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Hi Lisa, I live in Barrington. I'm using the Suburban Surgical Care (Kane Grp) office and will have surgery at St. Alexius. Hoping this liquid diet gets better as I'm pretty hungry still:) Good luck just 3 days before me so would love to hear how you are doing. Cyndi

Hi Lisa, I live in Barrington. I'm using the Suburban Surgical Care (Kane Grp) office and will have surgery at St. Alexius. Hoping this liquid diet gets better as I'm pretty hungry still:) Good luck just 3 days before me so would love to hear how you are doing. Cyndi

Hi Lisa, I live in Barrington. I'm using the Suburban Surgical Care (Kane Grp) office and will have surgery at St. Alexius. Hoping this liquid diet gets better as I'm pretty hungry still:) Good luck just 3 days before me so would love to hear how you are doing. Cyndi

Hi, I'm Cyndi a 48 year old mom of two (6 and 8) in IL. I worked so hard all my life to keep weight off and did yo yoing but got really serious in my 30's and lost allot (60lb) and worked hard to keep it in check (with tons of exercise). I got married at 39 and knew I wanted kids so it was now or never. I knew weight was going to be a challenge with pregnancy which was no surprise that it was! 60lb's with first and only 25 with second but had only lost about 30 pounds with the first. I had made a pact to myself that if I couldn't get it under control within five years I would take more drastic measures as not only unhappy with myself but as I get older I'm very concerned of my health and it's affecting things I can do with my young children. So here I am. Fought hard with insurance and lost as I have tried hard for 6 years to loose weight usually on phentremine which I guess unfortunately now kept me within 10 pounds or less of a BMI of 40 (I'm 40 last year and this year now a 42).. just enough for insurance to say I wasn't morbidly obese. Anyhow, it's important enough for me to go forward self pay. My biggest concern is the unknown of any complications not being covered but my Dr. offers some extended coverage for a cost which I will get. Surgery is 4/20 and trying hard to be a model patient. It will be hard but i really want to make this work. I hope the help of the lap band will really get me going once and for all. Looking forward to the forum and enjoying all I have learned already. I think a great way for support the folks that are on the same journey. Thanks. p.s. First day of liquid diet not exactly easy on Easter Sunday but I will survive.

LOL.. that's the way to do it! Luckily it's just my family and mother in law. Usually it's a whole brood. I guess I felt guilty not giving them something they would normally get. I know I'll get through it and tomorrow hopefully will be better. One day at a time. Thanks for the post. Cyndi

Hi, So you got me thinking.. I have surgery scheduled fro 4/20 for the band and start the liquid diet 4/6. I don't see the Dr. until 4/18. When had the ultrasound they did tell me that I had lots of little stones. I had gall bladder issues 20 years ago that were horrible and was going to get out then they stopped and have not had one since. Does the Dr. often times go ahead with band operation if no symptoms or what's the experience there? I'm wondering if I should call his nurse and ask as would hate to do this dang liquid diet and get all geared up and then have him say oh no you need that out first. What a deflation when you are so ready to do the operation. So just wondering experience there if others have. Sounds like most here were out after the band. Thanks.

April 20 for me after 3 denials with insurance and going self pay. Actually a relief to just get on with it. I'm excited, scared, and in the last week of "last meal" mentality before liquid diet. I think right choice for me and WILL be successful. Best of luck to all. I've been looking for the springster one but some reason having problem finding.

Hello, I was wondering opinions on getting the extra insurance to cover slip, erosion, port problems for self pay patients. My doctor offers this and wondered if others had this or thought good idea. My biggest fear is landing back in hospital for a complication and not covered.so leaning towards it if good idea. Also I'll look up statistics but anyone know current statistics on these issues in the first two years or if they occur are they happening later then 1 or 2 years?

Yea, I'm sure not all doctor's offices offer it so maybe I'm lucky in that regard. Here is the break down 90 day - $256 6 month - $481 12 month - $899 18 month - $1,124 24 month - $1,326 30 month - $1.506 I guess they only offered up to 12 months until recently. Covers doctor cost and hospital if any of that occurs. I do believe going to an excellent practice in Chicago suburb forcusing on bariatrics. From seeing price others are paying it looks like I'm paying at the top end at 17k but I'm ok with this if getting excellent experienced care. Sad lost insurance struggle but now have to think of these things. Any thoughts or opinions welcome. And if you are hearing of these things if they happen early or later. Thanks much!

Hi, I was wondering if anyone had done an External Review through UHC? I was denied twice and then they go to a third party external review if you appeal again which I did. I thought it might actually be better to have an outside party review as I did not think UHC was reading my companies policy (the one published to employees) correctly. UHC received 2/15/12 which they have 30 days but then the external company got it 2/29/12 (not sure why so long) and they send a letter saying they have 45 days. I called to see if it typically takes that long as Dr. office is pressing for whether going insurance or self pay. UHC did not know and but something in their system to find out (not helpful). I called the external agency and left message but they did not call back. With UHC my experience has been for other things I had to appeal if it was denied it was quite fast and if it was approved they took their time right to the end to do it. I don't know if that's always the case though. Anyhow was wondering if anyone else had any experiences. Thanks.

Hi, The denials were that I didn't meet the policy criteria which is 1) BMI of 40 and 2) Morbidly obese history for five years. I meet number 1 and they are saying in the denial letters that I don't have "serious" co-morbidities. I am fighting because I do have some co-morbidities (not serious hypertension or apnea or diabetes which they are looking for) but that my company didn't define in #2 to be a BMI of 40 and I've been within 10 pounds for 6 years if not at the 40. So I feel I meet the morbidly obese as quite frankly either they poorly wrote the policy if it meant 40 they should have said that like their first stipulation or I think that they actually left some leniency for people like myself that are not at a 40 just under but have tried very hard to diet medically supervised most of the time. I wasn't over 40 because of all the diet pill popping etc I did but never significant amount of weight came off. So surgery is the last option to get healthy and I definitely will get serious co-morbidities soon if I don't get it. So anyhow I'm arguing that #2 they are interpreting not to how the policy is written. Still waiting.. I called them Wed and they did not call back. I need answer hoping before the 45 days as will have to push surgery out as don't want to go forward without knowing for sure. Fingers crossed they will see it my way:)

Hi Sharonk, I agree and am in similar boat with UHC being denied and then appealed twice. See my long post in the United Healthcare subject in this forum. I would put out the outlay but like you mostly concerned with after the fact complications/fills and not being covered. Anyhow, in my situation I feel they didn't write their policy well and are trying to be so subjective in their response as I don't have "serious co-morbiditiies". I have co-morbidities but my policy doesn't even call out that they are needed. Just need to be a BMI of 40 which I am right now and morbidly obese for 5 years. I was within 10 pounds of my weight only only there due to constant dieting so without a definition of morbidly obese I certainly think I qualify. Anyhow I'm going to the next step of a third party reviewer and hope they agree with me that they are interpreting a policy stringently and not what is written in it. I called yesterday and said I would go self pay but after thinking out it I'm still so bothered so I am going to do this next filing. If they really weant strict co-morbidities if you are just under 40 BMI then I think the policy better clearly write them out what they are. I saw on one of these that bcbs did just that in their policy so at least you know what to expect in response. Anyhow good luck and I feel your pain. I am ready to change my life and I would definitley get diabetes and more if I do nothing which will cost them so much more as someone pointed out.

Thanks Bayougirl.. You know you did inspire me as I had just called yesterday to set up going self pay feeling defeated after 2 appeal denials that I will try the last thing which is the third party review. My biggest fear honestly is not the intial outlay but any complications and fills (not that I wouldn't love not to have to pay the outlay). I work for AT&T and I feel they did not write the policy well and they are trying to be subjective after the fact and deny unless you have a serious co-morbidity. I think the Dr. did a nice job with a long 2 page letter outlining the medical necessity and my medical issues. My two appeals I tried to be very specific too why I thought I qualified. The AT&T policy states only Covered Person must have a minimum BMI of 40 (I do as of now) Covered person must have documentation of a diagnosis of morbid obestity for a minimum of five years from a Physician. It has no stipulation written even about the co-morbitities which I pointed out but I also point out that I have several (albeit not as severe as the last letter Dr. pointed needed to be (this Dr. at UHC said I needed to have type 2 diabetes, cardiovascular diseasae, life threatenting cardiopulmonary problems). So here is my big arguement to them there is no defintion of morbid obesity here and I certainly feel like being with 10 pounds for 8 years of a BMI of 40 should qualify. The only reason I was not over a 40 probably is becuase most of the time was either on phentrimine and constantly worked hard at many diets (insulin resistance I have makes it even harder to loose weight). I pointed this out but I'm thinking maybe if a third independent party which is where it goes now will look at it maybe they will see the point. I don't like they way they can just interpret a probably poor written policy the way they want. I think they should change the policy to write out specifically then what needs to be met. If this is what they wanted to cover then they sure surely define much clearer what morbidely obese is and also put in co-morbidities as there is absolutely nothing stated about co-morbidities. Anyhow, you have made me rethink this and at least send to the third party. I hate putting off any longer as need to make this important change in my life but have to weigh things. My father died of copd last year and my mom has type 2 diabetes I know for me I must do this to be healthy and I wish the insurance company would see this is going to save them big time in the long run. Thanks for letting me rant.... off to writing my letter. Thanks again and I wish others not so much issues with insurance. Cyndi p,s, I have experience with appels with them as have a son with significant dev delays which they approved ST and OT and then deny claims.. I have won all my appeals for that but it's so frusturating as I had to take him out of therapy while fighting as I didn't know if I would win. They make it so hard and it's only hurting the patients.

I have same plan too. When Dr. sent in letter I think it was within a few days and I have appealed twice and they have gotten back within 2 weeks with the sad news of denial! I am a BMI of 40 but was just below the last 8 years (within 10 pounds) and have what I tried to argue co-morbidities of high cholestoral, high triglicerides, and insulin resistant (that I take metformin for) but they have come back and said my co-morbidities are not serious enough like diabetes, sleep apnea. The policy I have says "Currently BMI of at least 40 and must have been morbidly obese for 5 years". I tried to argue the policy doesn't define 40 as morbidly obese and being with 10 pounds I think should qualify. Also that it doesn't even specify co-morbities under it but I felt I had them anyhow.... So anyhow I feel they are very black and white about it. I felt my arguement was pretty decent but looking like I will need to go to self pay sadly as I don't want my health to deteriorate (which it will.. there is no doubt I will have diabetes soon as my mom has it and my insulin resistance is leading there) and not willing to keep myself at a BMI of 40 for 5 years on purpose!... Best of luck and if you meet their criteria I think you will be fine.

I'm in NW suburb of Chicago and it's 17k here. I'm a BMI of 40 but was just below it for 8 years (within 10 pounds). I have high triglycerides and cholesteral and insulin resistance but no "major" comorbidities so UHC has been denying my appeals. So sad but think going with the 17k as really feel like this is the tool for me to help get healthy.