Bella Luna

I wonder if you could submit the request again. I really have no idea about insurance stuff. But I had a BMI of 39, so I purchased leg weights with removable weights took out two one pound weights and stuffed them in my bra and magically my BMI was 40. I would do what ever I had to with a BMI of 39. I obviously don't know your health, only you do, but for me if just increasing my weight by a few pounds meant that I could get the surgery the I would do it. I would consider which is more dangerous: gaining a few extra pounds (either actually gaining more weight or with the assistance of external weights) for a month or two in order to get the lap band and reach a healthy weight or not gaining the few pounds and trying continue fighting the bulge for years to come. I hope this isn't a weird response, it's just my thoughts. I hope your insurance will see the light of how you will benefit from this. Good luck, it's never fun dealing with insurance.

Congratulations on your approval!!! I also have Federal BlueCross BlueSheild-Basic. Everything will be submitted to insurance next week for approval. I'm very nervous. How long did it take for you to get your response? Did you have to submit a 5 year weight history? I do and that is what's making me most nervous! I have one weight a year for the past five years either from my Dr., Jenny Craig or Weight Watchers. I'm not sure if I should sumbit additional weights showing that I have been able to loose weight in the past, or if I should only show them the high weight for each year. Any suggestions? One time on Jenny Craig I lost enough weight that my BMI was below 35. All the other years, except for this year my BMI was between 35-39. I can't decide if they want to see that I've been fat for the past five years or if they want to see that I've been able to loose weight, but just not keep it off. I also have high cholesterol so hopefully that should help with the approval. (I've never taken medication for it). Thanks for any insight you can provide. As to your question. I don't know the exact answer, but I think I read somewhere that someone else with Fed BCBS researched and determined your surgery cost depends on whether you're inpatient or outpatient. I think they said that if you're outpatient you still have the $100 copay per physician, plus I think $100 to the hospital and then about 30% or somthing of the devise, which could end up costing about $3,000-$4,000. But if you stay overnight then their is no charge for the device, only the couple hundred dollars co-pay for the surgeons. You should call the insurance to double check. I hope this helps! Do you have a date set yet?

I tried my first Zumba class. I got my 7 day trial pass at Bally and they offer the class three times a week. Their classes are free with membership. Once I get paid I'll pay a flat fee of $250 for one year's membership, then I can take all the Zumba I want, all over the country, with free child care. (There's typically not a year commitment, but figure for me I'll have to make the committment.) I'm so excited. It's much cheaper taking it through Bally then with the community center or taking Jazzercise (which I also love). I've also been using all their other equipment in addition to Zumba. Zumba really is a fun class!!! I feel great afterwards! I'm so glad that I found it, and for such a reasonable price and free child care!!!

What insurance do you have? Mine is supposedly easy as well, but I'm still nervous. Everything is ready to submit to my insurance, except for my 5 year weight history. I haven't always been at a 40 BMI, but I do have high cholesterol. I just don't have many years a weight history. I do have some stats from Jenny Craig showing I lost weight twice (but obviously gained it back). Both times I lost weight, my BMI was still above 35. I can't get my weight loss with WW, which I tried a couple of years ago. I just need to gather it all together to submit to insurance, but I'm nervous. I think I should also submit a list of all my other non-supervised weight loss attempts, but I can't remember exactly when they began and my beginning and ending weights. I can't tell if insurance is trying to see if I've lost weight in the past, but was unsuccessful at maintaining it, or if I've always just been obese. My insurance book says I need a BMI of 40 or more, or over 35 with co-morbidities, and prior weight loss attempts have failed. I'm so confused and overwhelmed by this. I supposedly have easy insurance to work with (Federal BlueCross BlueSheild-Basic), but I'm still worried.

I was just curious what insurance you guys have? I'm so nervous about this process!

I have been considering getting a Wii to use for my exercise routine. I was curious if anyone else has used to Wii for the exercise, and if so how they like it. Did the Wii work? Was it active enough to provide an aerobic workout? What games did you play? Did you do the Wii Fit? Thanks for your input!

That's great! I love it. Thanks for sharing!

I don't think my insurance will cover a panni. What insurance did you have?

I'm having a hard time being motivated to loose weight pre-op. It's not required by either my surgeon or insurance, but figured I'd like to go ahead and start the process while I'm waiting for my (hopeful) approval and surgery date. But I'm having a hard time knowing what to do or eat. I've typically joined Weight Watchers or Jenny Craig and then joined a gym. But I just lost my job and I have absolutely no money to spare, so I have to do it on my own. Without having someone or a program tell me what to eat I fell so lost and unmotivated. Any ideas? How do I get the motivation I need and how do I know what to eat. I know this sounds like a silly question, but I've obviously not been very skilled in this area. :redface: Thanks!

So I actually did gain weight. I knew I would still be a little under, so I got ankel weights. I then took out the actual weights from them and stuffed them in my bra. I think that is the safest place. I'm so glad I did it because with those extra 2 pounds I was thrown over into a qualifying BMI. I also drank a ton of water before the weigh in.

I haven't done a sleep study yet, but am scheduled for one. But I did have to do an REE test in the room where the sleep study is. The room was pretty decent. There was a TV with decent cable and a chair with a table to sit and read. I'm scheduled to go in at 8pm. I'm assuming I wont have to go to sleep so soon. I'm hoping they just want me here to go over instructions, get oriented, get ready for bed and relax before going to sleep. I also don't know why I have to go in, even the dr prescribing the study said he doubted I have sleep apnea. Oh well, I guess I'll just jump through the hoops. It'll be my last test, then I think they'll submit my information to insurance :scared2:

You could also throw in a copy of your driver's license. I'm sure any little bit will help. It's probably not going to be a problem, you just have to be a little creative in what you submit.

Hey Becca29, What happened with insurance? Were you able to get your surgery? I'm in the same boat. I currently have a 40 BMI with high cholesterol, but for the past 5 years my weight has been up and down. My BMI was not above 40 until just recently and sometimes it even got below 35 over the past five years. So, does BC/BS Federal just care about a history of BMI over 35, not 40? I'm anxious to hear how things turned out for you. Do you have basic or standard?

You should simply ask your surgeon's office. I am in the same boat. They said that they will weigh me during fevery visit, but the ONLY weight that will be submitted to my insurance company was my first weigh in. Remember, the surgeon wants your business, so they'll help you with what is needed.

I would check with your insurance before deciding. Your insurance may treat both inpatient and outpatient the same, but I think with mine, if I stay overnight I only have to pay a small co-pay for the lap band device, but if I leave the same day I'll have to pay a percentage of the device which would be much more expensive. Just something to look into.

Sorry, I don't know for sure. I had a c-section on August 2009 (as well as in 2007 and 2005) and will likely get the band in August 2010 assuming all goes well , but I'm assuming I could have gotten the band earlier, I just didn't start the process until recently. Plus I know with your federal BC/BS Basic you won't need a six month waiting period. I would go ahead and start the process once you've recovered from your c-section (maybe 1.5-2 months afterward). Then your weight will at least be documented and you can start the process. Even without the six month waiting period, it can still take awhile from the time you start the process to surgery date. Good Luck!

I also have Federal BCBS Basic. I've heard great things about how quickly and generously they approve the surgery. They only thing you'll need is 5 years documented weight and I believe they even want a listing of weight loss attempts. But I believe they will work with you if those requirements are hard to meet. You should be just fine with this insurance :thumbup:

I have my very first appt to start this process on Wednesday. I'm very excited. One thing though, I am just under having a 40 BMI (about 5-10 pounds). I think I have co-morbitities (?), but don't want to deal with proving them for insurance. I am planning on wearing ankle weights and even weights in my jean pockets for the entire appt so I'll be prepared for any weigh-ins. I've already bought the weights. My concern is that I don't plan on wearing these weight the rest of my life. I was curious if anyone else did something similar to this, and if so, how did you go about not wearing them for future appts? Did your doctors notice? What did they think or did they care? By the way, I'm going through Oregon Weight Loss Surgery. Thanks!

It's when your weight finally begins with a "1". No, I'm not talking about 1,000, I'm talking about 199 pounds and below (hopefully not below 100). :scared2:

Oh no! What's going on?

The Word of Wisdom is the commandment that Mormons follow which talk about keeping our bodies healthy. This is why Mormons dont drink alcohol, coffee, do drugs, etc., but it also discusses that we should eat heathly grains and fruits and veggies while they're in season and that we should eat meat sparingly. The last point is why this has been discussed on this Latter-Day Saint (Mormon) sub-forum: that we should be eating meat sparingly per the Word of Wisdom, but with being banded there is a need to eat so much protien. I hope this helps.

I'm also fairly new to this. I live in Oregon and am anxiously awaiting my first consult scheduduled on June 30th. How did you surgery go and how's the success so far?

I think the whole point of the WOW is to keep our bodies healthy in order to gain greater spiritual guidance and keep our souls healthy. I think that despite eating more meat, I will be better able to follow the WOW after I'm banded because my overall health will be better. I wont overeat junkfood and hopefully my cholesterol will go down.

I live in Beaverton, OR and I'm just starting this journey. How has your experiee and progress been so far?

I am in a similar scenario. However, my insurance doesn't require the 6 months waiting period. But I am just 5 pounds below having a 40 BMI. So I'm not trying to loose right now, not until I have the final go ahead with the insurance and have a surgery date set. It feels weird. I keep wanting to go exercise and start this diet going, but know that I have to wait. (I plan on just adding some ankle weights when I go in for the actual weigh-in). It is hard, but I know that if I again try to diet again without the band I'll fail again, and my only hope is getting the band, thus I need to just be patient until I have the tools necessary to succeed this time (the band). Good Luck and just think of the ultimate benefit for waiting.