New to LapBandTalk

Tammy22 · January 6, 2005

Hello everyone.. My name is Tammy. I live close to Ft. Worth Tx. My husband is stationed in Hawaii in the Navy. I was there with him but came back home for school. I recently just started looking into the lap band surgery. I have been over weight since I was around 14 and I am now 22. I am young and dont want to get all the health problems that run in my family. I was looking at getting my surgery at the Texas Lap Band Center in Dallas with Dr. Jayaseelan. I went to the appointment where they show you the band and how it works and to get weighed and get my BMI. They told me I qualify to get the surgery. I was excited to know that I was just a step closer to getting it. Well, we called tricare prime to see if they would cover the surgery and they said all I would need to get it was a referral from my prinary care doctor. I was like okay... I get an appt. with him to see about getting it.. He was asking me all kinds of questions like I was stupid or something. Then was trying to tell me they have doctors who do they same surgery. I was like okay and? I have chosen who I wanted but yet he still gives me the run around.. Well today, I get a phone call from the nurse about my referral trying to say that the lap band center does not take my insurance that they were out of area range for tricare to cover.. I was like okay how are you going to tell me that when i just went to see them and they took my insuarance for it but still had a copay.. Did not make any sence to me. She told me that she will call tricare prime to see if they will cover it or not. I told her i had called and told her what they said to me about only needing the referral and she was like well they tell patients one thing and tell the doctors another. I was tearing up at this point because I have the gut feeling nothing will come about this but my husband told me to stay strong and to keep thinking possitive. It is hard to do when you have your hopes set on something soo band then it falls apart. Does anyone have tricare prime who has had the lap band done and does anyone have any advice at all to what I could possibly do to help get this done? Thanx for taking the time to read my venting..

TrishS · January 6, 2005

Im sorry you are having to go through so much with your insurance. My Primary Doctor will not approve what I am doing... I hope i will not need a referral. Keep strong and so all you need to, to get it done... Im just starting myself so I dont have all the info that most can give on here. sorry. Good luck with it and let us know how it goes!!

Take Care

leatha_g · January 6, 2005

Tammy,

There is a guy named Charles Collings on the Yahoo Groups DFW Bandsters who has Tricare Prime. I do know he had some issues with this problem too and he may be able to tell you who all he found out takes this insurance. Also, you can find this out on www.obesityhelp.com website as well. If you click 'Find a Doc' you can choose your area and it will list docs, then by clicking on the doc, you can see the insurances they have used in the past.

Good luck to you!

Tammy22 · January 6, 2005

Thanx for the luck. I wish you luck as well. I wished we had it easy like some do with getting it approved. If you find anything out let me know and I will do the same..

Tammy22 · January 6, 2005

How do I find him? Thanx so much for your info..

Iluvharleys · January 6, 2005

Good Luck and keep trying. Sometimes the wait is worth it!

leatha_g · January 6, 2005

http://health.groups.yahoo.com/group/DFWBandsters/ - you can find Charlie here.

leatha_g · January 7, 2005

I can see that Dr Cribbins in Plano has taken Tricare Prime in the past. He's got an excellent reputation. You might try calling him.

Tammy22 · January 7, 2005

Your a great help. I thank you soo much for all the help you have given me..

Petunia · January 7, 2005

Tammy, approval takes time. I live somewhat near you. I am in Frisco! You may want to consider a new doc for the referral. These people who've been thin their whole life don't understand how it is. and Leatha G is right, Dr. Cribbins in Plano is a great guy! He is a general surgeon who has dedicated a large portion of his practice to lap band surgery.

New Hope · January 7, 2005

Tammy, you want to take the time to know that your insurance is covering your procedure, before you do anything. Please use this time to learn as much as you can about the band. There's a lot to learn -before and afterwards. My insurance first denied me, I appealed, 8 months later got my band. Good things take time! But they're definitely worth it!

Rebeccalee · January 7, 2005

Some doctors will not take federally funded insurance. I have a different branch -- for disabled vets, so it may be different, but what they pay is considered payment in full, like Medicare or Medical. The doctor can't ask the patient to pay more than the copay.

My doctor eventually did not take it, so I paid him myself. You might have to travel a bit to find the right doctor, but it is sure worth it. Good luck with getting approved. Keep trying with the doctor you have first.

May 11, 2005

Hi Everyone,

I am also a Newbie and searching for some advise. I had my surgery a year ago this past April 30th. I had my 1st fill last October. As of today I haven't lost anymore weigth since the 60+lbs I lost before the 1st fill. I have since started walking (hilly in my neighborhood)for 25 - 30 minutes each day and for the past 3 weeks working out at the health club with a personal trainer and riding a stationary bike for 45 minutes. I weighed this morning and I was up + 2.5 lbs!!!!!! I haven't talked to my doctor yet about this and I have never felt that comfortable with him. I feel he was primarily interested in taking my money as I was a cash client. Their office provided no weight-loss meetings post surgery with others post surgical patients.

I am really interested in finding out if there is anyone who has gone through the same thing and what they did about it. I am open to suggestions! I don't want to have a fill at this time as I am going to the Bahamas in June and don't want to restrict myself anymore than I am. I would like to enjoy the week without fearing that I need to run to the bathroom and vomit after every meal! I am thinging also about changing doctors!