New to the process and have questions...Houston area, hope for Dr. Spivak

hlyndes · October 18, 2004

I have researched the surgery and I believe it will be very good for me. I am trying to figure out how to proceed. I have found Dr. Spivak's website, and he looks like an awesome doctor to proceed with.

How did the journaey begin for ya'll? Any of you have Cigna insurance and did they cover anything? How do you begin?

I would love any ideas, suggestions...Thanks!

New Hope · October 18, 2004

Hi, I used Dr. Spivak (and there are a couple of others here - Lisa Green, and Clara Luz). I absolutely adore him! He's very competent, sweet, easily accessible, and has a great staff. I have United Health Care PPO. But the best thing to do is check directly w/ your Benefits Coordinator to find out exactly what your insurance does and doesn't cover. His website has an excellent pre-surg. questionnaire that asks you about the different types of weight loss that you've tried. Any and all that you can think of will help you w/ your case for the insurance co. Hope it works out for you! Best of luck to you on your search for better health!

LisaMG · October 21, 2004

Hi, yes Dr. S is my doc too. Love him, hard to find someone who dos'nt like him. Marie thats good advice about checking with your Benefits Co. first.

My first step was to call my ins. co. to see if they covered weight reduction surgery and found out that my husbands employer has an exclution on weight reduction proceedures. Bummer.

Why do you think this band could be for you? How over weight are you? Do you know your BMI? Tell us a little bit about yourself if you don't mind.

hlyndes · October 22, 2004

My BMI is 43. I weigh 245 pounds. I have had short-lived success with Atkins, Meridia, amongst others. I am a teacher (elementary-special education) and have an eight your old son. I have not yet found out if my insurance will cover any type of weight-loss procedure...I am hoping that it will.

New Hope · October 22, 2004

Do you have any pre-existing health problems (high blood pressure, asthma, diabetes, heart conditions, joint problems, sleep apnea, etc.)? What about a family history of any major health issues? I certainly hope you don't. But those will help your case against the insurance company (if they cover weight loss surgery.)

How did you find out about Dr. Spivak? Do you live in the Houston area? Have you attended any of his seminars? They're very informative.

Please keep us posted how you're doing.

hlyndes · October 22, 2004

No pre-existing problems. Family history of high blood pressure and heart conditions...but I do not share those problems. I found out about Dr. Spivak as I was researching different weight loss surgery options, and his name kept coming up. Everything I have read about him has been positive, so I am confident!

I live just outside of Houston (NW). I have not made it to a siminar yet,

Iluvharleys · October 22, 2004

Welcome! Start reading all the posts here and you will learn tons of information.

blossom · October 22, 2004

I am not a Spivak patient, but my dr also had a seminar where I was told to:

1. Find out if your insurance policy covers WLS.

2. Document your history of weight loss efforts.

3. Document any co-morbidities you may have (see Inamed website)

4. See your PCP to get a referral (if necessary) and a letter recommending that you

have WLS

5. See your surgeon, who will then get all the insurance paperwork started.

And then...

6. Wait, wait and wait some more!

Hope this is helpful. Good luck!

lauri · October 27, 2004

Welcome! I am new to this site and am an elementary teacher, also. When I first started, I went to every web site that I could. I even watched one site that performed the procedure on video. I was sold!! I have not had my surgery but have been working through the process for the past few months. My doctor's office has finally send the surgery request to my insurance. They had to make sure that I had everything so that we would reduce the risk of rejection. Each insurance requires different things but Blue Cross/Blue Shield required:

a. documented five years of obesity

b. 12 months of doctor monitored efforts of weight loss

c. 6 months of doctor monitored efforts exercise

d. a nutritional analyis

e. a psyc. analysis

And then....Dr. Cribbons (my surgeon) requested that I have a sleep study done. The tests showed that I have sleep apnea. I am soooo thankful to him. I have suffered from insomnia, migrains, fatigue, memory problems and much more. Many of those symptoms are now going away! I have even joined CURVES to get in the habit of exercising and to get a positive start to my journey.

The one thing that I have learned is that you must be proactive in the process. Jump through the hoops, make the calls, go to the appointments, ask the questions and EVENTUALLY you will get there.

Good luck to you! I hope that things go smoothly for you. In the mean time, You have found a wonderful place full of terrific people that are routing for you.