I am not 'fat' enough??!!!

[peaches9 3]

Hi all,

I'm from Australia but have been reading your posts. I can't believe how difficult it is for you all to get lap-banded. In Australia you need a BMI of 35, or if you have a BMI of 30 -34 you need a co-morbidity. In some states you can have the surgery done on our public health system - but there is a wait of anything from 6 months to 7 years. If you have private health insurance, about 75% is paid for and you are usually scheduled for surgery within a couple of months.

I am starting the banding process on Tuesday with my first visit to the Nurse practitioner (she is great as she has had the band herself). The following week I see the dietitian and the week after that I see the surgeon and hopeful get a date for surgery.

I wish you all the best of luck with you journey.

G'day Mate!

Wow are you ever lucky that your BANDING is covered so well by insurance there... very progressive.

I don't know why we have to suffer so much here and then to be denied the operation that will SAVE hEALTH CARE $$'s in the long run anyways...

How much is spent on Heart Disease, Diabetes, Arthritis, Knee Replacements, Hip Replacements.... OOur politicians are pretty short sighted !!

Actually my surgeon went to YOUR country to learn how to do the Lap Band;, now he has done 1000's in Canada... but he charges a heafty fee.

[sewenup1 0]

G'day Peaches,

Congratulations on your weight loss - over half way there.

Yeah, we are very lucky here in Aust. in so many ways. We are tryng (and this includes many of our doctors) to get more places on the public system for people wanting lap-banding. I mean its not like plastic surgery to make your nose smaller - it's actually life saving surgery and to have to wait 7 years or to find $16,000.00(Aus) is terrible.

As I said, I am extremely lucky as health insurance pays 75% and my superannuation fund will pay the rest, otherwise I don't know where I would have got the money and my state does not do the surgery on the public system. But expecting people to wait 7 years is ridiculous - the costs of other conditions that develop would exceed the cost of surgery. Unfortunately most of the public here see the obese as lazy and not willing to do anything to help themselves - they don't realise that most of us would if we could.

Sorry about that, I will get off my soapbox now.

[dr.sooze 0]

I was 70 pounds over weight so there was no way insurance would consider me. I had a lapband done in Mexico three weeks ago for $7,000. Have you considered Mexico?

Suzie

[WASaBubbleButt 41]

It's not the doctors that are refusing to band you, it's your insurance company that is refusing to pay for the band.

[mrspete 0]

I agree with giving them a new height when you go somewhere the first time, give them an inch shorter, they do not measure your height. Let them know you snore, even if you don't that is an indication you MIGHT have sleep apnea. I was a few pounds short of a 40 bmi and I ate ice cream all day for a week, gave them an inch shorter and wa law, I qualified. Had my surgery 4 weeks ago and I'm on my way to a new me. It's work but worth it.

[100lbsforsale 0]

LOL, This thread was so much fun! I was so bleeping angry you couldn't believe it. Here's an update on what happened. I ate and ate trying to gain the 20 lbs to get the 40 bmi, and yes I did lie about my height. Although, I didn't see the post about that until today. I went to my new PCP, wearing jeans, 2 shirts and had 2 baggies filled with pennies stuffed in my bra, and another with quarters in my pants. I'm cracking up just typing it. Anyway, I weighed 8 lbs heavier(256) than when I went to my last WW meeting 2 days before. So, I get to the doc and he looks at my weight and says his scale is 10 lbs TOO HEAVY. :cool: ARGGGGHHH So he says I actually weigh 246. Can you believe it?? I've never been to a doc office where the scale weighed me lighter than my home scale.

We talked about the Lap Band and he wasn't encouraging or discouraging but said he had 8 patients that have the band and they've all gained the wt. back. Then he told me to consider ordering an obesity drug from the UK (that isn't approved in the US) called Accomplia. He said it would kill my appetite etc etc. It costs about $170-200 for a months supply, cheaper than the band he said.. So I researched it just for the heck of it,=== not for me. After all that and the screening bs:mad: with these other docs, my husbands' company sent home a flyer saying that as of Oct. 1 2007, they will not cover any charges relating to bariatric surgery. :faint::faint::whoo:

Guess who is now going to be self pay??? I have to tell you the relief at being able to skip the 6 month diet pgm, the sleep apnea study etc etc. was unbelievable. How am I paying? I don't have 2 nickels to rub together but I have a dear friend who is loaning me the money. Lapbandland here I come, momma gets a Christmas present this year!

Thanks everyone for your input and for giving me a laugh over a really crappy situation.

[Jachut 487]

Absolutely the best decision and the best most worthwhile debt you will take on in your life.

I have a friend here in Australia who is very obese and wanting to conceive at 39. Weight loss is imperative for her to increase her chances. She looked into the lap band but has no private health insurance and docs often wont touch self pay patients here in Australia. Because although you can get banded from a BMI of 30, apparently only rich people need lap bands, so those in the public health system or without years of paying health insurance have to stay fat.

So she's gone on the Optifast program, supervised by the newest weight loss expert that appears to have sprung up here - the local pharmacist. Oh for sure, your local pharmacist would be an EXPERT on weight loss right?

I just sighed for her. Another useless time wasting expenditure of effort for fast and spectacular weight loss that will go back on even faster. I advised her to doctor shop until she found a doc that would take self pay. She's not poor, she just chooses not to have insurance as you can here. So should she have a complication she can pay for it.

Dont waste another year of your life staying fat - that is a great chance to borrow that money and do something effective.

[suecasb 0]

I was turned down by BC/BS because my BMI is only 38 with no co-morbids . I have a year to appeal. I'm wondering........ if I should happen to put on the 11 lbs sometime soon (which I'm sure I will) and had the Dr. to resubmit the claim....has anyone done this? I wonder if they would approve me then. Any thoughts on this?

[bellasmybaby 0]

I had BCBS and I had to lose weight to get under their guidelines of a BMI of 50 or less for lapband. They wanted me to have gastric bypass. I lost the weight and resubmitted the claim and I got approved. I think you would do well with this idea. I lost 18 # on the pre-op diet and 1 wk of post op full liquids. Who cares what you weigh after the claim is submitted. Just have to weigh that for the weight the doc uses to submit.

[Lucy 0]

If you really want th eband you will find a way to make it happen. My insurance company wouldn't have covered the surgery if my BMI was 90. So I found a way to pay for it. It wasn't easy and, sure, I would have preferred to not pay for it, but I would rather pay for it than not have it at all.

[gingerbug 3]

I did it. I gained a littleweight becuase Iwas on the verge of havinginsurance pay and it wass worth it.It only took me two weeks and i felt sick. I weighted heavy enough then it took a week of high Fiber to start feelingbetter. It is always scary to gain weight, expecially on purpose, but it saves thousands of dollars in the long run.

[socaldixiegal 0]

I was about 16 lbs from qualifying for insurance to pay. I choose to go self-pay. Mostly so I could control the schedule. Also, there's no way I wanted to spend the money on business clothing that I'd need to dress! My current clothing was too tight as it was!

I'm still using the doctor I started the research with - the cost isn't as high as I thought, but still $16k is a big chunk of change. Yeah, I know the clothing would cost less, but I really didn't want to gain nearly another 20 lbs. I feel horrible right now as it is.

I thought about Mexico, but wanted the local medical support of my doctors program (psych, fills, support groups, etc) especially as they recommend doctor visits every 6 - 8 weeks over the first year.

[VegasGrace 1]

Well, well. You are just like me. But I had no insurance so I had to be self pay. Mine was only $7,000 and included everything and after thinking about all I paid for Weight Watchers/Jenny Craig/Slim Fast/Trim Spa/Phen-Fen/Fastin/Meridia/doc visits/high blood pressure pills/ the list goes on....

7k was so cheap to NOT have to do this anymore.

But if you have an opportunity for someone else to pay...gain the weight back...but be careful. I'm afraid that if you continue using the same doc those who we don't mention WILL FIND OUT. So disappear for a while, eat like crazy Mt. Dew yourself and go see another doctor and do not disclose ever...ever seeing someone else.

Good luck and keep us posted.

[ras141414 0]

I guess I agree with the rest.. I would not want to gain 20 pds back,, I would try what the rest has said to do.. If that FAILS, THEN GAIN THE 20 BACK AND LET THE INSURANCE PAY FOR YOUR BAND.. NOT LIKE SOME OF US THAT SELF PAID TO THE TUNE OF 8000 AND MORE.....

GOOD LUCK TO YOU .. 10 PDS OF ANKLE WEIGHTS,, THAT IS EASY TO HIDE AND SWEAT SHIRT... ECT

DIANE in San Diego

178/120/123

3/29/06

slipped band 3/39/07 fixed. $5000. out of my pocket

Dr. Lopez TJ

unfilled now 2x months.

[kagoscuba 0]

Don't feel bad Sue. BC/BS turned me down with a BMI of 39.1 AND two co-morbidities (high blood pressure and sleep study diagnosed sleep apnea). They said because I didn't have 5 years of written proof I was overweight they were denying me. Lovely people.