Don't Give Up !

[ButterflyKisses 0]

Hi everyone : ) I just wanted to tell everyone not to give up your dream of being banded . I also want to say that make sure your medical records have your correct height. It sounds silly but this is very important. Those few inches make a big difference in your weight and BMI (make sure your shoes are off). My family doctor had me recorded at 5 feet 7 . I turned in my information to my banding doctor and recieved a letter back saying I do not meet the qualifactions for being banded (through insurance). I went to see my lapband doctor about self pay and he told me I don't look 5'7" and I took my shoes off and stood naturally and I was 5'4". Those 3 inches were enough to get me through and covered by the insurance co. I was border line with my BMI, and being shorter bumped me up from 38 to 41 . My insurance approved me in 2 weeks. I had my operation July 26th 2007. I go back Thursday to maybe get my first fill. My high weight when I started was between 245 - 250 . I have lost about 35 pounds so far and have about 50 to go.

I was curious about how much the cost would be for us out of pocket and how much the actual surgery even costs. I got my bill 2 weeks ago,,the total for everything,,,,((drum roll)).....20,576.00 . WOW ..My surgery started at 1:30 lasted to about 2:45 and I left the hospital at 5:30 . Today I got the letter from the insurance company saying what we pay out of pocket..I'm happy to say it is only 888.73 . I am very happy things turned out like they did. I'm very lucky and my heart goes out to all of you that are struggling to get your insurance to pay. Don't give up and make sure your height is correct! By the way my insurance co is BCBS . Good Luck to all of you!!

[wendy645 1]

Thank you so much for the words of encouragement, they mean a lot!! My employer is shopping for insurance and may be looking at BCBS.. do you know if the state makes a difference in coverage? I'm in Az. If not, or is BCBS AZ would cover, I'd be willing to try to pursuade my employer to go with them... I'm sure I could find something to make it not look so obvious as HEY I'M GETTING WLS AND NEED THIS PLAN!!! With neon lights all around it and stuff LOL

Thank you, this helps keep me going

[Dibaby 0]

Yes don't give up!!

I had to go through hell to get mine approved. But really if you are determined it's amazing what you can do with insurance companies. I had two denials even though I knew my insurance covered it. So lucky for me a good friend of mine also wanted the surgery and was in my HR department and started to get things going there. It turned out that Humana generally didn't cover the insurance, but my companies agreement with Humana says that they did. Soooo after going through hoops. Figuring out where the approval department was located. Getting really lucky and talking to someone who had a gastric bypass in the approval department I got approved! Took me 6 months. I was the first one approved. 6 others followed me after from my company..lol. There were sooo many hoops to go through. I was told I was the first one at Humana to get approved..LOL. I even had an HMO and there was no doctors in network that would do the surgery. Dr. Horgan was the only one nearby who would. So I got it approved out of network even. All in all..the surgery cost me 100 bucks Weeeeee

Almost 4 years later couldn't be happier. Just stay focused and don't give up! Good luck

Di

[LOUBOO12 0]

Congratulations on being banded. I have BCBS shield of Kansas City and I was denied because of an exculsion on the policy. What state do you live in.

[Candle 11]

Great thread!!

Where there's a will, there's a way!

I had a rough time too - my insurance plan had an exclusion but I was able to find that elusive self-pay plan that covers WLS. (GHI for NY'ers in need. IM me if you need any info)

I had to jump through a lot of hoops. The sun, the moon, and the stars needed to line up perfectly but it did work out and I got APPROVED!!

Good luck to everyone

[ButterflyKisses 0]

LOU~~ I have bcbs of Minnesota.

Wendy~~ Like your saying at the bottom of your page about your boyfriend !

Wendy~~ I see you are getting banded soon! Good Luck~~ Try not to get to nervous , I have had 3 c-sections and I thought this was a piece of cake. Keep in mind I had no complications. You are on your way soon!! yeah!!!!

[ButterflyKisses 0]

lol...candle, that last message up ^^ was for you.

[NDgirl 0]

My insurance requires me to see a doctor once a month going on a "diet" to see if I can loose wight without lap band. I am 34 yrs old and have been a yo-yo dieter for years. I know that this is what I need to keep the weight off for good. I love to exercise and eat healthy, but I am always hungry. My BMI is 34 with pre diabetes and other health problems. What did you have to do with the doctors before your insurance gave you the go ahead to have lap band?

[ButterflyKisses 0]

Hi ND

If your insurance provider wants you on a supervised diet , do it with your lapband doctor. They usually want you to lose some weight before the surgery and this way they can document it and submit it in with all your other information . I went about 3 months seeing him once a month just to check my blood pressure and weight and as soon as I lost about 20 lbs he submitted me in. Get any information you have from your family doctor regarding health issues and be sure the lap band doctor gets a copy . It also helps that it should have some of your previous weights on the charts. I can so relate to you, I'm a yo-yo dieter also. I can lose it but always regain with a little more.I have lost 95 lbs on my own and managed to gain that all back. I love to exercise too well I should say I love taking walks, it gets me away from the husband and kids for an hour a day! lol ,,I throw on my I-pod and walk about 3 miles or a little more. I think it's important if you can..to walk outside. There is something about the fresh air and beauty that no gym could possibly come close to! Good Luck!

[rkj123 0]

Thanks for the great post. I too have BCBS of MN and have been fighting with them since June. The people at Obesity Law in California are sending in my appeal on Monday so hopefully things will come together for me soon. It just gets so frustrating, being denied for healthcare that you pay an arm and a leg to have insurance for. Oh well, good things come to those who wait (and wait and wait and wait)!!

Robin

[ButterflyKisses 0]

rkj..it will happen, I just know it will. Keep your chin up and oh..if you ever see a first star at night ,Make a wish! It worked for me : )