I Need Help?!

April 18, 2004

I AM SEARCHING FOR INFO ON THE BAND PROCEDURE, I AM IN THE FIRST STAGES I AM 288 LBS I USE TO BE 190 WOULD THIS WORK FOR ME? ANY SUGGESTIONS ON WHERE TO START? I AM A DIABETIC , IS THIS SAFE FOR ME? I AM IN TALLAHASSEE FL, ANYONE KNOW ANY DOCTORS HERE?? I HAVE CIGNA INSURANCE DOES ANYONE KNOW IF THIS IS COVERED? HOW MUCH IS THE PROCEDURE. I GUESS I HAVE ALOT OF QUESTIONS......I HAVE YAHOO MESSENGER IF YOU WANNA ADD ME TO CHAT..DIFFICULTSUMO IS THE SCREEN NAME.THANKS ALL!

Alexandra · April 18, 2004

Hi Ricky,

You're right, you do have a lot of questions! I think you'll find a lot of answers if you read through some old threads here and on other bandster boards (SmartBandsters on Yahoo Groups is one of my favorites). To get you started, though:

You ask if this will work for you. Only you can decide that. From where I sit, banding is a great idea for people who are morbidly overweight (you probably qualify on that score) and who have been unable to get control of their weight through diet and exercise. It's not a picnic, of course, and you have to be prepared to say goodbye to eating the way you're used to. It's by no means a magic potion and if you try hard enough to get around it you could manage to not lose weight.

The band is not "unsafe" for anyone. Indeed, as a diabetic you stand to improve your health a great deal by losing weight. Your condition makes you more of a candidate for the band, not less.

You ask if Cigna covers the band. Again, this is specific to your policy, your company, your medical condition, and your state. Cigna, like most carriers, is not making it easy to qualify for major elective surgery, but if you are persistent and meet the medical criteria they do pay for weight-loss surgery.

The cost of the procedure varies from place to place. In the U.S. it's probably a minimum of $30,000 when you add in the hospital costs and everything. You can get it done in Mexico or Europe for about a third of that.

The place to start is where you are, here. Then visit your primary care physician and make sure you get a diagnosis of Morbid Obesity (the diagnosis code is 278.01 and the sooner that gets into your medical records the more likely insurance will pay for the surgery). Once you get the diagnosis, get a referral from your PCP to a surgeon who performs the procedure. Even if you don't need a referral, get you PCP to put in your file a letter saying he believes weight-loss surgery is indicated for you. This is the first building block in your file of information that you will eventually present to Cigna.

Stick around the board and ask questions, you'll find we're all pretty friendly!

claraluz · April 19, 2004

I agree with everything Alex said except that you can get the surgery done for less than $30,000 in the U.S. if your insurance will not cover it. I paid $14,000 for everything including a year's worth of follow-up visits and fills. I claimed it on my tax return and am getting about 1/2 of that back (how much you get back will depend on income, etc.)

I think the band works great for people who need a little help sticking to a healthy eating plan and who commit to following the rules. If one is determined not to lose weight, then even with the band there are ways to overeat and drink. But I'm about the most pathetic dieter there is and I've lost half of my excess weight so far. Research it well. Good luck.

Nancy