Diva01

I'm scheduled for June 30th. I have to be at the hospital for Noon and my surgery is at 2p.m. I was pretty happy that it's not scheduled so early in the morning. Plus I have to shower with some antiseptic soap the night before and morning of. Good Luck

I currently have BCBS TRS Active Care. When I started the process in January it was only 3 month supervised nutrition visits. But in March BCBS decided to change it to 6 months. ( I was pissed off) I finish all of my visits June 1st including PSY visit. Initially, I thought I wanted the sleeve and the office sent the paperwork on Thursday and I was approved that Monday. Then I changed my mind and it took a few changes for the insurance to change everything. I will be banded on June 30th. So it has taken 6 months to complete all of the criteria. I will be coming out of pocket $2,500 for everything. Now the worst part, BCBS TRS Active Care come Sept will have a $5,000 COPAY for any surgery that is related to bariatric. In addition, to deductibles and out of pocket max. So I am praying that I will not have any complications with the band and that my insurance will remove the $5,000 copay. It saddens me that they would add such a high copay for this surgery and anything related to it. Good Luck

Congrats on making the first step. My advice is to write down all of your questions or concerns about the band, procedure, aftercare, and living with the band in the future. I kept a memo pad in my purse and whenever I thought of a question in the middle of the day I would write it down. As far as finding out insurance coverage, I lucked up that my company was switching carriers and the enrollment booklet stated that the covered weight loss surgery. But you call before your seminar and ask about the coverage on bariatric surgery and the criteria. I have not been banded yet (June 30th) and its been a smooth ride. But I stayed on top of everything I needed to do and also checked the progress with my case manager. The most valuable advice is to make the best decision that is best for YOU! Whatever surgery you choose, remember it is a tool to be used to achieve weight loss. Good Luck!

I'm getting banded on June 30th also! I agree with the other post, try asking the pharmacist for liquid form.

I hope all goes well. I just received my approval this afternoon. Good Luck

I just got off the phone with the insurance company...and I got my approval! I'm soooo happy. Hopefully my surgery will be June 30th. I just want to Thank everyone on this board for all of your advice and being an inspiration to me! Next goal is to conquer the Pre-op diet for five days!

Thanks for the advice!

WOW Congrats on your new beginnings! I have not been banded yet but I would like to read about your journey so far with the band. I'm hoping I will have mine by June 30th.

I just got off the phone with the insurance company (they received my paperwork last Thursday) and so far the nurse has reviewed my file and has sent it to the Dr for the insurance company (BCBS TRS ACTIVE CARE). I'm hoping everything is approved by the end of the week, just in time for my June 30th surgery or earlier! I'm so happy and praying for a speedy process.

I'm from houston too! i have not been banded yet, but I would like to hear about your experience so far. I'm hoping I will be banded by June 30th

I have not been banded yet! I just completed my last nutrition visit this week. For the past few months, I have been going back and forth between the band and the sleeve. I was terrified at the thought of removing more than half of my stomach and the possibility that if I do not keep the weight off with the sleeve and gain the weight back, I lost part of my stomach for no reason. In the end, I chose the band. I'm only 28 and I don't have any children, so knowing I can have an empty band while I'm pregnant and fill it back again to jump my weight loss was great. Plus after reading all the success stories of people who have lost large amounts of weight, I realized I too can be successful. It's all up to me and my tool!

I am so inspired after looking at your pics. I have not been banded yet (hopefully in June) and seeing your success lets me know I can just as well as you.

Thanks for replying! I plan on harassing the insurance company until I get an approval!

Hello everyone, I am in the process of completing all the criteria for my insurance (BCBS TRS Active Care) approval for my band. I have completed the psychological visit, I have one more visit to the dietician this week (YEAH) and my bmi qualifies me for the band. So far, my surgeon's staff has been great. Since I work at a high school with special needs students and I am required to lift them. I want to make sure I am completely healed before I return to work mid August. How can I make sure all of my paperwork is submitted correct the first time and some suggestions on how I can get the insurance to quickly approve me. I'm praying that I can have my surgery by June 30th. Any suggestion will be helpful! Thanks

I have BCBS TRS Active Care. I was told at my nutrition visit not to lose or gain a large amount (50 pounds) during my visits. I am assuming whenever she submits her paperwork it will show my weight at every visit. I am not sure but I do know she does a lot of documentation when we do visit. She stated that the insurance company does not tell us everything and that they can be very picky about the documentation. I would ask your case manager at your surgeon's office her opinion.

I totally agree, you need to check with your insurance company to see what is the criteria for bariatric surgery. I would call your insurance company and ask for the requirements and where on the insurance website can you find this information. I have BCBS and they were great about walking me through step by step while I was on the phone and on the internet at the same time. So far, I have learned a valuable lesson in my journey, I started my process in January with my surgeon, at the time all I needed was 3 consecutive months of nutrition visits, a qualifying bmi, and one visit to the psychologist. I was thrilled! One day I was checking the website and saw that beginning in March BCBS was extending the nutrition visits to 6 months. My heart almost dropped. I called and was told that the information was correct. At first I was livid because I was so close. But I thank god because they could have done away with it all together. So, I have learned that you have to stay involve and up to date with the insurance company and their changing policies. Before I called the insurance company I had a list of questions from how much my out of pocket would be, clarification of the criteria to qualify for the surgery, and how long they had to approve my surgery. I could have gone with weight watchers for the six months of nutrition visits, but I chose to go with the dietician at my surgeon's office. I have read how people have had problems with approval because of the nutrition visits and I thought my going to the dietician that would eliminate that problem. In her documentation, she is thorough on my diet and increase in exercise and know exactly what the insurance is wanting. I hope this helps! And I am glad you have support from your family because that can make a huge difference. Good Luck

Hi, I am new to this board. Although I have not had the surgery and I can not be much help in what to expect, I want to encourage you to research and speak with a qualified surgeon and individuals from this board. Reading everyones experiences brings a sense of inspiration that I too can conquer obesity. One thing I have learned is everyone's experience is different. Some people have great success and others do not have the same success. Sometimes we don't hear the whole story as to why someone's band was not successful or the expertise of their surgeon, but all those things should be taken into an account. I am one of those who is quick to go to the doctor if I sense anything is wrong. I had concerns I would be one of those who would have many problems with their band. My surgeon and case manager have explained to me, the importance of maintaing regular visit to them and my nutritionist as a part of my after care. You should examine the regular maintenance of the band and be honest with yourself if you will be able to keep it up. Also, your surgeon needs to take into an account any other medical problems or issues you have prior to getting the band because maybe another wls would better suited. I don't want discourage you from the lap band but to look at all your options. Like you, I have struggled with my weight almost all of my life. My family is supportive of my recent decision to get the lapband surgery. I have never had surgery in my life and this would be the first. As I research and ask questions the more I know I am making the best choice for ME. I have wanted this surgery for 4 years now and researched the bad and the good. I am here to talk and you are more than welcome to message me. Good Luck!

My out of pocket max is 2,500 and that is including my $500 deductible if I have not met it. When I called the insurance company she said that once I pay the $2500, that is it! I don't owe any more money during that insurance year (mine is Sept to Sept). I hope this helps.

Please don't give up! I have wanted this surgery for 4 years. I started out on my mother's insurance trying to get approved only to find out they did not cover any wls. Recently my employer switched insurance companies and they cover wls. I feel like God has given me this chance and I will not go down without a fight. Currently, my max out of pocket expense is $2500. However, the insurance new year starts Sept 1st, any wls will have a $5,000 CO PAY on top of my deductible of $750 plus my out of pocket max of $ 2000. So right now, I'm fighting to make sure everything happens before Sept 1st. I would try to find a surgeon that is in network with your insurance company. Try checking out on the board if anyone has been banded by any of the doctors in network with your insurance company. Just make sure you feel comfortable with your dr and staff.

I don't think you are jinxing yourself at all! I am 28 and single with no children and I feel like it is my responsibility to make my wishes clear for my family plus, a personal letter. I have not been banded yet (I'm praying that I will be on June 28th) but lap band surgery does carry a risk like any other surgery. It never hurts to leave a letter to your love ones.! If writing a letter will help ease your anxiety then write the letter. Like I tell everyone, Follow your heart! Good Luck!

I have one more nutrition visit next week and then my stuff will be sent to the insurance company. I'm hoping I can get a quick approval (like 2 weeks) and be banded by June 28th. My surgeon (Dr. Speigel) only does surgeries every other Thursday and I would like to be healed before school starts in August. Good Luck!

Congrats on your new beginnings! I'm 28 and sweating like a pig down here in Texas! LOL I'm new here too and I can't wait till I can begin my new journey.

Hello, I am 28 and I have one more nutrition appt before my paperwork will be submitted to the insurance company. So far, I have found this website soooooo helpful. Good Luck with your weight loss