'folded my hand without even tryin'; will I kick myself?

[thinkthin1 0]

I have a pre-surgical BMI of 33; recently diagnosed with severe sleep apnea, have high cholesterol and have a significant family history for coronary artery disease, diabetes, and cancer ; will be banded in Mexico on 5/24 by Ortiz. I have Oxford Freedom and read the preconditions which included a BMI of 35 and just 'folded my hand' without even trying to get covered. I decided to do it in ASAP since it fit into my schedule. Tell me that down the road I won't have to kick myself in my soon -to-be skinny butt.

[the best me 6]

Maybe, do you have local after-care lined up? Do you have a US band doc who will see you in a pinch? Are you close enough to Ortiz to get to him quickly? By his reputation here, Ortiz will take good care of you, but you need to be able to get to him for whatever post-surgical needs you may have. You may be in a position, since your insurance covers banding (right?) to have your after-care be covered. ??? I'm sure more folks will chime in here, I'm just throwing all this out there. AFter-care is the big issue for being banded in MX. You gotta have local care! Good luck. I have no regrets!

[diva 0]

Please try and get banded using your insurance. You are one of the lucky ones whose insurance will pay for it. You just never now what is down the line. Use the money for new clothes or a vacation. Really-use the insurance.

[Carlene 12]

How much weight would you have to gain to meet the insurance company's BMI requirement? Maybe it would be worth it. I agree that medical coverage for the band, after care, etc is priceless. I know many people who struggle to get fills, etc because they were banded in Mexico.

[Anu 0]

I had a BMI of 35. My insurance wouldn't cover it because I didn't have any SEVERE complications due to my weight (define severe?). I went directly to Dr. Ortiz and I have only great things to say about him and my experience. That said, however, I would encourage you to try to get your insurance to cover your lap band procedure. I am a little nervous that with all your other health issues that if you were to have a problem (not related to the band) that they might decide the lapband is part of the problem and not cover some treatment that your really need.

So that is my two-cents. Best of luck-

[Mrs Sabre 1]

My insurance goes with the standard definition of morbid obesity, a BMI of 40 & up or between 35-40 with high blood pressure, diabetes, or heart disease. My initial attempt at approval was denied. My BMI is between 35-40, but I don't have any of the "standard" co-morbidities. I do have 7 other health/risk factors that are caused or made worse by my weight. One appeal letter and two weeks later, and I have been approved for coverage of my lap-band surgery. IMHO, if your insurance covers WLS, it's worth trying and appealing once before going to MX.

[joyrn 0]

I have just signed onto this site and I really need some help, advice whatever anyone can give me. I am 37 and have recently had 8 cardiac procedures and also have had a pacemaker placed in the last year. I have back problems and heel problems. I am at 286 pounds and am 5ft 9 I need some help!! My insurance does not cover this procedure and I need to find out if they have to due to medical necessity. My cardiologist says that it is a medical necessity and so does my general doctor and gyno. Please help if you can with any information..