Sharon T - PA 0 Posted February 12, 2005 Hi all, my name is Sharon. I'm 36 years old, 5'6.5" and 260ish pounds. I have finally recognized the need to fight my weight battle - so here I am. I'm married with two children (5 & 7) and couldn't bring myself to face the risks of RNY so after quite a bit of research, I've decided the band is a good choice. I have Anthem PPO insurance, which is self-insured. So far I haven't heard a definitive "no" on the banding, but not a yes either. The thing about self-insured plans is that the employer has the final say on coverage. I work for a very large company, but I do work in HR - so if I have to, I'm prepared to go up the company chain to get them to cover me. We'll see. My first MD visit is Feb 25th at Dr. Kwon's office in Port Jervis, NY. I'm really looking forward to hanging out here and learning from all of you. Sharon Share this post Link to post Share on other sites
Penni60 45 Posted February 13, 2005 Welcome aboard Sharon. Good luck with the insurance issues. I will keep you in my prayers that it is a YES. Ask any questions you might have and someone will be sure to answer. In fact several of us will answer. LOL!! We are in competition that way. No, I wanna answer. No I wanna do it. OH STop that, it's my turn. See but we love each other dearly. Share this post Link to post Share on other sites
Iluvharleys 15 Posted February 13, 2005 Welcome! You found the place to come for questions and support! Please browse through all the threads, you'll find lots of information. Penni - You are crazy! lol Share this post Link to post Share on other sites
Alexandra 55 Posted February 13, 2005 Hi Sharon! I'm in Morris County, NJ so we're practically neighbors! You're so lucky to be in the HR dept., since nothing will scare you off. I had a long battle with my insurer which finally resulted in third-party review which I won. If I hadn't been an insurance broker I probably would have given up partway through. Good luck to you and please keep us posted on your progress. I'm very interested in the insurance battles, especially in NJ or neighboring states. Nice to meet you!! Share this post Link to post Share on other sites
New Hope 37 Posted February 13, 2005 Good for you, Sharon! My insurance initially denied, I appealed, and 8 months later got my band. Your improved health is definitely worth whatever it takes to get your band. Best of luck to you! Share this post Link to post Share on other sites
Jammin & Losin 1 Posted February 13, 2005 Best wishes on getting your band! I hope all goes well for you! Share this post Link to post Share on other sites
Sharon T - PA 0 Posted February 13, 2005 I probably should have clarified a few things. Let's see. I live in Northeastern PA. I wasn't able to find any local docs outside of Geisinger - I've been in the Geisinger health plan for years, and never got any kind of warm fuzzy about my desire to pursue surgery. So, on 2-1-05, I was able to switch to my company's insurance (due to husband's open enrollment). Dr. Kwon's office is about an hour away from me, which I think I can handle ok. Anyway, I'm hoping beyond hope that I won't have to fight within my company - that means I have to notify the world about what I'm doing, and I'm not sure I want to become the poster child for WLS, you know? I've enjoyed reading all the posts and plan on hanging around!!! Thanks again. Sharon Share this post Link to post Share on other sites
Sharon T - PA 0 Posted February 13, 2005 I'm a die-hard Dilbert fan, primarily because of Catbert, who is the Evil Director of Human Resources (my hero). There aren't many places you can find reference to HR folks outside of the business place, and I find myself feeling ever so evil on a regular basis :devious I welcome any HR related questions/advice you might need. I've been at an executive level for a few years and feel pretty secure in what I know. (although don't be surprised if my Catbert side comes out now and then) Sharon Share this post Link to post Share on other sites
Alexandra 55 Posted February 13, 2005 Anyway, I'm hoping beyond hope that I won't have to fight within my company - that means I have to notify the world about what I'm doing, and I'm not sure I want to become the poster child for WLS, you know? I felt exactly this same way. But as it turned out, I only had to take one person in my office into my confidence, and he was very supportive and helpful. When I ran into another problem with my carrier AFTER they'd been told they had to pay for it, I did confide in our sales rep for the carrier. Believe me, I resisted that BIG TIME. I don't know if he pulled any strings for me or not, but the problem was solved within a couple of days. My point is that as you go forward, your feelings about going "public" may change. For the most part I'm still very private about it--of the 7 people in my office 4 still don't know (or at least, they don't mention it). Confiding in a select few for assistance doesn't mean you'll be the "poster child" for WLS. After all, you'll have the HIPAA laws to protect you. (Also, one thing I made VERY VERY clear to those people I did tell was the difference between banding and RNY. No one wanted to see me have RNY.) Cheers, Share this post Link to post Share on other sites
