tsteves1 14 Posted December 30, 2011 Hello! My name is Tracie Steves and I am just started my attempt to take the Lap Band journey. I will attend the seminar on January 11th and turn in the paperwork at that time. I plan to contact the insurance company next week, I have just switched from Select Health to United Healthcare and all I know so far is that they cover it but I don't have the requirements for my plan yet. I found this board that night and it had a lot of helpful information so I decided to join early. It sounds like this is a roller coaster of a journey but I am excited at the prospect. Share this post Link to post Share on other sites
Cocoabean 430 Posted December 31, 2011 If you have your new health insurance card, you should be able to look up the requirements online. Most companies have their policies posted for members. Take a look around. A quick google took me to this: https://www.unitedhe...ric_Surgery.pdf Bariatric surgery, as a primary treatment for weight loss is proven for the following: 1. Class III obesity (BMI > 40 kg/m2) 2. Class II obesity (BMI 35-39.9 kg/m2) in the presence of one or more of the following co- morbidities: Type 2 diabetes Cardiovascular disease (e.g., stroke, myocardial infarction, stable or unstable angina pectoris, hypertension or coronary artery bypass) Life-threatening cardiopulmonary problems (e.g., severe sleep apnea, Pickwickian syndrome, obesity-related cardiomyopathy) The following bariatric surgical procedures are proven for the treatment of clinically severe obesity as defined by the National Heart Lung and Blood Institute (NHLBI) in adults: Gastric bypass (Roux-en-Y; gastrojejunal anastomosis) Adjustable gastric banding (laparoscopic adjustable silicone gastric banding) – See FDA section/information Gastric sleeve procedure (also known as laparoscopic vertical gastrectomy or laparoscopic sleeve gastrectomy) Vertical banded gastroplasty (gastric banding; gastric stapling) Biliopancreatic bypass (Scopinaro procedure) Biliopancreatic diversion with duodenal switch Best wishes!!! Share this post Link to post Share on other sites
New Me 0 Posted December 31, 2011 Good luck. You picked a good place for info sharing. Share this post Link to post Share on other sites
tsteves1 14 Posted January 4, 2012 Thanks for the welcome. My new insurance company finally had all of my info up on Monday so I called yesterday and got the ball rolling, sadly in a different direction I had previously started but everything sounds ok so far. I cant use the surgeon I originally chose because my insurance requires i go through their resource center. They explained my benefits, what is covered and what percentages I will be required to pay and sent my info to a case worker who will call me in the next 2 days to explain the requirements further, get me set up with a surgeon and get a nurse case worker set up for me. Now I am just trying to figure out what I will have to pay as my deductible is 2k and the insurance company pays 80% after I meet that, however my OOP max for my insurance is 4k. I am trying to figure out if that means I will have to pay a max of 6k or 4k. I am sure the case worker will explain it all to me. Share this post Link to post Share on other sites