Edivel 0 Posted October 2, 2010 So, Im going through Weight loss centers, top surgeons, 1-800-getslim...or whatever they are called and intially i was told that they verified my insurance and my lap band would be covered and that I only need 1 month of nutrition class. Well, now Im told I need a 12 month medically supervised diet and excerise program and that my insurance is not going to pay for this. I called them and that is what they said ..( the insuarance) so im so upset right now and have been since they told me. I dont know what to do now....:smile2: Share this post Link to post Share on other sites
BetsyB 9 Posted October 2, 2010 If I'm correct in understanding that your insurance has in fact verified that banding is not a covered procedure, your best bet is to make a case for an improvement in coverage to your employer. (If pressured--and convinced that providing this coverage will cost them less than covering comorbidities and absenteeism of morbidly obese employees, they may change the policy when it's time to renew.) Can you get coverage through a spouse's employer? (Or vice versa--through your own, if you are currently using your spouse's insurance?) If so, read the available policies to determine which is most favorable for bariatric surgery. I would not assume anyone in the doctor's office [italic]lied[/italic]. Sounds like there was a mixup, and they thought you were preapproved----and notified you as soon as they discovered the error. Share this post Link to post Share on other sites
racheyrach 0 Posted October 2, 2010 wow a 12 month thats alil excessive! thats a really big upset. but you have to think to your self realize the cost of the 12month program see if you can do that. or cost of lap band out of pocket (payment plan option) but you gotta think is this worth the cost of a new life everyone wants things to happen faster but hey do the program and get it done so you can. cuz its either do this or keep gaining weight! a year from now you can have ur surgery or you could be wishing that you did it and be more overweight and your health deteriorating more. time goes by fast and you will get there:smile2: Share this post Link to post Share on other sites
Edivel 0 Posted October 2, 2010 Well, our insurance does cover the lap band or any weightloss surgery but they want me to do a 12 month medically supervised diet and excerise program so now i have to do that before i get the surgery. I guess I have to do it..dont know what else to do at this point. thanks for the responses.:smile2: Share this post Link to post Share on other sites
racheyrach 0 Posted October 2, 2010 Well, our insurance does cover the LAP-BAND® or any weightloss surgery but they want me to do a 12 month medically supervised diet and excerise program so now i have to do that before i get the surgery. I guess I have to do it..dont know what else to do at this point. thanks for the responses.:smile2: lets put a positive spin on the process! you will be losing weight before the surgery which makes you getting the band so much more successful. because as people put it this is not going to be a "magic fix" you are going to have to do the exercise and the food after the surgery you will be more educated and this will get you prepared AND in shape able to do more exercise than most people which means losing weight faster!! BE POSITIVE!!! Share this post Link to post Share on other sites
BetsyB 9 Posted October 2, 2010 Oh, sorry I misunderstood. A year does sound terribly discouraging. But think of how well prepared you'll be! You'll have lots of opportunity to work on the habits that will make you a banding success. (You never know, either; my insurance changed from a six-month to a three-month supervision right before I started the process. Maybe during your wait, the policy will change, and you'll get to the OR sooner.) I know it's really frustrating--but it will be worth the wait. It really will. Share this post Link to post Share on other sites
btrieger 21 Posted October 2, 2010 PLEASE PLEASE PLEASE Do a Google search on them. They are notorious for being dishonest; sloppy and even killed a couple of people. Find another surgeon in LA, there have to be hundreds. Share this post Link to post Share on other sites
arittel 0 Posted October 4, 2010 When they say a 12 month weight loss program, make sure they don't have any "Catches" to that. I chose Weight Watchers because it was one of my insurance company's approved WEIGHT LOSS PROGRAMS. Only to find out 3 months into my 6 month time frame that because my Weight Watchers Team Leader was NOT a certified Dietician or a licensed nutritionalist it did NOT count as part of my 6 months. GRRRR!! So I did it through my doctors office . Share this post Link to post Share on other sites
Cali Sal 0 Posted October 4, 2010 PLEASE PLEASE PLEASE Do a Google search on them. They are notorious for being dishonest; sloppy and even killed a couple of people. Find another surgeon in LA, there have to be hundreds. Yes, I think you should find another surgeon. I'm in the LA area too and I'm going through the USC Bariatric Dept, my surgeon is Dr. Katkhouda. He is an excellent surgeon and my experience has been nothing short of incredible. My insurance would only cover certain doctors and he was one of them. Those 1-800-get-slim people have billboards up all over the LA area and that alone raises red flags. Share this post Link to post Share on other sites
SecondHandRose 0 Posted October 5, 2010 Hi BTRIEGER, we live in the same area...have you heard of Dr. Marsden? Who did your surgery?? Share this post Link to post Share on other sites
btrieger 21 Posted October 5, 2010 Hi BTRIEGER, we live in the same area...have you heard of Dr. Marsden? Who did your surgery?? Dr David Kim in Colleyville. I researched Dr Marsden as well and he is great. Dr Kim's office just happened to be more convenient. It was halfway between my home and work. Share this post Link to post Share on other sites
whatever 2 Posted November 2, 2011 I also went to USC, Dr. Peter Crookes was my surgeon. I couldn't be happier with the care I received, or the outcome. I have been at goal now for about months. I lost 136 lb... went from 296 to 170. Everyone at USC treated me professionally, and the care was excellent. Share this post Link to post Share on other sites
SkinnyMiniMe 63 Posted November 2, 2011 Search for a Center of Execellence in your area. They will guide you along properly with your insurance mine its going to take only 10 weeks or less --start to finish. Good Luck Share this post Link to post Share on other sites
Dawn200321 146 Posted November 2, 2011 12 month diet does seem like a long time. I agree with the others however. Use that time to prepeare yourself for what is coming. Learn new eating habits so on and so forth. That way when you get your band you will do excellent! I mean what is 1 more year of your life to change your life forever? Share this post Link to post Share on other sites
Kaye21 46 Posted November 3, 2011 I know it stinks but it will go by fast. I had to do it for 6 months and it only felt like 2 or 3. Share this post Link to post Share on other sites