Please give me hope

[iluvlongnecks 0]

I am a Sacramento Kaiser member and my doctor has just referred me to see a surgeon in SF to see if I'm a candidate for the lapband. My BMI is 37-38 and I have sever sleep apnea. I currently use a CPAP and have had it almost 2 yrs. I am now having allergy issues and I'm finding myself waking up during the night and wanting to take it off.

I too have done the diets, Atkins, Weight Watchers, Herbal Life to only hit that plateau of 25 lbs and then gain back more than when I started. I am currently at 225, but have been as high as 230 and I'm 5' 5".

What I'm looking for is hope that I will be approved to have this surgery and I can get on track again and see a light at the end of the tunnel to get beyond my pateau to being healthier.

Does anyone out their know of any Kaiser LB approvals with 37-38 BMI?

I have myself a nervous wreck that they are not going to approve this and I'm not going to get the help that I need to get healthier.

:help:

Shannon

[mbanja 1]

Hey Iluvlongnecks, My fingers are crossed for you! I am 5'5", 230lbs, with a BMI of 38. I am as healty as and ox and 20lbs away from being morbidly obease. My Ins won't pay for mine because I don't have any health related issues (YET!!!) Which I think is stupid for them to wait until I do, but anyway. I am not going to binge eat to pack on 20 extra lbs just so I can try to get my ins to cover it. I have decided to pay for my own out of pocket. Since you have severe health issues though, I have heard that Ins will cover if you are over 35BMI. I have also heard that specialists are on the patients side and will work very hard at getting you your surgury. Best of luck. Head up it will work out!

[coltonwade 27]

Do a search for Kaiser , Look under the insurance responses, There is quite a bit of info on them . It looks like it goes either way depending on where you live and what policy you have . You can get some good info , My suggestion would be find someone in your area on the boards that has had luck w/ approval and tap into their resources on how they got approval .

Good luck , I had to pay $12000 self pay for my surgery . I hope your insurance goes through

Mindy

[iluvlongnecks 0]

Thanks so much for your encouragment. I want this so badly. I want to feel healthier. I want to feel better about myself. I pray that Kaiser will approve this surgery for me, so that I can start this journey and know that I will reach my goal.

I'm very nervous as to what Kaiser will say, but also prepared to do what it takes to get them to approve this. I know in my heart that this is what I need to get healthy.

I love this LBT and want everyone to know that it gives others alot of answers and encouragment.

Thank you again,

[faithmd 14]

iluvlongnecks, the only way to know for sure is to get your insurance card out and call and ask. Do it NOW. That way you won't have to live in suspense. After you find out, ask them to send you a copy of their requirements so you have them in writing.

Good Luck

[iluvlongnecks 0]

I just now opened the letters from Bariatrics in SF and they have scheduled me for the clinical evaluation for surgery. The orientation is on Sept 11th. Now for all the test that have to be done before that date (EKG. chest x-ray, blood work) Gheez... I just did this back in March for shoulder surgery, but I guess it has to be done within 6 mos.

I know this doesn't mean that I'm approved, but I sure hope it's a good sign! Pray for me everyone!

[beardpa 0]

I don't want to discourage you but I think you should be prepared. I too am a Kaiser member. I received a referral from my practitioner to go to the weight loss center around the corner from my home. The referral was for Lapband. When I got to the orientation, they informed about 50 of us that Kaiser was not performing this surgery at this time, they were only performing bypass. They do not have a surgeon to perform Lapband at this time. I was 75 Lbs overweight and they require that you be over 100 Lbs for bypass. I live in Riverside,CA. I decided to go to Tijuana, MX for my surgery. My surgeon was Dr Kuri and I paid 7,500. I hope that they have more resouces in Northern CA than they do here and that you can have your surgery. Good luck!

[iluvlongnecks 0]

They do lap bands in SF, as a friend of mine has been through the whole spill and they are looking into doing a lap band on her instead of gastric. Kaiser in SF started doing lap bands in Feb. 07. Sorry to hear that you chose to go to TJ and pay for it on your own, but I'm sure it was worth it right? When did you get banded?

Thanks for the advice, I appreciate any info that anyone can pass on, that's what LBT is here for.

[beardpa 0]

They do lap bands in SF, as a friend of mine has been through the whole spill and they are looking into doing a lap band on her instead of gastric. Kaiser in SF started doing lap bands in Feb. 07. Sorry to hear that you chose to go to TJ and pay for it on your own, but I'm sure it was worth it right? When did you get banded?

Thanks for the advice, I appreciate any info that anyone can pass on, that's what LBT is here for.

That's wonderful! I wish you all the best. I guess I'm just unlucky to live in an area that they can't offer it. you bet the 7500. was worth it. I was banded on 6-4-07 and have lost 31 Lbs. I went for my first fill 1.6 cc's but had to have all of it removed. I have a severe problem with PBing. I started back on liquids only today in order to heal my esophagas. Hopefully I will get another fill by the end of the month. Even with the problems I have had, I don't regret the surgery at all. I have 44 Lbs to go.

[macacoza 0]

I had a weird thing happen to me. My insurance approved everything...Then 3 months after the surgery insurance sent a letter saying they had made a mistake and would only pay for half. We repealed that decision, but it was no use. So I had to pay back half of the money..ugggggggggg..Oh, well..half was better than nothing! That was 4 1/2 yrs ago..I have lost 98 lbs and have maintained with-in a 5 lb radius for over 2 yrs...This was the best thign I ever did for myself..Good luck and look forward to a healthier YOU!!

deb