another newbie

mamato3 · September 12, 2007

Hi... I wanted to introduce myself and say thankyou to everyone who posts here regularly. I have been reading lots and lots here and I have learned so much.

I only recently decided to pursue lapband surgery. I haven't even attended an educational seminar yet (I have that scheduled on Oct. 4). I am hoping that it turns out to be an option for me. I am currently 35 years old and dont really have any significant health issues at all, but I do have a BMI of 44. (YIKES!) According to things I have read, I would be a candidtate due to the BMI itself, but I was wondering if anyone has the same situation and has been approved by there insurance? I also am wondering how long the insurance approval usually takes? And then following approval how long it normally takes to actually have the surgery. I am guessing this varies, but I am just hoping to find out a general idea.

I am VERY excited about the idea of having this done. I have been overweight my entire life and have tried what seems like a hundred weight loss programs. I have lost weight only to gain it all back. I am hoping the lapband is a tool that will finally help me reach the goals I have always dreamed about.

Thankyou all again for all of your posts and the great information. It's great to know that you all are here for support as I go through this journey.

mamato3 · September 12, 2007

OK so I posted like 12 hours ago. Somehow I thought people would respond. Is there someplace else on this board where I should be posting? LOL

TexGal · September 12, 2007

Mamato3, congrats on your decision to have the lap-band done. I am not banded yet, but I am working on it. 2 days after the seminar I went to, I found out that my insurance would pay for it as long as I did a 6 month medically supervised diet. 5 more months to go. I am soooo.... ready for this. Congrats again and keep us posted.

reeces5 · September 12, 2007

I was just banded August 13. From what I learned at the seminar I went to insurances companies all differ, so it is hard to say what they will require to approve you. As far as your BMI, that may be good enough for the surgeon to do the surgery but not for the insurance. I think a lot of them require other health issues or they just don't cover weight loss surgery for any reason (which was my problem). I had to refinance my house in order to pay for the surgery, but anyway you do it it's worth it!

My friend is also having the surgery done and she thought her insurance would pay for at least part of her surgery but after waiting 6 weeks her insurance denied her claim and so her only choices were to sue the insurance (who knows how long that could take!! you could gain another 100 pounds by then), pay for it herself, or just forget the whole thing. She decided just to pay for it, as she already waited for a long time. Hopefully your insurance company will be better at paying. Hope I'm not discouraging you, but it might need to be something you should think about--what are you going to do if your insurance will not pay for it?

Dave01 · September 13, 2007

Mamato3,

Welcome to the board. I had to jump thru many hoopstrying to get Aetna PPO of Fl to pay for mine. I was approved 2 days prior to my surgery only because my primary dr told Aetna he was going to take them to the Insurance board for delaying my surgery. What a great doctor he is. It took me a total of a year to get all required things done, mostly because I work out of town every other month, and scheduling appts was tough.

Good luck with your case. I'm sure it will all work out. Make sure your dr lists any other conditions you may have, ie. blood pressure, cholesterol, painful joints, sleep apnea ( a big one).

Dave