legnarevocrednu 47 Posted November 10, 2011 I'm freaking out. My insurance coordinator just called to tell me that my insurance will not cover the sleeve unless I have a BMI of 50 or higher...which I do not! I'm scheduled for surgery on the 21st! She said it will cover lapband. I need advice PLEASE!!! I have to call her back and tell her what I decide to do. Have any of you been through something like this? Is it worth appealing? Should I just get the lapband so the last 6 months weren't for nothing? I'm so upset! I have no idea what to do but my doctors office has sure done a good job at scaring me off the band because I'm shaking at the idea of it. I just don't know what else to do! Opinions or ideas would be much appreaciated...I have to call her back in a bit with my decision. Share this post Link to post Share on other sites
Sleevie WonderLand 41 Posted November 10, 2011 Man, I feel for you, this is a tough one. Why didn't your coordinator find out the requirements before they began working with you? STuff like that really ticks me off. I know the lap band hasn't been getting the greatest reviews lately, but there are several success stories related to the lap band. I believe there is a lapbandtalk.com site that is also related to VST, maybe you can get some insight from there. If you have serious co-morbidities, maybe you can appeal and fight but you may not wanna go there and waste more time with that, especially since your coordinator doesn't seem to have it together. I wish you the best of luck in your decision. Be encouraged... Share this post Link to post Share on other sites
legnarevocrednu 47 Posted November 10, 2011 Thank you. I just talked to my coordinator again and she said that I could make a member appeal but that it would take a while. I don't have any co-morbidities at all (sucks that I feel bad about that). During the pre op class and nutrition classes, I have heard so many bad things about the band. I can't believe I'm going in that direction now but I feel backed into a corner. I just told her I would do the band :*( Share this post Link to post Share on other sites
favoredone 590 Posted November 10, 2011 I would call back and start an appeal..In the mean time, I would speak w/ who ever supervises her... I believe it will work out! 1 2bfit reacted to this Share this post Link to post Share on other sites
NikiS 31 Posted November 10, 2011 Wow..this really stinks!! I'm still trying to understand how they would give you a surgery date without knowing if you would in fact be able to have the surgery. It's a blessing that you don't have diabetes or sleep apnea but in this instance it would definitely qualify you for surgery even with your low BMI. I know a few people who have the Lap Band and they've done wonderfully. I say research it and weigh all of your options. If there is a chance for you to appeal, definitely do so. All the best and please keep us posted. Niki Share this post Link to post Share on other sites
legnarevocrednu 47 Posted November 10, 2011 Does anyone know how to appeal it? Or how long it would take? Share this post Link to post Share on other sites