In the beginning...

GuyMontag · June 27, 2006

I am at step one of possibly getting a lap band. I saw my doctor today and he is referring me to a lap band specialist in Indianapolis. A little about myself, I am 5'8 and 290lbs. I used to be skinny but have gained about 10lbs. per year for the last 14 years...you do the math. I have tried dieting, exercise, weight loss progams and nothing seems to work for me. I must admit that I'm a little nervous that I'll be turned down by my insurance company for the procedure mainly because I don't have any "life threatening issues" so to speak. The major health problem I have due to my weight is acid reflux. Other than that it's the million other daily problems I face due to being large. I'm not sure that will convince an insurance company that I need to lose weight. I guess I'll have to wait and see. I hope to visit here often and get/give support from/to others as the case may be. Thanks.

JMO · June 27, 2006

You meet the BMI requirements for MOST ins. companies. Yours is at 42.6. Mine is 40.2 and I qualified and am having surgery of the 25th of july. I also have no comortalites but I know if I keep going in the same direction I will have problems and soon. !st just make sure that weight lose is not written out of your policy. you can do that by calling your ins. company, then to be on the safe side call the HR of the company that provides you with the ins. After that most docs. will tell you what you need to get approved. THere are ALOt of hoops to jump through to get approved. We have all done it and yes it gets old but when you are approved it will be worth it. Keep us posted and get used to this site it will give you tons of great info.... Good luck

GuyMontag · June 27, 2006

Thanks for the encouragement. Something I failed to mention earlier was that my insurance company is Anthem BC/BS out of Kentucky. If anyone has any tips on how to deal with this particular company I would appreciate the help. Thanks again. Peace.

beachgirl · June 27, 2006

I'm Anthem BC/BS of Kentucky PPO. I have got all of the info they sent me in the mail and it says they will pay after 6 months supervised dieting but I wanted it sooner and I wanted a doctor of had done a bunch so I'm going to Mexico.

You shouldn't have any trouble though. Have you talked to them yet? I had a B.M.I. of 40.4

If I can help let me know.

GuyMontag · June 27, 2006

I just got off the phone with Anthem BC/BS and they said that any and all bariatric surgery was specifically excluded under my current plan. That's a bummer. I guess my only two options now are to either get my company to change my policy to start covering the surgery or fight the insurance company tooth and nail

GuyMontag · June 29, 2006

I got this response from my employer after I requested that we get a policy that covers the lap band procedure. Any thoughts?

(just talked to)...our anthem provider to see what can be done on your surgery request. because of the risky nature of the procedure, anthem has eliminated this and anything related to it from their coverage. only the largest of companies can add this to their rider and it looks like anthem is going to nix doing that as well.