What Would You Do?

[aldmb2 24]

Based on my current policy (highmark bcbs) it doesn't look like I'm going to get approved. They require the BMI of 50. I have a 46. I have no comorbidity. I am healthy with the exception of obesity, which is not enough for them. I have hit a wall. I am lost and don't know where to turn. I have fought for 6 months for this, and I'm afraid I have no more fight left in me. I will write my one appeal letter then walk away. Would you have the band? Or buy the next plane ticket to Mexico?

[spadesmcloven 8]

I was banded in mexico and am going back for my sleeve. I recommend mexico all the way!!

[aldmb2 24]

I hope this isnt rude. But, how much does it cost to have done in Mexico? If you dont want to answer that is fine.

[spadesmcloven 8]

Not rude at all. The doc that did my band is now 9000 for the sleeve. I am going to an associate of his for 5500. They both are HIGHLY recommended. Took me months to decide to go back. I feel comfortable with it. I'm nervous because it Is a revision but I feel safe. Make sense lol??!!

[Bedhead 158]

I'd rather pay cash for the sleeve than ever even consider putting the band anywhere near my body.

[aldmb2 24]

I'd rather pay cash for the sleeve than ever even consider putting the band anywhere near my body.

Haha, Did you have the band? And surgery in Mexico?

[spadesmcloven 8]

Wish I had known aBout the sleeve years ago. I have had the band for 5 years. It's been great just no restriction anymore

[mydelilah 1]

I went to Mexicalia in January and I love the sleeve. I too fought with my insurance for months and then decided my health and happiness was worth the cost of the surgery

[lisahg 9]

I have Highmark BCBS also. I had a bmi below 40 with hypertension and type 2 diabetes that was controlled with diet. I was intially denied, appealed and denied again before submitting an external appeal. I was finally approved through the external appeal process and sleeved Dec 26th. Sure, it was a hassle and a pain in the *ss but I didnt have the funds to consider Mexico. You are pretty close to the 50bmi requirement. I just wanted to let you know there is hope in being approved going through the appeals process. Highmark is banking on people becoming frustrated and giving up. Good Luck

[aldmb2 24]

I have Highmark BCBS also. I had a bmi below 40 with hypertension and type 2 diabetes that was controlled with diet. I was intially denied, appealed and denied again before submitting an external appeal. I was finally approved through the external appeal process and sleeved Dec 26th. Sure, it was a hassle and a pain in the *ss but I didnt have the funds to consider Mexico. You are pretty close to the 50bmi requirement. I just wanted to let you know there is hope in being approved going through the appeals process. Highmark is banking on people becoming frustrated and giving up. Good Luck

Thanks for your positive quote. Precisely how long was your appeal process until you were approved?

[ocean_ophelia 31]

I had a few friends who had horrid experiences with the band. My insurance excludes all WLS, and I was a 30 BMI anyway, so no insurance would approve it. I saw Dr. Kelly in Mexico; it cost $5700. He was excellent, and I recommend him. I didn't care for Mi Doctor Hospital I stayed at, but it was ok.

[circa 333]

Go through your insurance appeal process if you're denied. If you can get your doctor to write a letter to send with your documentation stating that the sleeve would be the best procedure for you, that may help as well.

I went to Mexico and paid 4500 for my surgery. Had a fabulous experience.

[aldmb2 24]

Go through your insurance appeal process if you're denied. If you can get your doctor to write a letter to send with your documentation stating that the sleeve would be the best procedure for you, that may help as well.

I went to Mexico and paid 4500 for my surgery. Had a fabulous experience.

My Surgeon is going to call on Thursday to see what he can do, and I know the insurance wants me to give up. And I'm afraid they have won. Hopefully some miracle happens & they say yes. Otherwise, Mexico is looking better by the minute.

[circa 333]

My Surgeon is going to call on Thursday to see what he can do, and I know the insurance wants me to give up. And I'm afraid they have won. Hopefully some miracle happens & they say yes. Otherwise, Mexico is looking better by the minute.

Of course they want you to give up. They always want that. Be persistent. Its worth it if you can get them to pay.

[spadesmcloven 8]

I am a 30.2 bmi as well no co morbilities. My ins will cover the removal but I still have to pay 11850 for the sleeve. Removal and sleeve by Dr. Garcia is 5500. Sign me up lol