Where to go from here...

[bripilot 0]

Hello all...

I'm from the Kansas City area and have recently decided to start the process to get banded. My wife was banded in 2002, her two sisters after that and between the three of them, have lost almost 500 lbs.

I swore I would never get fat. In high school and when I was in the military, I was never more than 210 lbs. I'm 5'10, but was athletic and physically fit. About the time I turned 25, I had gotten out of the military and started working for a local police department as a dispatcher. Sitting for 8-12 hours a day, talking on the phone and radios. It didn't help much that our office was right next to the break room and the vending machines. By the time I was 30, I was weighing in at 260. I got married to a wonderful cook and here I am, almost 40, and topping at 365. If I had held true to my word as a young man, I would have killed myself when I hit 300. Luckily I didn't and here I am.

Eating for me has rarely been psychological. Or at least I don't think it has been. I enjoy food. I enjoy the tastes, the textures, and I enjoy a good meal. I guess I enjoy it too much. The only time emotion has ever come into play is every once in a while, when I get down on myself and down on life, I will order a pizza and finish the whole thing in one sitting. That happens about once every 3-4 months.

So that's brought me to where I am now. I currently travel alot for my job and every time I board a plane and have to ask for an extension, part of me dies inside. It's not pleasant to watch people when they realize they have to sit next to the fat guy. Most people try to hide it, but many times I've gotten that "You've got to be kidding me!" look. I used to love flying.

I decided to call my insurance company, Anthem / BCBS. I wanted to find out if they even covered bariatric surgery. Turns out that the plan my employer has with them does NOT cover any kind of weightloss surgery. Not the bypass, not the band, not a thing...

So now, I wonder... do I self-pay or do I go thru the initial process and see if my Doctor can get them to approve the surgery?

I went in for my initial consult with my local family doctor and he referred me to Tallgrass Surgical in Topeka, KS. They have a rule that before they will even see you, they require you to attend a monthly seminar for the lap-band. This is not uncommon from what I've seen. So, one Saturday morning, my wife and I packed up, drove over an hour to Topeka in the middle of a rainstorm, and got there 10 minutes late. I was turned away at the door, being told that they don't allow late arrivals. I will not do business with someone who is not only rude, but has no compassion for prospective clients. There are many other local doctors I can go to for my procedure.

Anyway... has anyone had the same block with their insurance? What did you do? My credit is not the best, otherwise I would just finance it.

I know I need to lose the weight, I just don't know how to overcome this $10,000+ hurdle.

My name is Brian and I'm a fat guy... *sigh*:biggrin:

[WOWOX7 0]

BRIAN,

Hi,

I am from Kansas City and had the lap band done in Jan of 08. Although my insurance"might" have paid for my procedure, I was unwilling to wait the 9-12 + months they required for supervised dr visits, nutritionalist and physcoligist visits. I decided to self pay. I like, you looked at two or three different Weight loss surgical Doctors. I was discouraged with one,the other surgery center just flat out lied to me just to get me in for consultation visit $150. out of my pocket. I then found Dr. Malley. I went with him. He has a free siminar, I was soooo impressed with him... Still am. He is wonderful, along with his staff. I ended up using half savings and putting the other half on a "very low" intrest credit card. You know.. I used the little checks they send you.

I can not and did not put a price on my health, a family history of diabeties scared me to death. 9 months out and the only regret I have is that I would have done it earlier.

I do not know if Malley has a payment option. but here is his website. Please look into him. You will not be sorry.

www.malleysurgical.com

Please let us know what you decide on your journey.

Lois

Edited October 20, 2008 by WOWOX7

[brownskin82 0]

Hi there, I am know what you mean. I myself have just begun the process with the lap band. I waiting for approval from my insurance. I am going through Dr. Jessie Lopez at KClapband.com. I know a few people that went to him and all I heard is praise. He is very nice, honest and genuine. With him you only need to attend one free seminar which he has once or twice a week.

Good Luck!:biggrin::thumbup:

[bripilot 0]

Lois - Funny you should mention Dr. Malley. My wife also highly recommends him and I had all but made the decision that he was going to do my surgery.

I don't have much in savings, and I don't use credit cards... I'm just praying that somehow the funds will arise to pay for this. I may be able to sell-back some of my vacation time to my employer and get some money that way, but that could take a few months at least.

Anyway... Thanks for the reply... =)

[Guest abs-of-steel]

Hi Brian and Ladies,

I am from the KC area too, actually Harrisonville. But, close enough :biggrin:

I too have terrible insurance that would not pay anything for this surgery. Plus I would have had a hard time waiting out all of the hoops to jump through.

So, I went to Mexico in Feb '08 and had surgery. The best $8,000 I've ever spent! I'm so glad I decided to do this for myself.

I have my aftercare done at IABS in Lenexa. They are pricey, but I called Dr Malley's office and the waitlist for Mexico patients was just too long. I'm thinking of trying to get in with him again because he was a lot cheaper for fills.

Good luck on your decision and journey Brian, we are all here to help.

Abbie

[bripilot 0]

Abbie...

Nice to meet you... I graduated from Harrisonville HS many moons ago...

Nice to talk to a home-town girl... hehe...

Anyway... I've decided that if I do have to self-pay, I will most likely go to Mexico. My sister-in-law went down there to have hers done and she was thrilled with the doc, the service, everything...

I'm just overwhelmed at the cost. You would think that more insurance companies would pay for this rather than the alternative of high-blood pressure medications, Nexium, arthritis meds, etc... all the co-morbidities I have will, I'm sure, cost them far more than the surgery today.

Brownskin -

What insurance do you have? What are you going to do if they decline payment?

[gentylwind 1]

Brian, I just want to give you a hug and tell you it is all going to be okay.

If your employer did not purchase coverage for bariatric surgeries no amount of appealing will get them to do it. I would not waste your time on that.

I thought about Mexico too but found a place here in Dallas that does it for under 10K. Be sure you get a doctor to do your fills and aftercare lined up BEFORE you go to Mexico to have this surgery. Seems a lot of the local doctors don't accept patients who had the surgery in Mexico.

[Kalipso2 25]

my company did not cover any weightloss surgery either. i didn't even bother to try and fight it. i wanted the surgery NOW, not after months and months of fighting.

being self-pay the process goes by so quickly. i had my initial consultation, nutrition class, pre-op testing and the surgery within 30 days of the free seminar!

yes, it sucks i have a huge bill to pay off but it is SO worth it!

[Guest abs-of-steel]

So Brian, a 1987 Grad?? My hubby graduated in 87 from Harrisonville, you prob know him, Doug Johnson? Small darn world, haha.

I completely agree with the other reply on getting your aftercare setup before going to Mexico. Just to be safe :biggrin:

Plus, I know a lot of doc's schedule very far out with the mexico bandsters. Good luck and keep in touch!

Abbie:thumbup:

[ckelly37 1]

Hey guys and gals

I can relate i had aetna thro my employer and he also did not pick up bariatric surgery so it was excluded from my policy...since i didnt want to self pay (lack of funds) i opted to find my own insurance..i went with personal choice...june 6th i had my seminar they informed me aetna would not pay i got my new insurance july 1st and by july 8th i was approved!! Good thing is my employer picked up the tab on the insurance since i dont use his anymore he was willing to pay $400 a month towards new insurance which was great since it costs me 474 a month (family plan)..i got the band sept 8th and my total out of pocket for surgery was $1,300 better then 8,000 or 10,000...my suggestion to u is look into an insurance company that will pay for it.