Back~To~Amy

Well, my insurance originally and incorrectly told me they would cover 100% of WLS after my deductible and maxiums. I found out oficially, that is not the case. They only cover 50% and that is after my deductible with no maxium out of pocket. The WLS center told me I'm better off going with the cash price than the insurance price as it would be cheaper. There is just no way in heck I can pay 10,000 or even make the monthyly payments if I were to finance it, so I guess that means I'm done! :-(

Well, Angela called me from the bariatrics line but won't give me coverage. She said I have to look at the Blue Care Centers list she is mailing me, pick a surgeon who works out of one of those facilites, go to a seminar, submit proof to her then she will mail me the benefits. I tried to ask her what my benefits would be because I will use an approved facility. She said "I'm not telling you that. You have to go through the process and then they will be mailed to you". It's a waste of my time to go to a seminar if I don't have good coverage! Plus, it will get my hopes up for nothing! Ugh! I hate their procedures!!

Aaww Rae, I'm sorry you are going through such a rough times. I'm sending virtual hugs your way. It sounds like you really need them. I haven't had surgery yet, but I did lose 75 pounds years ago only to regain double it so I know the emotional struggle you are going through with food. Also, I quit smoking too over 6 years ago and remember being so depressed that I had "lost my best friend". How sick is that? It's really is all part of the process of the journey. I had the same kind of emotions about food and about cigarettes and will go through it with food again at some point. What you are experiencing is normal and it will pass. Hang in there. Learning how to have a normal relationship with food isn't easy. Congrats on the weight you lost! Take Care!

Thanks Steph and Jen. You both make such true statements. I haven't given up yet. I just hope if I go forward, the doctor will have more than just verbal approval.

Actually, the call was recorded and I have the reference number so the call can be easily found and listened to. The problem is before a rep comes on the line there is a recording that says " this is not a guarantee of payment". The rep I talked to today did say she will have the supervisor over my account listen to it, but I don't think it will matter with that disclaimer.

Thanks Steph. I actually left Angie a message earlier and am waiting for her to call back. I started googling that center for excellence stuff and it looked like it is only hospitals. My potentional surgeon uses an outpatient surgery center so I called customer service back to see if they had referred me to the right place. Somehow during that call my benefits came up. I'm glad yours is covered at 80/20. However, I think that has to do with your employer and not the insurance company itself. Employers have a lot of say so on the coverage. Anyway, the girl with Customer Service was super nice and is going to get with the lady who manages my companies plan and get clarification. I will discuss with Angela too when she calls back. Thanks for the advice.

I called my insurance company (Anthem BCBS) yesteday and was told I had coverage for LB surgery. The guy told me that once my deductible and copays are met (which they will be because of another surgery), the LB would be covered at 100% by them and I'd owe nothing. Well, I called back today because I was trying to get additional information and now am being told they will only pay 50% of it and it isn't subject to my deductible and out of pocket maximum. I told the girl of my conversation yesterday and she is going to check further and call me back but she is pretty sure I was given wrong information yesterday. If I have to pay half, there is no way I can afford this surgery now with what I'm going to have to pay out of pocket for my other surgery. Yeah, I might could finanace, but I doubt I could afford that monthly payment so that would nix that! Ugh!

Oops! Double post.

I'd like any food lists too. My email is amyh@tx.rr.com. Thanks!

Wow! Thanks for all the support and information. Everyone is making me feel confident in my original decision of LB surgery.

Oops! Weight, not wright.

Congrats on your wright loss SageTracey. That is awesome!

Thanks bhursey and congrats on your awesome success! You inspire me. I have about 150ish to lose. Your response pretty much convinced me that LB is the way to go. I like the permanent feeling of this and being able to "start over" if need be.....not that I'm planning on that. But, hey, you never know.

Thanks Steph. I'm okay with the extra visits to the doctor. You said something that made me think of a question. I hear that some regain lost weight. Say years down the road you start gaining weight, can you go back in for a fill to help with appetite control? The office I'm going to offers lifetime fills for free. If this is the case, I see huge advantages to this procedure.

Hi all. I am considering WLS. Initially, I was all the way Lap Band. However, I read websites that seem to give discouraging success rates. They say things like 30 to 40 percent weight loss after 1 year and 60 percent after 3 to 5 years. Those may not be exact but they are similar to what they say. That got me thinking about the gastric sleeve which touts higher statistics. The thought of having a lot of my stomach cut out is sickening though. Anyone have any thoughts on the LB statistics and/or words of encouragement to convince me LB is the way to go? I have my consultation next Tuesday. Thanks!