How To Start The Process ?

[lovexalways56 0]

Hi. I'm 17 years old and I've been trying to get approved by my insurance for the surgery since age 15. I have been approved once or twice but the hospitals for adolescent lap band surgeries are limited and so far away. I decided to wait till I'm 18, next May but I have heard it's a long process and wondered if I should and if I could start now. Could someone give me an idea of how long the process will take and where to start? My doctor approves of it and I know of some hospitals near me that perform the surgery but I have no idea where to begin. My parents support my decision but I basically have set appts., find hosptials, etc. on my own. Some information about starting out would be helpful. Thank you.

[CarmenPonce 0]

I would say start with your insurance carrier. Find out if you have coverage for bariatric surgery. Request and “EOC” Evidence of Coverage. This will be a full description of your coverage’s. Next ask what are their requirements for bariatric surgery? With this information you can go to your “PCP” primary care provider if you have a HMO or if you have a PPO you can ask you regular doc who he would refer you to. If you have a PPO most insurance carriers have a web site for you to be able to search for a bariatric surgeon. There’s no point in picking the hospital before picking a surgeon as not all surgeons operate at all hospitals.

I hope this gets you pointed in the right direction

[pennreporter 12]

I second everything the previous poster wrote. The first place is your insurance company. My insurance is an HMO with its own hospitals/doctors. So they had their own bariatric department, and my only choice was to go through their program. But when you go through what your ins. co does/does not cover it should be very specific. If not, call them and request what their requirements are as far as BMI/comorbidities. Mine was at least a 40 BMI for I think a five year period and history of failed weight loss. If between 35-40 you had to have other medical issues.

But my primary doctor was wonderful. I had one previous to him that when I mentioned it, he pooh-poohed the idea and gave me the whole watching-your-calorie speech.

My program was also a six-month program, which actually is more like 8 months. So I would start your process now because assuming you would meet ins. co's requirements, sometimes it takes time to get into doctors, etc.

I would be very specific when asking ins. co if they cover surgery for your age, because if they don't, that may be your deciding point. Some doctors, if they know your plan won't cover it, won't even start you on the journey.

But I will give you this bit of info. My daughter had hers done Feb 08. She's 37. She struggled from the age of 5 with weight issues. If your family is supportive of you doing this, it's wonderful. In hindsight, had this procedure been around when she was 17-18, I would have consented in a heart beat. It has been life changing for her and I know first-hand the heartache that teenagers go through with the weight because I've lived through it with her.

Best of luck and please keep us updated on how it goes with your insurance company.

Trisha in da Poconos