Insurance question

[missjoli 0]

Hello all! I'm just starting my research into the lap band procedure and am attending a seminar at the end of the month. I will be 33 in July and have 3 children under 3. I have struggled with weight all of my life and am at my highest weight now (I'm guessing 260 but haven't been on a scale in 5 months since I gave birth to my daughter). Anyway, our insurance says "Not Applicable" under bariatric surgery. But there are some things listed as "Not covered." Does anyone have any experience with this or know if it's possible to get it covered when the insurance says "N/A" under coverage? I'm afraid to get my hopes up.

[readytolosemomof5 0]

It won't hurt to check it out. My insurance paperwork says it won't cover weight loss surgery, but after digging around a little bit, I found out that it did! I'm still not going to use it, but that's another story. Also, keep checking around, there are financing options, healthcare flex spending accounts, etc. Good Luck!

[Rachel412 116]

I'd definitely call them to check.

[missjoli 0]

Thanks for your replies. I know the bariatric place where I'm going will handle insurance stuff, but maybe I'll do a little more digging before I go to the seminar. i'm just now learning that some companies make you see a dietician for 6 months and/or have other stipulations. Now I'm afraid this could get complicated. The research is overwhelming. Especially when I have next to no downtime (stay at home mom to 3 under 3). This forum looks very informative!

[nayttap 4]

Thanks for your replies. I know the bariatric place where I'm going will handle insurance stuff, but maybe I'll do a little more digging before I go to the seminar. i'm just now learning that some companies make you see a dietician for 6 months and/or have other stipulations. Now I'm afraid this could get complicated. The research is overwhelming. Especially when I have next to no downtime (stay at home mom to 3 under 3). This forum looks very informative!

My insurance says NO coverage for weight loss surgery, except in the case of morbid obesity............morbid obesity is >40 bmi, or >35 bmi with one or more comorbidity like sleep apnea, hypertension, etc.

It is a journey towards weight loss surgery, a marathon, not a sprint.

I too, prefer a sprint..................but am finding it is truly a journey.

[readytolosemomof5 0]

Thanks for your replies. I know the bariatric place where I'm going will handle insurance stuff, but maybe I'll do a little more digging before I go to the seminar. i'm just now learning that some companies make you see a dietician for 6 months and/or have other stipulations. Now I'm afraid this could get complicated. The research is overwhelming. Especially when I have next to no downtime (stay at home mom to 3 under 3). This forum looks very informative!

The group that I'm going to- True Results- would've walked me through the whole process had I chosen to use my insurance, and would've done it all- the physician directed diet plan, nutritionist consult, everything. The only reason I am not going through my insurance is that I would have to come up with 8 grand out of pocket for the deductable, and the surgery only costs 9,900 all inclusive self pay. But the way I am doing it, I only have to come up with $400 cash thanks to our health flex spending account, and guaranteed financing through True Results for the rest. My goal is to be banded late July, early August.

So definately check around to different surgeons, groups. Hook up with people that are near you that have had the band, make sure you check out all your options.

[mytwomiracles 0]

Hello all! I'm just starting my research into the lap band procedure and am attending a seminar at the end of the month. I will be 33 in July and have 3 children under 3. I have struggled with weight all of my life and am at my highest weight now (I'm guessing 260 but haven't been on a scale in 5 months since I gave birth to my daughter). Anyway, our insurance says "Not Applicable" under bariatric surgery. But there are some things listed as "Not covered." Does anyone have any experience with this or know if it's possible to get it covered when the insurance says "N/A" under coverage? I'm afraid to get my hopes up.

My insurance policy says the same thing but I called (and happen to get a nice guy) and he told me what I have read but then I told him what if my PCP is recommending due to an illness and he said it will have to go through appeal but to make sure my doctor provides historical information and he even gave me the fax number to give to my PCP lol

I am praying to God each night that I get approve.

Good luck.