tripletmomma2000

It's taken me 7 years to make this decision, and now that it's been made, I'm more excited than scared about my new life that's coming. I'll spare the long, melodramatic introduction.... I've decided that anything I need to say, I can say in less than 1 minute! I'm super morbidly obese. I've yo-yo dieted for over 25 years. I've decided to get the band, and my insurance company just removed it from the policy effective 1/2009. I am in appeals, but am prepared to self-pay if necessary. I need an unrelated surgery to biopsy a lesion on my spleen, and Dr. Gazayerli has agreed to do them together. I am hopeful because there's a dual purpose to the surgery, that my insurance will pay for at least a portion, and leave me with only $5200 to pay for the band. Fingers crossed.... and savings ready to be raided for the surgery that's going to save my life. I have 9 year old triplet boys at home, and dammit, I'm going to see them get married and have kids..... if it kills me :confused3: Karen T.

It's taken me 7 years to make this decision, and now that it's been made, I'm more excited than scared about my new life that's coming. I'll spare the long, melodramatic introduction.... I've decided that anything I need to say, I can say in less than 1 minute! I'm super morbidly obese. I've yo-yo dieted for over 25 years. I've decided to get the band, and my insurance company just removed it from the policy effective 1/2009. I am in appeals, but am prepared to self-pay if necessary. I need an unrelated surgery to biopsy a lesion on my spleen, and Dr. Gazayerli has agreed to do them together. I am hopeful because there's a dual purpose to the surgery, that my insurance will pay for at least a portion, and leave me with only $5200 to pay for the band. Fingers crossed.... and savings ready to be raided for the surgery that's going to save my life. I have 9 year old triplet boys at home, and dammit, I'm going to see them get married and have kids..... if it kills me Karen T.

I am very excited to hear this! I am going tomorrow to have the endoscope done, and hoping to be banded at the end of the month! Dr. G certainly seems very knowledgeable, and has a nice disposition!

Hi all, I am brand new to this forum... though obviously, not new to weight management (and failure thereof!) I *finally* made the 7-year in the making decision to get a Lap-Band. All things considered, this is the correct WLS for me. Here's my stats: F/41 Ht: 5'6" Wt: 350 BMI: 56.5 I have struggled, on the "books" with my weight, since about 1980. So... past medical history is with me. I've been over 300# for about 13 years. I decided to go and see a Surgeon in my area that came highly recommended. He does 2-3 Lap-Bands/week, and actually has a band himself. When I went in for a consultation, I presented my Insurance Card, which is BC/BS Mi PPO, and the office staff assured me that everything would be covered, because I meet all the requirements. Apparently, however, this applies to the same plan with GROUP coverage. I have INDIVIDUAL coverage. The individual policy does not cover. My surgeon's office is filing an appeal for medical necessity, and I sent in a 3-page personal medical history, including all of my ailments, meds., etc. Unrelated: I am currently having serious pain in my pelvis. I have had an ultrasound and a CT scan. The ultrasound came up with nothing. The CT scan didn't show any problems in my pelvis; however, it does show a lesion on my spleen... too large to be a cyst, and I've been referred to a general surgeon for further evaluation.. read: surgery + biopsy. My Lap-Band surgeon of choice is a General Surgeon. He agreed to do the biopsy of my spleen while he does the lap-band. I asked the doctor's assistant if we could do the spleen (possibly spleenectomy?) as a covered procedure, and I'd pay the lap-band OOP... she said "perhaps" and that it would be about $5200.00. So... this is where I sit. Because I was under the impression that I covered, I had the pysch eval, and am in the midst of having sleep study (totally have sleep apnea!) and a cardiac clearance. The bills haven't started rolling in.... yet. I'm looking for any advice I can get at this point. I've waited myself out for 7 years making this decision..... I honestly don't want to wait 5 more minutes to get this rolling. Thanks for listening, Karen