Question About Insurance, How To Start, Where To Go.

[banded2soon 0]

So i was banded in march of 2010 at the age of 19. After a horrible year, of throwing up everyday, getting stuck, going to the gym SIX TIMES A WEEK, being paranoid to eat in public and angry everyday that my lapband isnt working im sick of it and want the sleeve ASAP. almost one year later and im only down 30 lbs. Everyday i feel like this is a sick joke.

My lapband i paid with cash, went through no insurance, no paperworks no headaches.

My question is, where would i even begin to look into getting the revision, what insurance would approve? Do i ask my lapband surgeon to refer me? Write me letters? How does this process work ?

Or if i did chose to go to Dr.A in Mexico is that a different type of insurance? Im just too lost to even begin with this nightmare.

A friend of mine got the sleeve 2 months before i was banded and shes so satisfied. She looks amazing and is happier then ever! So that inspired me, but doctors told me i was so young i should get banded instead. it was the "BETTER CHOICE" for my age. I regret it everday.

I would like any advice/information possible. Please and greatly appreciated.

I feel like im throwing all my money in the trash, every doctors appointment for a lapband adjustment is $250, plus my gym membership, plus the already $14,000 i had to pay for lapband. I just want it all to end.

[Becca 108]

I self paid for my band too because of an insurance exclusion. BIG WASTE OF $$$. I feel ya! My insurance started covering WLS when my band broke apart. I was lucky, but I did have to wait a long time for them to approve the revision. If you have insurance, call and check with them. Request their answer in writing with an explanation. Lots of times, the insurance companies will tell you that you don't have coverage when you do. They don't want to pay for these surgeries. If you do have to pay for the revision, I will say that it is worth it. You don't have fills with the sleeve. I know those add up! The sleeve has worked amazingly well for me. Good luck! I wish you the best.

[Formerly Fluffy 5]

My band was a big waste of money for me as well! :-( So glad you were able to revise!!!

[CamarilloCA 41]

I feel your pain here. I self-paid also for a lap band -- a total of $15,000, which included life-time fills. I did qualify for the lap band through my insurance, but they wanted me to do a weight loss program of theirs first, which would require driving into Los Angeles once a week for six months, which I couldn't do.

I have had my lap band for four years and regret it also. I throw up at nearly every meal and recently had all the Fluid taken out. I'm trying to see if my insurance company, Kaiser Permanente, will cover the removal of the band and revision to the sleeve.

I think Kaiser insurance is pretty good in general if you have the option to get that insurance. If you opt to go to Mexico, I think you will have to self-pay as I don't know of any insurance that would cover surgery in Mexico, but they most likely will be less expensive than having surgery here.

I would think that your best bet is to see your primary care physician about your lap band problems and request that he refer you to a bariatric surgeon for revision surgery.

[Wheetsin 714]

1. Call your surgeon's office and get the current CPT code for the sleeve (I have it, but not with me)

2. Call your insurance company and ask if your policy has an exclusion for that CPT code, either from your company or from the primary's employer. You ca, also get employer exclusion info from HR, or you can pour through your SPD, but the insurance company should be able to tell you.

3. If you have neither an employer nor provider enforced exclusion for the procedure (CPT code), call your surgeon and make sure he/she takes your insurance.

The rest depends on the type of insurance you have. ***? PPO? Open ***? PPO+? The "how to go about it" changes accordingly. For example, a traditional *** will likely want a referral/letter of recommendation from a primary care physician. I had my lapband with a PPO sp I didn't need anything from a primary care physician (I don't even have to have a primary are physician), I just selected the surgeon I wanted and went from there.

Find the surgeon you think you want, and just call and ask them what kind of insurance you have, and what you should do first. They have coordinators whose job it is to manage the insurance process for you (with some help from you, of course).

[Wheetsin 714]

Hmm, my H-M-O's above have been filtered out. Guess the board doesn't like them, either. But *** is supposed to be H-M-O.