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Don't know how to feel

I am not a big blogger but I just needed to get something out. I was told that I would be able to get the lap band by my insurance because of the information given to me before I signed up with them. I had been putting it off for a while and just decided the last week that I would go get my evaluations done and get the ball rolling. I am all happy and excited about the prospect of being able to finally do something about my weight. A few girls where I work have had it done and they look great and they are so happy they had it done. So I am happy and excited until I get to the doctors office and they call the insurance company. They were told that I would not be approved. I almost cried. I called and talked to insurance company myself and they said that I would have to go through an medical review. I told them that I knew that and asked again what the requirements where and they said that I needed to have a bmi over 35. Which I have. So I talk to the Dr about it and we do all the work ups to send in for the evaluation but the Dr still seems to think I will be denied. She said she has dealt with alot of insurance companies and it didn't sound good but she would do what she could. So now I am waiting. I don't want to hope and don't want to think about it but it is really all that is on my mind and it is weighing me down greatly. I just wanted to feel better.

4 Comments

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bmann

LAP-BAND Patients

I am not a big blogger but I just needed to get something out. I was told that I would be able to get the lap band by my insurance because of the information given to me before I signed up with them. I had been putting it off for a while and just decided the last week that I would go get my evaluations done and get the ball rolling. I am all happy and excited about the prospect of being able to finally do something about my weight. A few girls where I work have had it done and they look great and they are so happy they had it done. So I am happy and excited until I get to the doctors office and they call the insurance company. They were told that I would not be approved. I almost cried. I called and talked to insurance company myself and they said that I would have to go through an medical review. I told them that I knew that and asked again what the requirements where and they said that I needed to have a bmi over 35. Which I have. So I talk to the Dr about it and we do all the work ups to send in for the evaluation but the Dr still seems to think I will be denied. She said she has dealt with alot of insurance companies and it didn't sound good but she would do what she could. So now I am waiting. I don't want to hope and don't want to think about it but it is really all that is on my mind and it is weighing me down greatly. I just wanted to feel better.

betzeebug

LAP-BAND Patients

Bmann, if you really want this then fight the insurance company. Once they deny you, you can write an appeal and if they still deny you, then go to your state insurance commission. Every state has one. go on line (google) and look it up and how to appeal your insurance denial. That's what I'm doing. First I got a loan for the surgery now I'm going to sue my insurance. Believe me I'm going to win!!! so fight for what you want!!!...betz

Lisa07

LAP-BAND Patients

Sounds like everyone is battling their insurance agencies for this surgery! I just posed a blog that my insurance Care First Blue Cross wants you to have two 3-month structured diet programs as one of the criteria, I have one, I tried Nutrisystem last year for four months and I lost a little but immediately gained it all back. I've done WW several times but not within the two year timeframe they are looking for. I guess i could start WW online and pay for it for three months right? Any other suggestions for me?

starr

LAP-BAND Patients

For everyone who has been approved and had LapBand surgery...stories like this should make you appreciate the opportunity you have been given and don't abuse the Band. Bmann, hang in there and don't give up. My wife was denied at first and she kept after the insurance and finally was approved and is scheduled for surgery on June 3.

Give them everything they ask for in terms of requirements and more. My wife attended extra dietician appointments and met with counselors. It paid off for her.

Good luck and I will pray things work out for you!

Brian

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