just starting the process

[StarbuxQueen 0]

Well, I went the the seminar on Saturday and got VERY excited at the prospect of being able to wear normal size clothes, not get out of breath doing normal things, not pay for 2 seats on an air plane, ride on the Harley with my husband...but they shot me down on Monday. My AETNA plan "excludes" any type of weight loss surgery. Now I have to decide if I want it bad enough to finance it.

DON'T BE DISCOURAGED. I HAVE AETNA AND THEY APPROVED ME. THEY STATE IN ON THEIR WEB PAGE THAT THEY DO NOT COVER ANY WEIGHT LOSS SURGERY UNLESS... I WILL SEND YOU THE LINK. THEY REQUIRE A BMI OVER 35, SIX MONTHS OF NUTRITIONAL VISITS AND A FEW OTHER THINGS. MY NUTRITIONIST HAD IT ALL OUTLINED FOR ME. I HAD TO MAKE BEHAVIOR CHANGES. ONE A MONTH AND DOCUMENT THEM. THINGS LIKE. ..NOT EATING IN FRONT OF TV, WALKING, NO CAFFIENE. I WILL INCLUDE THE LINK FOR YOU. IF IT DOESN'T WORK JUST GO TO AETNA.COM AND FROM THE HOME PAGE SEARCH FOR LAP BAND. IT IS ONE OF THE FIRST ARTICLES.

GOOD LUCK!

Obesity Surgery

[cleanteeth 1]

Bama, I'm so sorry. I wish I had an answer for you. That is a hugh amount of money to pay out of pocket. I don't think I could do it. Again, I'm sorry:sad_smile:

[newin 0]

I just have a few questions for those of you who know a little more about the process. Ok I have found out from my insurance co that they do cover the lap band surgery if I meet certain criteria. Medically supervised weight loss plan for 6 months which I have not done. I guess overall I just need to know the correct steps to take because I was already thinking of going to talk to the surgeon...any advice will be helpful. Thanks

[Bama_belle62 0]

Thank You!!! Thats a very interesting article.

Unfortunately my policy does exclude weight loss surgery but I'm going to contact the human resources dept at my physicians suggestion and see what it would take to get them to change or make some exceptions.

I'm trying to keep positive thoughts, it's hard, I'm impatient.

Thanks again

[Enchanted 2]

Best of luck to you, Bama.

Try to keep your chin up.

-Christine

[StarbuxQueen 0]

Every company is different. My surgeon has a nutritionist on staff. She had all the details for my insurance plan. She kept track of everything I needed to do.

I went to my insurance companies website and did a search for lap band and it was all laid out in an article.

I had to have nutritionists visits, follow a low cal diet (but my friends insurance required a high Protein diet), & note behavior changes.

[Bama_belle62 0]

Ok, so here's my options and concerns:

1)

I can finance it, BUT the $16,100.00 only covers everything for the first year. So lets say in 18 months there's a problem or in 5 years something major happens to the band, I'm on my own for that cost.

2) I pay for the surgery, lose the weight and I have this hideous excess skin, I'm on my own to pay for that as well.

3) How much are "fills"?, after the first 1 I have to pay for those out-of-pocket as well. How long do we have to continue to get "fills"?

*screams* lol

I'm not giving up!

[ready_2_lose 0]

Hi. I am in the same boat. My insurance company said that since my BMI is "only" 38, I don't have any co-morbities except for a slightly elevated sugar level. I am really bummed. My DH knows how bummed I am so he actually tried to apply for a loan to get the surgery. He got turned down, but it was sweet of him to try.

I looked at the charts and saw that if I gain (ugh) 12 pounds, then I would be at a BMI of 40. Does anyone know anyone that actually gained weight to meet the requirements? Someone told me to wear ankle weights, if you can believe that! LOL what if they say to take off my clothes and weigh! Yikes!

Thanks! I love hearing your stories! I'm rooting for everyone!

[cleanteeth 1]

I have sleep apnea so I'm hoping that is my "condition" .. my BMI is 39. Honestly.. I would eat my self to a BMI of 40. Which would be for be about a week. I don't know if you will need to wait a certain period of time to re-apply. Isn't that crazy..! Talking about making yourself more sick and fat! Shame on insurance companies!