\Mara/ 11 Posted February 24, 2013 Hi! Im so happy to find this website, and greatful information about lapband surgery. I have 38 years, yo-yo dieter since 18 yrs old. I m searching information about the lap band surgery, I have a low BMI 34. Anyone can help me, or advise me...I have Masshealth (Medicaid) with BMC Plan, and I dont know what is a good surgeon in this area (I live in Western Massachusetts)....I'm tired of loss and gain again pounds, and I have diabetes too. Really appreciate any information or help!! God bless! Share this post Link to post Share on other sites
dylanmiles23 2,198 Posted February 24, 2013 welcome. I had MassHealth but only Network Health would cover the Band. My doctor's office told me that and said I could change the plan over the phone. I went to the BI in Boston. Is there a BI campus in your area? Good luck. Share this post Link to post Share on other sites
vacationgirl1 6 Posted February 24, 2013 Hi, Go to lapband.com. It is the website for this surgery. It gives you lots of info and testimonials and videos. Also, with a low BMI and if you have a comorbid illness like Diabetes, you may be eligible. Check out a seminar on that website. Go to one and contact one of the surgeons to get yourself started. That's what I did today, just educated myself. Good luck! Share this post Link to post Share on other sites
\Mara/ 11 Posted February 24, 2013 Hi! Thanks for the help....well I live in Springfield MA (western area), Its far for me the Boston area...I will check with my insurance tomorrow, if they dont cover the surgery Im gonna change it with other one like Network Health. ..anyone know if I need a refer of my doctor? Thanks again! Share this post Link to post Share on other sites
vacationgirl1 6 Posted February 24, 2013 Hi again, I live in the Boston area. Did you go on Lapband.com? There are doctors in CT that may be closer. There is a doctor in Hartford, CT. His name is Dr. Scott Ellner. Phone number is 860-714-4819 Address: 1000 ASYLUM AVE STE 4320 HARTFORD, CT 06105 He is only one doctor on the website. You can call Lap-Band and they will send you information and give you surgeon names near you. Check out Lapband.com today and you'll have a lot of your questions answered so you'll be ready for your calls to doctors and insurance tomorrow. Also, my insurance is open 24 hours for questions about coverage and doctor coverage. Try them today too. Good luck! Share this post Link to post Share on other sites
\Mara/ 11 Posted February 24, 2013 YOu are great! Im gonna check the website now, and call my insurance maybe the can help me today right....Let you know whats happen.... Share this post Link to post Share on other sites
\Mara/ 11 Posted February 24, 2013 welcome. I had MassHealth but only Network Health would cover the Band. My doctor's office told me that and said I could change the plan over the phone. I went to the BI in Boston. Is there a BI campus in your area? Good luck. What is BI? Share this post Link to post Share on other sites
vacationgirl1 6 Posted February 24, 2013 BI is Beth Israel. I am happy to help anytime! I'd love to hear what you find out! Please keep me posted! Share this post Link to post Share on other sites
\Mara/ 11 Posted February 25, 2013 Hi everyone! I called my insurance today..., a lil rude guy told me that I need a referral from my PCP, explaining my necesity, and my medical situation, and then their doctors check my case and will took a decision. I have Masshealth too, and he told me that I need to wait 14 days more for their approval???! I really dont understand, and honestly I didnt ask more questions because I didnt lke the attitute of the insurance guy. That was BMC Health Network... Any advise, anything to me!!!? Share this post Link to post Share on other sites
skikyd 165 Posted February 26, 2013 I live in eastern Mass. I thing there is a bariatic program at UMass Medical in Worcester. Play their game. They hold all the cards. If you need a recomdation from your PCP. Then get one from your PCP. 1 \Mara/ reacted to this Share this post Link to post Share on other sites
\Mara/ 11 Posted February 26, 2013 Yeah thats the way...how about you? You had the surgery? 1 skikyd reacted to this Share this post Link to post Share on other sites
skikyd 165 Posted February 28, 2013 Yeah thats the way...how about you? You had the surgery? No I have not. I am in program at Lahey clinic. I met with nurse once, nutritionist twice, and finished 4 week psychiatric behavior mod program. I need a 6 month medically supervised weight loss program before getting approved. I am trying to get the paper work filed for that. 1 \Mara/ reacted to this Share this post Link to post Share on other sites
vacationgirl1 6 Posted February 28, 2013 It's a LOT of paperwork and process! Good luck with the nutrition program at Lahey. It's a long time, but I believe that it will all help and be worth it in the end. I go to my 2nd seminar tonight at Beth Israel and have my first blood labs and group nutrition meeting Monday. Here we go!! Share this post Link to post Share on other sites
\Mara/ 11 Posted February 28, 2013 Good luck to both! I found Pioneer Valley Surgical Group in Springfield MA, they told me that they accept BMC/Masshealth. I have my first seminar in April, because I cant in March...I'm a concern about the insurance approval, and my BMI....oh thats not easy... Share this post Link to post Share on other sites
vacationgirl1 6 Posted February 28, 2013 Call the insurance company and ask for their written policy. Get a copy (probably online) print and read it carefully. Call them with any questions to clarify their policy and make sure you know all the "parts/pieces" that you need to have (ie: primary care doctor referral letter, certain medical tests like an echocardiogram, and others, 3 or 6 months of a nutrition class, and more) You can start working on those things and gathering all of that. Keep calling them and getting all of your questions answered so that when you are ready to go to your seminar, you will be more confident of your insurance coverage. As for your BMI, are you worried that you may be too low by the time you start your appointments? They supposedly take the first weight that they take from you at the start. If this is your worry, you need to maintain your weight now until your first weigh in. Or are you worrying for other reasons. I hope this helps! Share this post Link to post Share on other sites