Frustrated and need to talk...

casablnca1 · August 25, 2006

Hello. My name is April. I am 26 yrs old and been working very hard to have the lap band procedure done. I don't know where to begin. I have been a patient of Dr. Steven Simon in Phoenix Arizona since about February. I checked my criteria from my insurance and went over it and over it to make sure I knew exactly what they needed. I have done everything and finally the surgeons office when to submit to my insurance yesterday. They found out I was given the wrong information. I was hopefully going to have my surgery by the beginning of November but just found out today that I need to have 3 months with a nutritionist. I have had every negative emotion today. My insurance doesn't cover nutrionists so I have to pay out of pocket (which I don't have). Well and of course even after all is done there is still no guarantee I will be approved. I am oware of this but now I am pushed back another 3 months and frustrated. My insurance is one of the more difficult insurances to approve this procedure already. Anyone been there and done that? I have never met anyone that is interested in the lap band or anyone that has had it done so any advice is good!! Thanks :help:

PhotoNut · August 25, 2006

Hi Casablnca and Welcome to LBT,

I was self pay so I didnt have to go through this kind of thing. I can only imagine how let down you must be feeling. I can't believe the insurance company would require medical care that they don't even cover. What a bummer!

There are a lot of folks here who have battled insurance companies and won, so you've found the right place for adivce. Hang in there, don't give up hope. Everything happens for a reason.

Anwyn · August 25, 2006

I went through insurance approval and they sure do make you jump through the hoops! Hang in there - I know how frustrating it is. I thought I would be having my surgery in December and it didn't happen until July. Try to think of the delay as time when you can get your head on board with all of the changes (both great and not so great) that will come with banding. Good luck with your approval!

Dianechef · August 25, 2006

There's always the option to go to Mexico. There are several of us AZ Bandsters who went to MX because of the great doctors there & also so that you don't have to jump through all the insurance hoops. Good luck!!

Elisabethsew · August 25, 2006

Most insurance companies specify "medically supervised diet" and this can be done with your MD. All it requires is your MD documenting that you tried a sound weight loss program (weight watchers for example) and weekly weigh-ins with your MD. That should help with costs. My insurance does not cover nutritionists either.

Call the insurance company and ask to speak with your CASE MANAGER. That is the person who will tell you everything you need to know.

RLE · August 25, 2006

Hi this is RLE, check with Dr. Ortiz in TJ. He has put in over 3700 lapbands, that is all they do. Cost is $9,500, I got in on a deal they were having for $8,500. My insurance wouldn't cover me so I borrowed the money from my credit union. Good luck