Please read :(

[legnarevocrednu 47]

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.

[Sleevie WonderLand 41]

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...

[legnarevocrednu 47]

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 :*(

[favoredone 590]

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!

[NikiS 31]

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

[legnarevocrednu 47]

Does anyone know how to appeal it? Or how long it would take?