connie3 43 Posted May 31, 2012 Im new here and I love reading everyone's experiences. I always thought that bariactic surgery was just the easy way out until a friend got the fobi pouch. It's been quite a journey for her and has made me look at weight loss surgery in a completely different light. I am very interested in getting the lap band, but I don't think my doctor wants me to get it and I need her recommendation.. Right?! If anyone can help with their experiences that would be great. I'm 30 and about 260... My BMI is EXTREMILY high so there is no question that I do qualify for this surgery. Share this post Link to post Share on other sites
Teresa555 7 Posted May 31, 2012 Well not really what insurance do you have? My ins requires that you have a BMI of 40 or higher or a BMI of 35 with two comorbids and I have to use an in network doctor!! Share this post Link to post Share on other sites
connie3 43 Posted May 31, 2012 I have Kaiser Permanente. I checked my policy and it said that it doesn't cover it. Do I just go to my doctor and say I want this done? Share this post Link to post Share on other sites
connie3 43 Posted May 31, 2012 *does! Not doesn't! Lol Share this post Link to post Share on other sites
lolitawantsaband 45 Posted May 31, 2012 I have a PPO so I didn't need my PCP I made my appointment with the Surgeon and got all the info I needed and started my journey. Good luck with your everything! 1 duckydoom reacted to this Share this post Link to post Share on other sites
lolitawantsaband 45 Posted May 31, 2012 *with your journey* oops Share this post Link to post Share on other sites
connie3 43 Posted May 31, 2012 Thanks Lolita! sorry for the ignorance lol but what's a PCP? Share this post Link to post Share on other sites
lolitawantsaband 45 Posted May 31, 2012 Primary care physician Share this post Link to post Share on other sites
Teresa555 7 Posted May 31, 2012 Primary care doctor and you must live on Cali right? I believe your ins is state ins correct? So I do believe you would need a referral from you pcp! I would start there and good luck Share this post Link to post Share on other sites
connie3 43 Posted May 31, 2012 Umm I don't think I have state insurance. I have it through the company I work for. Share this post Link to post Share on other sites
connie3 43 Posted May 31, 2012 Umm I don't think I have state insurance. I have Kaiser through the company I work for.. And yes, in Cali. What kind of insurance do you have Teresa? Share this post Link to post Share on other sites
lupediva 56 Posted May 31, 2012 I went to a seminar and a surgent gave me paperwork for my pcp to fillout every month with diet/weigh in. after six months it gets put in insurance. Share this post Link to post Share on other sites
Mlivingston04 11 Posted May 31, 2012 I actually have a male doctor and did not feel comfcrtable talking to him about it so I went to my OBGYN doctor and asked her for the referal. She gave it to me and BCBS excepted it. Maybe you could try that. Share this post Link to post Share on other sites
duckydoom 128 Posted May 31, 2012 I actually work for an insurance company that's partnered (sort of) with Kaiser - We have reciprocal benefits in each other's areas. Anyways, you would need a referral from a primary care physician, and they would refer you to an in-network doctor. I'm sort of new in the process (though I have had my psych eval, ekg, bloodwork, etc, I just need a surgery date), and my PCP first referred me to the surgeon, and then I went from there. My insurance requirements that I am falling under at the time is a BMI over 35 and a comorbidity - I'm currently at 36, and have sleep apnea, so I'm pushing it... but the surgeon is gung ho about it, and my insurance seems to be supporting it so far... Share this post Link to post Share on other sites
Teresa555 7 Posted May 31, 2012 I have united health care! I work in an ER in Phoenix and I know when we have patients that have Kaiser we have to get Auth! And I only meant state because I think I don't know for sure but isn't kaiser only in Cali? If your insurance covers it you probably only need to get a referral! Share this post Link to post Share on other sites