Don't know where to start!

[gind 0]

Ok So I have Higher Education Consortium Benifits Trust from Arkansas and I don't know where to start. They will pay 10,000 per lifetime for lapband which I think is GREAT. I am currently 260 and need to be at 120 for idea body weight. First about how much does it cost, I am attending a seminar in June with the surgreon I picked.(which wasn't hard...there is only one!) but I want to know what I am up against with insurance. Do I need to look into diet plans, start accumlating data.....I'm so CONFUSED!!!!!! I finally have my family on board with me and my husband is GREAT and has always been supportive. I just don't want heart break and find out that I get denied.

[NewStart95987 35]

Ok So I have Higher Education Consortium Benifits Trust from Arkansas and I don't know where to start. They will pay 10,000 per lifetime for lapband which I think is GREAT. I am currently 260 and need to be at 120 for idea body weight. First about how much does it cost, I am attending a seminar in June with the surgreon I picked.(which wasn't hard...there is only one!) but I want to know what I am up against with insurance. Do I need to look into diet plans, start accumlating data.....I'm so CONFUSED!!!!!! I finally have my family on board with me and my husband is GREAT and has always been supportive. I just don't want heart break and find out that I get denied.

I'm not sure about your insurance but you may want to try looking up the coverage/requirements online so you have something in writing. OR call the insurance and ask what the requirements are then have them send you, IN WRITING, what the policy is. Different insurances and different surgeons ALL have different requirements. You may even be able to get some of this information from your surgeons office who, chances are, have dealt with your insurance before. I would start there.

You may or may not have to show proof of dieting or 6 months work of some kind of program. If you have done WW or something of that sort, I would have that information ready to go just in case, start digging for that information now. Better safe than sorry! Believe me! My surgeon has a $3,000 non-professional fee which insurance will not cover. I would also ask if your surgeon has a "non-professional fee" so you may be able to look into how you may pay that. I don't know your financial situation but I had to figure out a way to pay since I didn't have it sitting in the bank.

Good luck to you and again, from my experience, I would try and get everything in writing. I have seen some people take YEARS to get everything finalized and others just a month. Be patient, don't get discouraged! Your husband will help you with support and so will the thousands of people you will read and will read your posts right here on these forums!

BEST of Luck!

[Diva01 1]

I totally agree, you need to check with your insurance company to see what is the criteria for bariatric surgery. I would call your insurance company and ask for the requirements and where on the insurance website can you find this information. I have BCBS and they were great about walking me through step by step while I was on the phone and on the internet at the same time. So far, I have learned a valuable lesson in my journey, I started my process in January with my surgeon, at the time all I needed was 3 consecutive months of nutrition visits, a qualifying bmi, and one visit to the psychologist. I was thrilled! One day I was checking the website and saw that beginning in March BCBS was extending the nutrition visits to 6 months. My heart almost dropped. I called and was told that the information was correct. At first I was livid because I was so close. But I thank god because they could have done away with it all together. So, I have learned that you have to stay involve and up to date with the insurance company and their changing policies. Before I called the insurance company I had a list of questions from how much my out of pocket would be, clarification of the criteria to qualify for the surgery, and how long they had to approve my surgery. I could have gone with weight watchers for the six months of nutrition visits, but I chose to go with the dietician at my surgeon's office. I have read how people have had problems with approval because of the nutrition visits and I thought my going to the dietician that would eliminate that problem. In her documentation, she is thorough on my diet and increase in exercise and know exactly what the insurance is wanting. I hope this helps! And I am glad you have support from your family because that can make a huge difference. Good Luck