would be a huge health risk to even have it done. With a low bmi did you all have to go through all the 6 months of testing and appointments? Or does that depend on the doctor. Did your insurance cover the appointments and testing? thanks for listening and pray for me that the insurance can see in favor of the surgery for me. Deb

I am so happy, one step closer. I had my appointment with my pcp today and he gave me a letter of med necessity. Now I have to call for the semminar and go from there. I know it's a long road ahead but It's a step in the right direction.... my bmi today was 38 so I'm at the low end of getting approved.

I am 50 miles north of Albany and in the pre approval stage. My pcp appointment is Wednesday, wish me luck! I'm looking into Ellis Hospital for a surgeon. Dr. Imgram

If ther any where I can get a "form" letter to give my doctor so he will have all the right information in the letter. Or an example of a letter that the insurance will be looking for? tia Deb

I had an appointment today to see my therapists nurse. She was going to set me up for blood work, so I thought. I had an hour session with her and she told me the lap band wouldn't work for me. This is the first time I have ever seen her!She doesn't even know me!! I worked all weekend on my weight history and provided her with 40 years of everything I have tried and how much I lost and regained, which to me is not showing a chemical imbalance, which they are looking for! I thought once I got my therapist on board I would then go to my pcp and talk to him. I don't know if I should just make an appointment with my pcp and not go back to the therapist. I have an appointment with my regular therapist for next thursday. Any suggestions? I am so discouraged right now. I wanted to say "maybe I'll wait until I'm over 300 and come back"

I so appreciate everyone input. I really do. I guess I went about this a**backwards. I should have never mentioned it to the therapist. From what I NOW understand the surgeon will use a therapist she recommends. One that deals with wls patients all the time. Same with a nutritionist. I spoke with an old friend that had the full gastic bypass 3 years ago. She said she has never been happier and for me to fight to have this done. She has lost 115 lbs, and lost most of that in the first year. I'm getting my big speech ready for my pcp on Wednesday. Any thing I really stress to him to get him on board. I have no idea what his feelings are about any wls. I'll find out Wednesday. Wish me luck. again thank you all for your support. Deb

Head hunter thanks for your input. I have been seeing this therapist for 6 months. She has helped me through some tough times and has been trying to help me find out why I eat like I do. When I mentioned lap band, that's when she said she would have me see her new nurse and the nurse could write me orders for blood test. I didn't know she would be doing anything other than writing a scrip for blood work I just looked at the nurses card and it says Psychiatric Nurse Practioner and under it says "comprehensive holistic approach" THINK THAT ANSWERS ALL. Here's an example that now makes sense to me. I told her I didn't sleep well. She told me not to watch tv for at least 2 hours before bed time because the light from the tv is a stiminulate! I had blood work done this morning and have to go back after work for the p.m. part (cortisol test) Anyone have that test done? Not sure what it is for, something with the adrenal gland. Deb

I called my pcp today and can't get in until next Wed. Then I called the surgeons office just to see how far out she is booking. The girl asked my height and weight and asked about comobitity(? spell) She said she couldn't even sign me up for the next semmiar until after I saw my doctor (she was already to sign me up until I told her one of my issues was high cholostrol) She said that didn't count! So do I hope my blood work finds something terrible or do I gain 50 lbs so I qualify????? Guess I need to calm donw and just wait until next week when I see my pcp.... It's just that I really need this...

Hi I'm 59 and hope to be joining in your journey soon.

The insurance co is the first place I called for their requirements. If they wouldn't even consider wws, there is no way I could be a self pay. They were very nice and mailed me the guidelines and their requirements. With a low bmi I have to meet one/two of the medical issues, which I do, my blood work I'm having Wed. will confirm that part. Thanks again for your information. I hope I can get into my pcp this week or next. Deb

I am about 50 miles north of Albany so I was looking in Ellis Bariatic Care Center with Marlene Ingram MD. Thanks for eveyones words of encouragment. I do feel better. I don't have anyone here that has had wls so I have no one close by to talk to. This board has been very helpful.

Boy that was a quick process for you. I wish mine would be that easy. I think I am in for a fight. I am at the low end bmi 36.9 and have about 50-60 to lose.

thanks for the info. I will call my pcp tomorrow and hopefully will be going in the right direction. Deb

Maybe I'm doing the process in the wrong order! The therapist I am seeing deals with weight lost and eating disorders. I have been seeing her since November and like her but this is the nurse in her office I saw today. What is the order of who I should talk to. pcp first, surgeon? I guess I'm confused. I have seen my pcp for weight issues and he is the one that sent me to this therapist. The surgeon I wanted to go to is about an hour away but you can't attend the seminar until you are approved by your regular doctor. How do you get eveyone on board? thanks

Hi, I, like probably everyone here has fought weight issues all my life. If I added up all the money I have spent on weight loss (Nutrisystem, Diet center, WW, books, videos equipment) I could pay for the surgery without insurance! I'm 59 and am at my wits end. I have been seeing a therapist since Nov and she feels I have a chemical imbalance. Next week we will be doing blood work to see just what my issues might be. I have very high cholestral, high blood pressure, back issues, including one surgery and depression. I am so sick of feeling useless and hating myself because I can't lose weight on my own. I have tried pills inthe past, lost but regained all plus. When I mentioned the lap band surgery to her she wasn't thrilled and suggested all these test. I called my insurance and I believe I would qualify. I'm 5'4", weigh 215 and my bmi is 36.9, which is at the low end of qualification. I just hope I can get everyone on board and agree with me. I know this surgery is not a free ride and I still must work to lose the weight but I need this tool to help me. Hubby is nervous about it but I'm sure once he can talk to the surgeon, once I get an appointment and go to a semminar with me, he'll understand more about it. Well I've rambled enough, thanks for listening. I'm sure I will be posting many questions and thanks in advance for any advice and encouragement you can give me. Deb

You're a little bit west of me. I'm about 50 miles north of Albany in the beautiful Adirondack mountains. Pm me any time. Would love to talk. Deb

I have only told my husband and my boss, who is a very close friend that I want to start the process. If I am approved, I will try and take vacation time so no one at work will know until it is over and I am ready to tell them.

Thanks so much for the encouragement. All depends on the blood work from next week and my insurance. I'll keep you all posted DEb