decision making

SisterMadly · July 27, 2003

My husband and I are both considering the band. He has 175+ pounds to lose and I have about 75. He has his first consult with Dr. Li in Burlingame, CA in a couple of weeks and is really excited.

I, on the other hand, am trying to get pregnant right now and don't think it is the right time for WLS. After I am done with having babies, I will be more open to having surgery. By the way, if anyone here has had infertility issues related to PCOS on this board, I would love to talk to you in particular.

My husband's main concern right now is whether or not to go with the band or RNY. Of course, insurance is more likely to cover the RNY, a story many of you have heard a million times. I am willing to private pay for the band, even if that means going out of the country. He has a "wait and see what the insurance says" attitude.

I am very supportive of his endeavors to lose weight and will be there every step of the way. After having read a few posts on the friends and caregivers section of Spotlight Health, I am a little nervous about the psychological toll of weight loss on both partners in a marriage, but we are committed to working it out together.

quakergirl · August 1, 2003

It's good that you're being so supportive and planning to work on this together. Personally, I think the lap-band makes it easier to adjust emotionally to the changes because the weight loss is more gradual than with the RNY. However, I guess any weight loss can cause emotional issues to surface.

I hope that your insurance covers the band. Some companies are more open-minded than you might expect. I was pleasantly surprised at how easy it was to get approved (I had United Healthcare). Personally, I am not that enthused with the RNY. Since the lap-band is so much safer and less drastic, I think it's a better first choice for most people than the RNY is. You can always go back and get the lap-band revised to an RNY, but if you have trouble after a RNY there are not as many options left. So I'm really glad the lap-band was a choice for me.

Good luck

tanna · August 1, 2003

I can relate to your desire to have a baby! I too want to have another child. I decided to go ahead and have the lapband surgery to lose as much weight as possible before getting pregnant. I have a lot more to lose than you do so I feel like it was a good decision for me! One of the main reasons I chose this surgery was because the level of restriction can be adjusted when you are pregnant! I liked that feature a lot!! Good luck to you and your husband on your weight loss!

roxanne · August 2, 2003

Hi, my husband and I were both approved for the band he has since chickened out but I am going ahead with it and will be having it done on Monday.Our insurance approval was quick the Dr. office faxed it in on June 9th and the approval was stamped on the 12th,no questions asked.My BMI is 35 but was approved dut to diabetes.If I do well my husband will have it done the approval is good till Dec. Roxanne

Alexandra · August 2, 2003

Wow, Roxanne, congratulations on your quick approval! Can you share some information on your insurance? Who is the carrier, and what sort of plan do you have? (And what state are you in?)

roxanne · August 2, 2003

Alex, I have Blue Cross/Blue Shield Alliance Select.It is hard to beleive that my husband and I both had our consult the same day and got our approval letters the same day.No questions asked.I was floored and I cried because I really thought I would be denied or at least have to fight them.I think alot of it has to do with the Dr.'s letter and how convincing it is.I wish I could help you more.There is a lawyer that has been listed on obesityhelp.com at different times but I never paid any attention to his name cause I didn't need him.Is going to Mexico an option for you?I hear it is fairly affordable done there.Just don't give up keep trying.I know medicare even pays for it my aunt is on disability and medicare paid for hers, so if the goverment is paying for it I don't see why insurance companies are draging there feet.I wish I had a copy of the letter my Dr. sent into insurance co. to get me approved and I would share it with you but I don't suppose he would share his letters.Let me know how it's going for you. Roxanne

Alexandra · August 3, 2003

Hi Roxanne,

Thanks for the info! I wasn't asking for myself, though--I'm just very interested in which plans cover the band and what their policies are. I'm sort of doing an informal ongoing survey.

A lot of people seem to think that BCBS is evil, but I've now heard of several states' BCBS organizations that do cover it. Your experience is amazing! Do you work for a large company or is your plan a standard one? Can you tell me what "Alliance Select" means?