NukeChik 1 Posted December 10, 2007 Hi All, I have been going through this journey for quiet some time now. Hopefully, I can schedule my band operation for the first or second week in January. I should find that out in the next couple of days. I will have to be a self-pay gal. My insurance tells me I'm not fat or sick enough for the surgery to be "medically necessary". My BMI is 37 and I don't have any health "problems" yet, and I stress yet. My insurance requires a BMI of 40 with no co-morbidities (they only have 3 in their criteria, Diabetes, sleep apnea, and coronary disease). I've decided to invest in myself though!! I still am very afraid that this will not work for me, or I'll have major problems that my insurance won't pay for. I just have to have faith, that as long as I follow the rules, everything will be alright. I live near Chattanooga, TN and my surgeon will be Dr. Ponce. People I work with have used him and are very pleased, plus I want someone with his experience since I'm a self-pay candidate. Share this post Link to post Share on other sites
Tuono_John 0 Posted December 10, 2007 Hi Nikki, Just take a deep breath and enjoy the holidays. You are giving youself the best holiday gift ever. My wife and I had lap band surgery 1/23/07. It has been the most amazing thing. I know it is a lot of money, but just on what you save on food you will be amazed. They estimate that your food bill goes down 60%! That is not to mention that you will feel so much better, look better, and others will coment on how much better you look. In my case after surgery and loosing so much weight I was offered and took a better job that pays more. Good luck. John Share this post Link to post Share on other sites
NukeChik 1 Posted December 10, 2007 Thanks for the encouragement!! I spoke with my surgeons office today and it looks like I'll probably get to get banded on 01/07/08. I'm so excited! Share this post Link to post Share on other sites
Lana24 10 Posted December 10, 2007 Thanks for the encouragement!! I spoke with my surgeons office today and it looks like I'll probably get to get banded on 01/07/08. I'm so excited! good luck and keep us (those of us waiting) posted Share this post Link to post Share on other sites
Tuono_John 0 Posted December 10, 2007 Hi Nikki, Have fun over the holidays and know that if you need morale support we are here for you. John Share this post Link to post Share on other sites
RonKat 0 Posted December 14, 2007 Hey Nuke, My insirance denied me too after doing evrything they asked of me for 6 months. My Doctor referred me to someone(lawyer) that appealed the case. It worked and I am having surgery on 12/21. Share this post Link to post Share on other sites
Daisalana 33 Posted December 14, 2007 Good luck new bandsters-to-be! The nervousness is normal, hang in there :scared: Share this post Link to post Share on other sites
NukeChik 1 Posted December 14, 2007 Good luck with your surgery. I know how you feel, I'm nervous but I think that this is the right choice for me. My insurance has a WLS exclusion -- I do not have any co-morbidities myself either. So I am also self pay. I live in the Atlanta area and would like to hear more about Dr. Ponce if you are willing to share. I have a surgery date in Mexico but I am still concerned about going there vs. finding someone local. Especially with the aftercare issue.I have yet to see anything but positivity about Dr. Ponce. So if you can provide any insight -- cost, etc -- I would appreciate it! My self-pay with Dr Ponce will be $13,800. There is a specific list of conditions that you must meet to get that price. Look at his website: Gastric Band Institute - Chattanooga, Tennessee - The LAPBAND® Procedure It has all the information on the cash pay option and what you must meet to get that. It should also be noted that the 13,800 option is for surgery in Dalton, GA. He has offices in Dalton and Chattanooga. The cash pay option does include a year of follow ups and fills, you are charged a facility fee with each fill, They told me how much that was but I can't remember, I have to go back in on Wed, for my Pre-op class so I'll check and get back to you. I went with Dr. Ponce because he has vast experience. I wanted that since I'm self-pay!!! Share this post Link to post Share on other sites