Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

Hi there! New to the boards and just starting my lap band journey. I am gathering as much information as possible. I am 99.9% sure this is what I want to do. I think my biggest obstacle right now is getting Kaiser to cover my procedure. I am 36 yr old, 5'4" and 234 lbs. I have a BMI of 40 and was diagnosed with PCOS a year ago and have been taking Metformin and unable to lose weight. So frustrating!!! Anyway, just wanted to say hello, and I look forwarding to getting know all of you :)

Share this post


Link to post
Share on other sites

Hi there! New to the boards and just starting my lap band journey. I am gathering as much information as possible. I am 99.9% sure this is what I want to do. I think my biggest obstacle right now is getting Kaiser to cover my procedure. I am 36 yr old, 5'4" and 234 lbs. I have a BMI of 40 and was diagnosed with PCOS a year ago and have been taking Metformin and unable to lose weight. So frustrating!!! Anyway, just wanted to say hello, and I look forwarding to getting know all of you :)

I don't want to discourage you from the band, but I have heard that Kaiser won't pay for it--only the RNY. You may already know this. Just check it out thoroughly. all the best to you. You will find that the folks who post here are very knowledgeable and supportive. Drop in often.

Melinda

Share this post


Link to post
Share on other sites

Hi Ladies! Thank you for the welcome! Yes, I have heard that Kaiser won't cover it, or it is a miracle if they do. I will explore my options with them and if I get no where I will just pay cash. It would be nice to actually have your insurance company do something for you, but in the end I will do what it takes to have this surgery! I have been lurking here for a few months, and yes everyone here is very knowledgeable and I can't wait to learn as much as I can biggrin.gif

Share this post


Link to post
Share on other sites

Hi, I too have Kaiser in Nor CAL, just depends on coverage provided, I have checked 3 times now and lap band for me is coverd consider outpatient surgery as Gastic is considered hospital stay which is double of outpatient costs

Share this post


Link to post
Share on other sites

Hi, I too have Kaiser in Nor CAL, just depends on coverage provided, I have checked 3 times now and lap band for me is coverd consider outpatient surgery as Gastic is considered hospital stay which is double of outpatient costs

Thank you! That is great to know! I am praying that this works out for me!! Where are you in the process??

Share this post


Link to post
Share on other sites

Hello,

Congratulations on the beginning of your journey. I have Kaiser Permanente in Ohio and was told by their bariatric coordinator that they would cover RNY, sleeve and band. I have the PCP visit on August 24, so I will learn more then. I am 5 ft tall with a BMI of 37.1, but I also have three of their 4 hot button co-morbidities, diabetes, high cholesterol and high blood pressure. I probably have number 4, sleep apnea, as well but have never been tested. She seemed pretty confident that it was a slam dunk. PCOS is a pre-diabetic condition and you are already on a diabetic medication. Have you been tested for apnea? With you BMI I don't know why they wouldn't cover it. Except that prevention is just not the way our health care/insurance system works.

I wish you the best of luck. I be cheering for you.

Robbie :party:

Share this post


Link to post
Share on other sites

Thank you! That is great to know! I am praying that this works out for me!! Where are you in the process??

I just begun myself last week,, I have my inital class/consultation 9/2, my regular dr gave me a "heads up" to start early losing the weight so I'm shooting for 15-20lbs off by 9/2, He put me on 1200/day calorie diet and work out 50min a day routine biking and swimming , was told Surgeon asks for 10% weight lose, for me that 42 lbs, So far not really hungry, and have a slight bit more energy, sure the cravings will it soon, just have to get through it, luckily my wife is also trying to lose weight, not through surgery but we are watching what we eat and no more junk food, sodas, juices. Best of luck to you

Share this post


Link to post
Share on other sites

Hello,

Congratulations on the beginning of your journey. I have Kaiser Permanente in Ohio and was told by their bariatric coordinator that they would cover RNY, sleeve and band. I have the PCP visit on August 24, so I will learn more then. I am 5 ft tall with a BMI of 37.1, but I also have three of their 4 hot button co-morbidities, diabetes, high cholesterol and high blood pressure. I probably have number 4, sleep apnea, as well but have never been tested. She seemed pretty confident that it was a slam dunk. PCOS is a pre-diabetic condition and you are already on a diabetic medication. Have you been tested for apnea? With you BMI I don't know why they wouldn't cover it. Except that prevention is just not the way our health care/insurance system works.

I wish you the best of luck. I be cheering for you.

Robbie :party:

Robbie thank you so much! I have not been tested for apnea, maybe I will look into that! My husband tells me I do snore a lot rolleyes.gif and I often wake up tired like I haven't had enough sleep even after 9+ hours in bed. I know what you mean, prevention is the key! I don't have my appt with my PCP until 9/9, wish is was sooner, I am so ready to get this journey started! Keep me updated on your progress with Kaiser! Good luck!!!!

Share this post


Link to post
Share on other sites

I just begun myself last week,, I have my inital class/consultation 9/2, my regular dr gave me a "heads up" to start early losing the weight so I'm shooting for 15-20lbs off by 9/2, He put me on 1200/day calorie diet and work out 50min a day routine biking and swimming , was told Surgeon asks for 10% weight lose, for me that 42 lbs, So far not really hungry, and have a slight bit more energy, sure the cravings will it soon, just have to get through it, luckily my wife is also trying to lose weight, not through surgery but we are watching what we eat and no more junk food, sodas, juices. Best of luck to you

I have too heard that they like you to lose weight prior to surgery. I recently re-joined weight watchers hoping for some loss and to be able to prove to them that I am trying. I have done WW before, it is a great program. I just need the weight to stay off after I lose it rolleyes.gif. Good luck! Keep me updated on your experience with Kaiser! I am rooting for you!!!

Share this post


Link to post
Share on other sites

Hi, I was just wondering how the Kaiser thing was going for you? I'm also lookin into getting the surgery and I also have Kaiser.

Share this post


Link to post
Share on other sites

I had my surgery done through kaiser in 2010. The issue you will have is that you only have 1 co morbidity. You need two with a BMI of 40. I have diabetes and I had high blood pressure.y BMI was 35. You can have NAND RnY or the band and I think they are covering sleeve now as well.

Share this post


Link to post
Share on other sites

Hi, I was just wondering how the Kaiser thing was going for you? I'm also lookin into getting the surgery and I also have Kaiser.

Hi!! The Kaiser process has been looooonnngggg! They will cover gastric bypass, the sleeve and the band. I have a BMI of 39 and only one co-morbitiy. I really think it depends on each persons situation. After all the classes, psych eval, and bariatrician appointment I have decided on the sleeve. I just feel it is the best fit for "me". Good luck with your journey, be patient and know it will take you about a year to get through everything. :)

Share this post


Link to post
Share on other sites

Where do you have Kaiser? I have it in Southern Cali. My BMI is 40 something, but I don't have comorbidity. Can I still qualify?

Share this post


Link to post
Share on other sites

Where do you have Kaiser? I have it in Southern Cali. My BMI is 40 something, but I don't have comorbidity. Can I still qualify?

Hi! Yes I am still with Kaiser. I think if your BMI is 40 you don't have to have any comorbities. I have PCOS, and insulin resistance. So not really "red flag" co morbities. I am going through the Fontana facility. Which one are you looking into??

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×