Ready to make this happen, but i'm worried!

[MaybeBanding26 5]

i am soon to be a former student. i have been in college and without usable health coverage for about ten years. i saw doctors intermittently, i havent had a PCP in about 13 years.

so, now i have a job like a real grown up and im getting benefits and i want to have lap band surgery. i have an aetna hmo in case that matters. my worry comes with all this talk of a 5 year history that is required. where on earth will i get that if i havent seen a doctor in like two years??? ive been obese since childhood, but hospitals arent really that great at keeping records are they?

so, what am i supposed to do when my obvious girth isnt enough?

granted i havent started the process yet, i havent even decided on a doctor (PCP nor surgeon) but i like to be able to plan, so i figured i would ask now. this forum is super helpful! thanks for reading!

[oliviasmommy 0]

Call your ins company find out if its covered and see your psp he can help with the paperwork good luck

[MaybeBanding26 5]

as soon as i get word that everything has gone through and i have coverage i will do that, thanks!

in the meantime though, if someone hasnt really been going to doctors, what are some options for this 2-5 year history thing?

[btrieger 21]

Aetna only requires a 2 year history.

Did you see a doctor in 2007 or 2008 at all?

I had records from 2 doctor visits in 2008 and the lapband surgeon's office said my visits there would cover 2009.

[MaybeBanding26 5]

I do believe that i had at least one visit in 2007, nothing in 2008 though. and at that visit i was too heavy for the scale, so there's no recorded weight. is that sufficient?

[btrieger 21]

Bariatric surgeon's have specialists in their office for dealing with insurance companies.

Call a local bariatric surgeon and ask your questions to the person that answers. Many of them will answer simple questions without ever asking your name.

If the questions are answered in a positive way you can make your appointment for initial consultation while you're on the phone.

At the top of this page there is a tab to click for surgeons. Give one a call. It can't hurt.

[Blaze21 5]

Although I've been obese since childhood, I didn't have medical coverage from the time I was 15 to 27. I got my surgery when I was 28. I had my new doctor write a letter to my insurance company explaining my medical history.

See if your current pcp will write a letter to your insurance company, on your behalf. Have him/her explain your weight history and medical issues in the letter. Every little bit of information can help.

Good luck!

[MaybeBanding26 5]

thanks blaze, that sounds a lot like my situation. i dont actually have a pcp right now, and my benefits and coverage dont start until jan 2nd. but ive been browsing through the list on the aetna site. i feel silly, i dont even know how to go about picking one! i guess i'll just close my eyes and point, then meet the person and figure out if i like them or not.

[btrieger 21]

Where are you located? The larger metropolitan areas seem to have countless bariatric centers and surgeons.

[MaybeBanding26 5]

philadelphia

[Blaze21 5]

philadelphia

If you can get to Darby, I recommend Dr. Ramachandra. He's affiliated with Mercy Fitgerald Hospital. He's absolutely wonderful.

[MaybeBanding26 5]

If you can get to Darby, I recommend Dr. Ramachandra. He's affiliated with Mercy Fitgerald Hospital. He's absolutely wonderful.

is he a bariatric surgeon or a PCP?? either way, thanks for the rec! darby isnt far from where i live, i used to work at mercy fitzgerald.

[Blaze21 5]

Sorry about that. He's a surgeon. He has a great staff as well.

[MaybeBanding26 5]

no biggie...i went to the aetna site and put his name in right after i asked that. :thumbup: so, he does bariatric surgery? there isnt much info on aetna, but he is in network so thats good news!

[Cocoabean 430]

I used Weight Watchers records to prove a history of diet attempts. I'd think something like that might work to prove weight as well. If you did any type if weight loss program, submit that.

If it doesn't apply to you, hopefully it might help someone else.

Denise