CoolBrze198

Hi Veronica, Thanks for the info. I have no co-morbidities. Altho my PCP said I am a boarderline diabetic. And I did have HBP a few years ago. But other than that, nothing now. Almost all of what you mentioned, runs in my family as well. I am hoping my UHC will approve me like they did you. I sure don't want to have to go thru the appeal process. But I will. Never give up! Also, have you heard if your UHC covers fills? I need to look into that as well. Take care

Hi Veronica, A big congrats to you. What did UHC require? I have UHC choice + and in our Plan booklet it says 40 BMI 40 BMI for 5 yrs and of course using in network provider & hosp (which isn't a prob) I am having trouble with the 5 yrs of 40 bmi. I have been getting all my records from my Dr's. And my BMI has ranged from 35-41.... So I am hoping that will work. What'cha think? I would hate to go another year or 2 Ugh.... I have my Orientation on 3/14 and consult with Dr 3/15. Can't wait! But anyway congrats again. And keep us updated.

:help: I am curious as to what the total out of pocket you had to pay for this surgery, Psych, Consult, Deductibles, etc...and what ever else I am forgetting about. I need to get a good idea so I can start preparing. I know all is different, but a ballpark is better than nothing...for now. Thanks in advance, Rosanna

Hi Sissy, I live in Polk county. I am not banded, yet. But I have a consult with Dr. Rehnke in St. Pete next month. I have done a lot of research and from what I heard he is awesome. I went to his Orientation and he is very personable. Check him out. http://www.obesitynomorefl.com Good luck. And keep in touch. Take care, Rosanna

I am a prebander. But with my previous surgery (hyst) I didnt have a problem with them. I am hypo. My thy levels have been under control for many years. Just check with your Dr. to be sure. Good luck on your journey. HTH, Rosanna

So, what was it? And would you do it again? (pre-op & post-op) :help: We pre-oppers are looking forward to the stories we can get our eyes on. Lets see what kind of stories we will end up with... Give us your stories... :clap2: TIA,

:help: I am curious as to what the total out of pocket you had to pay for this surgery, Psych, Consult, Deductibles, etc...and what ever else I am forgetting about. I need to get a good idea so I can start preparing. I know all is different, but a ballpark is better than nothing...for now. Thanks in advance, Rosanna

Tracy, I have been following your posts. And am soooo happy for you. :clap2: Congrats on the date. You have worked hard for it. And it is all about to pay off. Keep us info'd if anything changes and luck to you with your headstart on weightloss. Take care, Rosanna

I have been wondering what the effects of Optifast would be. I know I will find out when I talk to the dr. I want to kinda of plan those 2 weeks out, since I will be at work. With a bunch of nosey @$$ people.. ) I have only told 2 people in my small office that I am going thru this. But my main concern is there any negative effects from optifast? Diarhhea (sp), gas?, sick stomach? :heh: My consult isn't till next month and I know I would be able to get some great answers from this wonderful board. TIA, Rosanna

:laugh That made me laugh.. Woo Hoo.. Thanks for the input Susannah & Gaffer.. I was worried that I would have some 'ill effects' and working in in office wouldn't be pretty. Esp. in our office. LBT are the best group of people. Thanks again, Rosanna

Hi all, I am wondering.... My Ins requires : * Minimum of 40 BMI * Documentation from a Physician of a diagnosis of morbid obesity for a minimum of 5 years What my question is.. Has anyone not had 5 years of morbid obesity that was required by ins? I have been collecting all my records from all my Dr's. And for the past 5 years my BMI has been between 35 & 41. But not a steady 40 for the last 5 years. Anyone dealt with this? If so, what was your outcome? TIA,

In what order does everything happen from the beginning... I faxed some paper work into the Dr. office. Will I be set up with the initial meeting. I have already attended a seminar. Then when does the Dr try to get pre-authorization from the Ins. co. Is that before or after the psych eval.? I have requested all my records from previous dr's. Should have them with in a week or so. Just wondering what stages you went thru?? And the length of time it took. :help: TIA, Rosanna

The requirements are: * Minimum of 40 BMI * Documentation from a Physician of a diagnosis of morbid obesity for a minimum of 5 years :omg: * Over 21 years old * Surgery is preformed at a network hospital by a network surgeon even if there are no network hospitals near you.. Being they want a 5 yr documentation.. I am getting a copy of all my records. Then I was told that I would be covered 80% after my deductible. Any other hints, stories or anything you want to share is welcome. Thanks again, Rosanna

Thanks so much for the quick replies.. I will be on the phone tomorrow and call them. My BMI is like 40.02 or something like that. I am only 5'1" Vertically challanged.. LOL

Hi, I just got a copy of my benefits booklet. The requirements are: * Minimum of 40 BMI * Documentation from a Physician of a diagnosis of morbid obesity for a minimum of 5 years :omg: * Over 21 years old * Surgery is preformed at a network hospital by a network surgeon even if there are no network hospitals near you.. What my problem is.... I don't think I can get 5 years of documentation. I have only been with my curent PCP for a few (2-3 years) and went to a few different Dr's before him. Not sure if any of them put down morbid obesity in my file. Most of the time I never questioned my weight. Or they never questioned it.. Can anyone help or been in this situation and got all the needed docs? Also, anyone know how long dr's keep your files if you no longer go to them before they are destroyed? TIA, Rosanna :help:

I would have to say my favorite commercial of all time. Was the Citi Identity Theft commercial.. The one with the 2 old ladys sitting on the couch talking about some mtorcycles... LOL.. Too funny. Esp. when the 1 says "shoot" and the other says "yeah shoot"... LOL I miss that one

If you know anything about these Dr's please post your stories. Thanks

Hi Jukebox, Thanks so much for the info. I will check it out. If any of you know a PCP that has patients who did the lapband, please let me know. I am looking for someone here in Lakeland or maybe Plant City. I would hate to change PCP's but will if I have too. I am gonna try to talk to my PCP again when I go back for my blood work follow up in 6 weeks. Hopefully I can get him to say that he would refer me for the LB.. Keeping my fingers crossed. And I am still waiting on my benefits booklet as a clarification on the coverage. Guess I will send hubby to HR on his day off next week. Thanks again, Rosanna

How many of you had your PCP deny or not referr you out? What did you do? My Dr. told me today that "LapBand wasn't for me" And that I should take everything I eat and cut it in 1/2.. Tried to do that, but dern I was still hungry..Also put me on some appetite suppressents.. Been taking them for a couple months now and nothing... grrr So, how many people out there in my shoes? I am trying to get a bunch of different situations I could look at. I really don't have the funds to be a self pay... TIA,

I also have UHC Choice Plus.. The girl on the phone told me I was covered at 80% with a $1000 dudctible. But I needed to get documents from Dr saying medically necessary. with Docs showing HBP or Obesity related items...But I am not gonna keep thinking this will be covered until I get my benefits booklet in the mail. Bad part with me, is the Dr said it isn't for me. And I don't have any obesity related items. He just told me I am boarderline diabetic. And the only other thing I have is hypothyroid... Grrrr.. I think I may be shopping for a new Dr. Hope all goes well with you all. Take care,

Hi Everyone, I have been doing research on LB.. I would love to have it done. I have not went to an orientation. I will attend on Jan 23rd. I am really excited to get more info. I did get a brochure in the mail from Dr. Rehnke's office. I have it all filled out. Will take it with me to the meeting. What all happens at the orientation/informational meetings? After the initial meeting is that when you schedule your 1st meeting with the Dr. to discuss the surgery & ins. and the whole shabang? I called my ins. co and they told me they cover 80% of surgery. And I think she said I had a $1,000 deductible. I am having them send me a copy of our benefits booklet. Want to get it in writing... One of my biggest things I am concerned about. What if my PCP doesn't agree with this surgery. I am sure there are many Dr's out there that will not approve having LB done.... ?!?!?! I haven't talked to him yet. But will soon. I have a followup on my bloodwork on tues. Have to get it done every year because I have an underactive thyroid.. Have any of you had a PCP not approve surgery? If so, how did you handle it? Did you get another Dr? :nervous Also tell me about the Optifast? Is that a drink? What is the taste? Thanks in advance.... :wave:

Hi Melody, Thanks for the input. I am very glad ins is doing 80% Because I don't have the $$ for self pay. But then, I need to find a Dr that will agree to it. So I am sure if I don't get a yes, then I will have to go as a self/pay... grrr....I know when I called ins. They told me I would have to get all documentation from Dr claiming medically neccessary, HBP or obesity related items etc., then once approved I would have 80% of eligible expenses. After $100 deductible.. Still waiting on my benefits booklet. Will keep you all posted. Thanks, :wave:

Thanks for the replies everyone. I did mention it to him. And he said "it's not for you" Then he went on to ask who was diabetic in my family.. Well of course, my mom & all my aunts...Because my sugar is borderline high.Then he proceeded to tell me I need to cut every thing I eat in 1/2... I don't think I eat a whole heck of a bunch. And have tried several appetite supressants. He prescribed me more. Will try, tried last time with no help. I did see on some website that there were Dr's that believed in the surgery.anyone know where this list is located? And if my Dr won't send me a referral I guess I will have to find another new Dr. or to self pay. Trying not to do that don't have that much $$ I can't just give up. I would have to pull some strings and do a lot of work to make it...Look out credit cards here I come. For the ones not already maxed out. hehehe Help? Any other things you can think of for me to try?

Hi everyone. I am over in Polk county. I actually live just south of Lakeland. I have been doing research on LB.. I would love to have it done. I have not went to an orientation. I will attend on Jan 23rd. I am really excited to get more info. I did get a brochure in the mail from Dr. Rehnke's office. I have it all filled out. Will take it with me to the meeting. What all happens at the orientation/informational meetings? After the initial meeting is that when you schedule your 1st meeting with the Dr. to discuss the surgery & ins. and the whole shabang? I called my ins. co and they told me they cover 80% of surgery. And I think she said I had a $1,000 deductible. I am having them send me a copy of our benefits booklet. Want to get it in writing... One of my biggest things I am concerned about. What if my PCP doesn't agree with this surgery. I am sure there are many Dr's out there that will not approve having LB done.... ?!?!?! I haven't talked to him yet. But will soon. I have a followup on my bloodwork on tues. Have to get it done every year because I have an underactive thyroid.. Have any of you had a PCP not approve surgery? If so, how did you handle it? Did you get another Dr? :nervous Also tell me about the Optifast? Is that a drink? What is the taste? And on the fills, what is the "with flouro"? I have seen this in several posts but nothing explaining what it was. Thanks in advance.... :wave: