a little help needed

[xOkrystah 0]

i have just made an appointment with a surgeon for Feb 3rd. I have been trying to do as much research as possible online and gettin some stuff mailed to me but i seem to get many different answers and opinions based on different peoples stories and expieriences. i have lots of questions and juts need a litttle help

thanks

[TinaM 0]

Hi there-

Some descrepancies may be due to BMI and other medical factors. So when it comes down to it you have to follow your surgeons protocol so pick a good surgeon.

Looke at the lap band system and realize systems website, here, obesity help.com BUT above all else attend some support groups. My area mixes those that are pre and post op and it is great to hear from live people you can ask questions. I found it even better when the support group mainly consisted of person's who used my surgeon.

Good luck in your journey.

[xOkrystah 0]

i do plan on attending a meeting but its hard i just started school this month and its at night id never be able to pull it off right now. im more concerned about my insurance not approving me. i am roughly 5'2 and 220 but i bounce back and forth from 220 to 240 because i have struggled with severe binge cycles very often because i have just never felt full. so im looking at this band as a chance to finally get some control in my life over my constant hunger

[HappyHomeCC 2]

i do plan on attending a meeting but its hard i just started school this month and its at night id never be able to pull it off right now. im more concerned about my insurance not approving me. i am roughly 5'2 and 220 but i bounce back and forth from 220 to 240 because i have struggled with severe binge cycles very often because i have just never felt full. so im looking at this band as a chance to finally get some control in my life over my constant hunger

Just like me on height and weight! I am from MA too originally been out here 17 yrs ;o)

[xOkrystah 0]

ahh yes good old MA my whole life but to be honest id much prefer to be sittin in nyc right now =) so your my height? and what was your starting weight? im worried they wont approve me even tho i have reached welllll over 220 many times and never feel full

[HappyHomeCC 2]

ahh yes good old MA my whole life but to be honest id much prefer to be sittin in nyc right now =) so your my height? and what was your starting weight? im worried they wont approve me even tho i have reached welllll over 220 many times and never feel full

I am happy in CA ;o) love the weather, it beats that snow any day! LOL

yes I am the same height and starting weight as you. I have been as high as 235. I had to do 3 months of supervised nutritional counseling and show a willingness to make changes and follow a plan. I have no co-morbidities.

[ParrotheadCathy 0]

Your BMI at 220 lbs is 40.2-40.3.

I suggest that rather than worry about your insurance, CALL THEM! Look on your card. There should be a customer service phone number (probably an 800 number). Call them, tell them you need further information on coverage.

Tell them you want to have lap band surgery SPECIFICALLY as some policies will cover gastric bypass but not lap band. They will ask for your policy number will confirm coverage (or tell you it's not covered but hopefully not that:smile2:). THEN ASK

1. What are the other requirements? They may require: (a) a supervised diet for some period of time; ( a weight history for a period of time -- bear in mind that every time you go to the doc for anything, they weigh you so that is probably not hard to get; © a visit or visits with a nutritionist (your surgeon should have a nutritionist in the office or make referrals); a psychlogical evaluation (again, your surgeon should have one in the office or make referrals).

2. Confirm your deductible and percentage the insurance will pay after you meet your deductible....don't want any surprises later!

3. Ask if they can give you a list of bariatric surgeons in your area that are on your policy --- that way you can start your research on only those docs your insurance would pay.

4. ALSO ASK if they require that the surgeon use a hospital versus a surgical center and if they require that he/she use a particular surgical center. I've read a couple of posts where their surgery ended up not being covered because the doctor used a location the surgery that was not approved by the insurance company.

5. And ask if there are any other details that you need to know about, such as if they require any specific pre-op testing (just so you know that your doc does everything necessary to get the approval on the first try).

[xOkrystah 0]

ahhh thank you guys sooo soo much. i have aetna so ill have to do some extra research and phone calls and hope for the best. i need to keep you 2 around now lol very very helpful

[happy2lose 0]

If binging is your issue, I suggest you also research the sleeve procedure.

[HappyHomeCC 2]

ahhh thank you guys sooo soo much. i have aetna so ill have to do some extra research and phone calls and hope for the best. i need to keep you 2 around now lol very very helpful

I have aetna choice POS II covered at 90% or what ever detuctible you have to meet, my max would have been 1500 but I only had 800 left to meet so that is what it cost me.

If you work for costco it will cover

[AZSunshine 0]

Your BMI at 220 lbs is 40.2-40.3.

I suggest that rather than worry about your insurance, CALL THEM! Look on your card. There should be a customer service phone number (probably an 800 number). Call them, tell them you need further information on coverage.

Tell them you want to have LAP-BAND® surgery SPECIFICALLY as some policies will cover gastric bypass but not LAP-BAND®. They will ask for your policy number will confirm coverage (or tell you it's not covered but hopefully not that:smile2:). THEN ASK

1. What are the other requirements? They may require: (a) a supervised diet for some period of time; (:tongue: a weight history for a period of time -- bear in mind that every time you go to the doc for anything, they weigh you so that is probably not hard to get; © a visit or visits with a nutritionist (your surgeon should have a nutritionist in the office or make referrals); a psychlogical evaluation (again, your surgeon should have one in the office or make referrals).

2. Confirm your deductible and percentage the insurance will pay after you meet your deductible....don't want any surprises later!

3. Ask if they can give you a list of bariatric surgeons in your area that are on your policy --- that way you can start your research on only those docs your insurance would pay.

4. ALSO ASK if they require that the surgeon use a hospital versus a surgical center and if they require that he/she use a particular surgical center. I've read a couple of posts where their surgery ended up not being covered because the doctor used a location the surgery that was not approved by the insurance company.

5. And ask if there are any other details that you need to know about, such as if they require any specific pre-op testing (just so you know that your doc does everything necessary to get the approval on the first try).

This is FANTASTIC advice.

Also wanted to add, DOCUMENT EVERYTHING!!!!!!!!! Dates and times of phone calls, the name of people you spoke to, etc. Keep detailed, thorough notes.

If at all possible, have them fax or mail you a list of requirements for the surgery... that way you have IN WRITING what exactly you need to do in order to be approved.

Good luck, I hope everything goes well!!!!!!

[BigMomma 0]

ahhh thank you guys sooo soo much. i have aetna so ill have to do some extra research and phone calls and hope for the best. i need to keep you 2 around now lol very very helpful

If your Aetna policy has coverage visit the Aetna website for Clinical Policy Bulletins. I think the obesity surgery is either 150 or 157. It will show you Aetna requirements.

- Val

[xOkrystah 0]

i think i might switch to harvard pilgrim cuz aetna is giving me a hard time letting me back on. but how long after your 1st meeting with the surgeon is surgery usually booked?