will i be approved??

[JYNX 0]

hey everyone! i have been driving myself crazy for the last couple of weeks wondering if i will be approved for the LAP-BAND®® and i was hoping i could get your guys' input.

here are my stats:

5'2"

192 lbs

35 bmi

24 years old

CIGNA PPO

i have a family history of hypertension, diabetes, obesity, cholesterol, and high blood pressure. i do not suffer of any of these myself (except obesity), but i do suffer from constant back, neck, knee, heel, pain and severe anxiety.

this friday (oct 1st) i am having my pre-op test done and on the 12th i am having a sleep study. i have met with the surgeon, nutritionist, and psychologist, and have been approved by all of them. what do you think my chances are of being approved by CIGNA?

[BetsyB 9]

It depends entirely on your specific insurance policy.

Mine covers banding for BMI of 35 if there are two comorbidities present. (Family history does not count--they have to be present in the patient.) Your policy may or may not consider back pain and anxiety to be comorbidities. (Mine would accept the back pain.)

Pull out your policy---or pull it up online. It will spell out exactly the conditions you must meet. That way, you'll have no surprises :drool:

(I wonder if your surgeon's office got preapproval before having you submit to all the preop testing; I knew before my first appointment with my surgeon that I was covered---final approval came once they submitted all the specialist clearances. Since you've already jumped through most of the hoops, it sounds as though maybe the insurance specialist at the surgeon's office already is operating under the assumption that you will be approved.)

Edited September 30, 2010 by BetsyB