kvr1977

My doc is Dr. Wright also I have my last appt on sept 10th. I'm with true results as well. I would love for you gals to keep me updated with your progress.

-Kelly

This is a great question. I am nervous as well. Although my surgery probably won't be till October ( fingers crossed ). I'm a little beyond nervous actually. : /

Hello, I'm am in San Antonio, TX. I have one appt left before re-submitting to insurance. I'm nervous and have almost backed out twice. I could use a buddy, found a few people who offered to be buddies but disappeared. I will be having surgery at Northeast Baptist by Dr. Wright. -Kelly

I was supposed to be banded in July but my insurance denied me so I had to start the process all over again. My last appt. is Sept 10 so I'm thinking I may be looking at October. (crossing my fingers) I am hoping and praying to be part of your group

Jason, my name is Kelly. I have Aetna also. I went through a 4 month nutrition and "weight loss" program as required by Aetna, like you, I did everything by the book and tried very hard to follow all their guidelines. Over that 4 month time period I gained 4 pounds. They denied me because I gained 4 pounds! I felt like they were trying to find any loop hole they could to deny it. I became very discouraged and told the people at True Results that I was throwing in the towel. I was so disappointed and sad. I gave up. I spoke to my husband about it and he reminded me that we pay Aetna almost $500 a month for health insurance and that they did not deny it and close the book on it. They left it open for re-submitting! I feel that I deserve this and that we have more than paid for this with all the money we have paid them over the years. We rarely even use our insurance other than regular health check-ups and other little things. I find your story very inspiring. Good for you for taking the bull by the horns and fighting back. I wish you all the best on your big day . All my best. -Kelly

I have succeeded in the past with weight watchers but wasn't able to keep it off for more than a few months. I will look into support groups, that's a good idea. What I've been thinking is that if I don't go through with it then I will be stuck in the same boat and will surely not see any results. What do I have to lose by trying? Except the weight! 8 months of preparation for this, we will be resubmitting to insurance for the second time. If it gets denied again then I guess I have no choice. but I will keep my fingers crossed.

I am so very very grateful to all of you for your support. I needed this encouragement. My Mom went to heaven last year so it's hard to find people who will listen. She was overweight for years and developed cancer, she died at 56. I decided to do this so I can live longer and try to go down a different path. I am totally willing to make changes, I already feel like I should have done this a long time ago. Seeing so many success stories on here has got to say something about the band. I'm ready to be healthy. I love this forum, so much help and advice from people who understand this. Thank all of you from the bottom of my heart. ❤

Thank you for listening. I got denied by Aetna once already because I gained 4 pounds over a 4 month period. So I had to start the process all over again. I'm frustrated already. I seem to want it more and more but I'm 1 month away from re-submitting to insurance and I'm getting scared. I guess I'm just afraid to go to such drastic measures to lose weight and the thought of screwing it up scares me. Your right I am tired of being the one reading about other peoples success and wishing it could be me. I want to BE a success story. Thanks for the encouragement

I was still writing my post and I accidentally hit "send". (stupid touch screen) anyway, I keep reading people saying that it's a lot of hard work and will power and dedication and that you have to eat healthy foods and exercise and on and on. If I had the capability to do all these things I wouldn't be the size I am in the first place. It just makes me think. I am not saying that I'm not willing to make changes but I know myself. If we have the will power to only eat healthy foods and make lifestyle changes then why get the band? I know this sounds totally rediculous.

Ok this is going to sound ridiculous to many people but I have seriously started to doubt whether to go through with this surgery. I have poured over everyone's posts and stories on LBT for 8 months, reading everyone's stories and looking at before and after pics trying to convince myself that this was for me and that I should do it.

Awesome!! You look beautiful! Keep up the good work gorgeous. - Kelly

Just found out Aetna approved me! Keep trying!!!

Congrats Kerra!

Hi yelorz, I have Aetna NAP. My plan covers lap band also, but my situation is exactly like Texassoccermom, I have to go thru the exact same regimen. I too am going with true results, they have been absolutely wonderful. The lady at true results is doing all the dirty insurance work on my behalf. I think it depends a lot on what type of plan you have. I will keep you in my thoughts. Take care.

Thank you both for your feedback. I have Aetna insurance. They said I need the 4 months of the nutrition classes. Hopefully the dated photo and letter will be enough. I have an undiagnosed hernia that they are going to check out as well, maybe this will help. I've never in my life wished I was unhealthy until now...lol. I guess I should be thankful I'm not in too bad off. If it is denied I will have to go mommykristies route. best of luck to you both.

I was told not to go under my BMI requirements as my insurance has denied in the past for showing success. In other words' date=' if the patient is being successful during the 6 months then just continue to lose weight that way. Code word for don't have to pay. Anyways, my surgeon and dr kept a close watch on my weight to not let me come too close to being under.

When I was providing my 3 years of records, my insurance denied me because on one dr visit during 2009, my BMI was lower than their required number. It didn't matter that it was higher before and after, but because of that one time ( when I was sick!!), then I was denied.

Once I got my approval , then I had plenty of time to prepare for my liver shrink diet.[/quote']

Hello, I was told to provide 3 years of records as well but I am missing 2009. I didn't see a doctor that year because my mother was dying of cancer and that's all I worried about that entire year. She passed away early 2010. How did you eventually get approved? They told me to write a letter and provide a photo???? - Kelly

Thank you Dawn for your reply. I am right at 40 BMI but without any comorbidities. Just severe hip/knee pain, hernia and chronic back pain. Hopefully my letter about my mother dying that particular year will persuade them.

My insurance is requiring 3 years of doctors records indicating that I have been over BMI of 40 for at least 3 years. I do not have records from 2009 so the insurance specialist at docs office told me to submit pictures from 09 and a personal letter as to why I don't have records for that year. ( my Mom was dying of cancer that whole year and passed away early 2010) has anyone ever done this and gotten approved? I'm starting to get worried that they won't approve it. Do they actually sit down and read these letters? Any thoughts or suggestions? Thanks - Kelly

My surgeons office submitted my paperwork online but since I was using a photo for my 2009 records it was denied. So they turn around and mailed my paperwork. I called ins today to inquire about the status and the lady tells me and I quote "I'm not suppose to tell you this but since they denied it the first time they will prob deny it the second time' date=' but I'm not suppose to tell you that" my heart sunk!! Why would you tell someone that??! I'm praying she is wrong![/quote']

Manda, if you don't mind my asking.... What insurance do you have? I was also told that I may have to submit a photo for 2009 along with a personal letter stating why I was overweight and why I didn't see a doctor that year. - Kelly

Welcome Graham. I'm new here too I'm just starting the process, probably won't be banded till June. Seems you are doing really well.... Down 83 lbs....WOW! Keep us posted on your progress . Take care.

Yea, I think what plan you have makes all the difference. Fortunately there's an insurance specialist to do all the dirty work with the insurance. I guess I just need to be patient and do what they tell me to do. Thanks for your input, I love this website!

Congratulations! I have Aetna too and so worried about getting denied I have "Aetna NAP". Ive heard people say that Aetna paid 30% and some say that paid 85%. Are you going to have to pay any portion out of pocket besides deductibles?

I hope so. I have Aetna And I have heard pretty good things from others who have Aetna. I guess I am just so scared of not getting approval.

Hi everyone, I am from San Antonio, TX. I have just recently made the decision to do this but have only been to one appt and already getting discouraged. The insurance specialist has called me once or twice and leaves a msg then I return the call and never hear back from her. I have a BMI of 40 but absolutely no other problems besides joint pain and back pain. I have normal cholesterol and blood pressure. Just starting to wonder if maybe the insurance is not going to cover it.

I am just starting the process of getting the Lap Band. I go from excited one hour to I am not going to do it because something might go wrong the next hour. I know it would change my life' date=' just scared I guess. Just found this site tonight already feeling better from reading posts. Any advise for someone at this stage???[/quote']

I am just starting too.... I am like you, one minute I'm excited, then I hear a horror story and I change my mind. I'm scared too but I am far more scared to develop cancer like my mother or heart disease like my dad.