cl_tx_42

Wantlapband: What was the reason for the initial denial?

It applies to only what they pay out. I just talked to the doctor's office. They said we still need to wait and see what my husband's insurance says...I just got the denial from my insurance but I don't know if they have submitted anything to my husbands insurance. She said that even though his company typically covers the surgery, they may opt not to if my company denies it. I'm curious about buying an individual policy. I bet most individual policies exclude WLS.

It is a $10,000 maximum for the procedure or any expenses related to obesity (fills, etc.)

Well...I got that bad news that my insurance denied me. They said morbid obesity is excluded from my plan. That it is a rider and my company elected not to opt for that option. Can you fight that? Another question? My husband's insurance (my secondary insurance) will cover it but there is a $10,000 lifetime maximum. Well...we all know that around $22,000 is billed to the insurance for the surgery. Someone mentioned a doctor in Colorado that does the surgery for $9950 - do anyone know how much he bills for the surgery? Any other suggestions? (Self Pay is not an option) Heck, I'll even change jobs just to get it to be covered by insurance. Willing to work in the Houston or Beaumont area :girl_hug:

Well...I got that bad news that my insurance denied me. They said morbid obesity is excluded from my plan. That it is a rider and my company elected not to opt for that option. Can you fight that? Another question? My husband's insurance (my secondary insurance) will cover it but there is a $10,000 lifetime maximum. Well...we all know that around $22,000 is billed to the insurance for the surgery. Someone mentioned a doctor in Colorado that does the surgery for $9950 - do anyone know how much he bills for the surgery? Any other suggestions? (Self Pay is not an option) Heck, I'll even change jobs just to get it to be covered by insurance. Willing to work in the Houston or Beaumont area :girl_hug:

Sweetsue: Please help us all in elaborating on why this gentleman had this procedure? :omg: I think we are all sympathetic by your concern of wanting to hide your surgery - but you kinda threw us off with the penis statement. I think we all spend too much time worrying about what someone is thinking about us. I know I don't do things with my friends as often as I did when skinny because I feel I'm too fat to be friends with them. I have never shared that with anyone before now...but I always think they are looking at me thinking "My God, she's gained a lot of weight". I'm even putting off going to visit a very good friend who lives out of town until after I had my surgery and can lose some weight. After reading your post...I guess I've realized that my friends love me for me and whats inside and not what the scale says about me.

Dr. Spiegel's seminar is not free. They required me to bring my co-pay. I wasn't happy about him wanting $25 to decide if I want to use his service. I went to Dr. St. Laurent's seminar instead and am waiting on insurance approval to be banded by Dr. St. Laurent.

I'm going through a similar situation with my husband. However, we just had a long conversation about this. I was 110 lbs when we got married and just gained a bunch of weight in the past 7 years. I assured him that my only reason for having this surgery is (1) for health reasons, I have lots of health problems on my mothers side and I had gestational diabetes during my pregnancies which pretty much guarantees I will have full blown diabetes in the future; (2) I told him that I want to feel good about myself, like the way I look in my clothes, not get depressed when I'm getting dress, etc. AND most importantly to feel better about myself when intimiate with him and for a better sex life with him and only him! I think that helped him some. He does tell me that he is jealous that I am able to have the surgery. His insurance covers the surgery but has a lifetime maximum of $10,000 so it doesn't help him much. Just give positive reinforcement to your husband (and his ego).

If someone takes this survey, please PM me or post here and let me know if the link works!! Thanks!

I created a survey of questions related to lap band surgery. I would like for those of you who have had lap band surgery and are at least 3 to 6 months post surgery to take this survey. The survey is completely anonomous. It is limited to 100 entries, so I will share the results after 100 people have taken the survey or a week from now, whichever is sooner. This is just a survey to help me better understand how people feel about their decision to be banded. There are only 9 questions and they are: 1. How tall are you? 2. What was your weight pre-banding? 3. What is your current weight? 4. Select which type of diet you follow: <O:p></O:p> 5. Exercise <O:p></O:p> 6. How much total weight did you lose from the day of banding until (sorry these may not appear in order): <O:p></O:p> 7. If you could do it all over again, would you get banded? <O:p></O:p> 8. Please select which best suits you: <O:p></O:p> 9. Do you wish you had selected a different weight loss surgery? Please answer these questions via the survey. Please only take the survey only once. http://www.surveymonkey.com/s.asp?u=678442574739 P.S. I'm a newbie to this survey thing so I'm praying this works :nervous (but actually its a pretty cool website to create your own surveys (surveymonkey.com)

Thanks! I just called Dr. St. Laurent's office. They are going to call Lap Band Solutions and call me back.

I am so ticked...I called my insurance again today to see the status of the approval of my surgery. They still say the never received it (I've called every day since Lap Band Solutions said they faxed it). So I called Lap Band Solutions. NOPE....she didn't send it over. She said when she called that my insurance excludes Morbid Obesity. I had already called my insurance a couple of times to make sure they cover it. I would have never gone this far if they do! She said she called my secondary insurance and they cover it but there is a $10,000 lifetime maximum for the surgery. So...I called again to my primary insurance company and got the nicest person...she said morbid obesity is excluded unless it is medically necessary and they have to review the doctors notes, etc. to determine that. So she started researching call history and saw where I called everyday but never show my doctors office calling. I am fuming . I called the girl back at Lap Band Solutions and told her she must immediately fax the information and predetermination over to my insurance. I want to have this surgery before October 1st because that is when my husband's insurance rolls over for the new year. Should I call Dr. St. Laurent and tell them the run around I'm getting? I went to AIGB 2-1/2 weeks ago...I feel everything should have already been sent to my insurance. Also, on the secondary insurance...have any of you delt with that where the maximum is so low? I'm wondering if that is just for the surgeons portion and not for the anesthesiologist and surgery center.