Sooverit!

I am exploring the option of going outside the states or at least NY to have my LB surgery done but do not find too many fill centers here. Does anyone know of a Lap Band Fill center in Western Suffolk County L.I. New York or anywhere on Long Island?

Hi Cathy: Thanks for responding and I just love your quote.. ..and so simple!~ but so true!:-) Mine is "Life isn't about what happens to you but how you choose to respond (or not) when it happens". Back pats to you for your great weight loss so far....you must feel great. I haven't lost that much weight in a decade but I know how great it feels to be in that direction! Hi Heather and thanks for responding. I'm thinking of going to Mexico...never thought I would but reconsidering now that there are so many fill docs around. Cigna is tricky they want me at a 40 bmi for at least a year and the 6 mo diet within a year...so.I would have to do the 6 mo diet over.

Hey gone being your age I would initially say it's the yard work for the back but jaw pain?? Has it gone away yet? I would call my doc just in case.?

:thumbs_up:Dear Karen: Thanks so much for all the great info on your fill doc! This has really given me hope as I've been banging my head against a wall trying to get my insurance company (Cigna) to cover, but I am starting to think outside the box thanks to you. I've heard great things about your surgery doc in Mexico as well. I'm thinking of trying to find a lap band doc within the states. Anywhere outside of NY as here it's close to 28,000 dollars out of pocket. Thanks again! M

I was wondering if anyone was denied by their insurance co...my case CIGNA and resubmitted the claim a year later. I was only a 38 bmi when I submitted in March now I am a 40 and thinking of starting the whole bloody process all over again. Would really get depressed though if I went thu that again and was denied again. Was wondering if Cigna would go for that...if anyone has anything to offer it would greatly be appreceiated. Going thru a 2nd appeal process now...with kELLY and walter at Obesitylaw.com in the meantime this summer with all this excess weight is really taking it's tole on my soul. SOOVERIT!!!

Hey Lexy: Just came across our post from March about head hunger....I get that hunger all the time but I am prebanded and just shut it up with salty or sweet treat. I admire you for recognizing it and trying to tame it! How are things going now 4 MONTHs later? I hope you got that "sweet spot" with fills that people talk about. Hope all is well best to you Marg

I have the same dilema as well. I was deinied by cigna Cwith a 38 BMI also not the kind of major coomobidities they like such as high blood pressure, diabletes and sleep apnea ..that couldn't be controlled with drugs. I am in the process of an appeal process with Walter at Obesitylaw.com ...they are the best at what they do for sure. Currently I am a 40 bmi tho and wondering if I can't get the appeal if I should go :cursing:through this entire process all over again ...it would take another year tho.

Hi BB: I remember too, a long time ago when I had lost a very substainial amount of weight after a pregancy and caught a glimps of an attractive normal sized woman in the gym mirror ...my mind could not tell it was me at first. so "I" looked at that image acurately without the usual critism and negativitly. I'll never forget that feeling when it clicked that that image was me. I think that was the turning point and I no longer looked at that mirror with an inspectors vision. I just let go and said no need to really look to much anymore. May I ask you why you had to have the LB removed? Did you loose too much of your BB? Size 4 wowo. I was a size for when I was 3 years old! :-) Glad to see you are getting to a place of acceptance. All the best to you, marg

Or at best a waste of time and money!!

This is amazing to me ...after all the tests and bloodwork I can't believe it's required to have additional tests 7 days before the proceedure!! If this appeal doesn't go well there is no way I can afford this out of pocket. You folks are blessed that your insurance companies covered you. Feel grateful...for the rest of us with companies like Cigna and a BMI just shy of 40 it's tourture and feels like a dangling carrot.

Hey Carrie: Great to hear you are doing well! You are going to feel and look great this summer! Yeah and best part I think your body temp goes down so you won't feel the heat as much..that is if you are in a climate that the seasons change?> .(I can't stand the summer because I'm always so uncomfortable-any other time I'm fine) ! Sorry you had a rough time for the first few day though! Did you get pain meds I hope? You are so nice to ask about my appeal...I am still waiting to see if Walter at Obesity Law can save the day for me. Thanks for the heads up on Cigna also. Thurs will be here before you know it! ALl the best to you!:laugh:!

Dear Mekadig: I've been on this site for over a year now and read many posts and what I have gathered is 1. You are very normal to feel anxious 2. You went this far for a reason and I believe that this is a miracle surgery for anyone who needs it and so many people have gained their lives and their health back and you will too. Keep posting...smartbandsters.com is very good also Keep the faith, marg

Hey Carrie C: Congrats one being covered and your surgery...I see you had a date of 5/22!! Hope all went well and you are feeling great! All the best, Marg

I have to say I think hormones really are one of the big culprites for me. Also bad habits of snacking didn't help either but I was thin to normal to slightly overweight until I became pregnant at 29 then gained 80 lbs, lost it all though starvation and being very active and kept it off till my last pregnancy at 39 same thing but this time at this age those lbs weren't going anywhere. I lost about 20 of them though daily strenuous activity and protein diets etc. then my hormones starting up again at I around 46 and I steadiy and rapidly gained weight especially in my stomach and chest till now at age 49. I am uncomfortable and I am about 85-90 lbs. over my ideal BMI. I am waiting on an appeal process right now and praying I will be appoved by my ins. company ...unfortunately I have CIGNA the toughest one around to get an approval from!!!!:laugh: marg

So proud of you ......

Dear Deb: Thank you soo so much for sharing your victory with me. I am waiting for something in the mail from Walter at ObesityLaw. what a great service. I am so happy for you! Keep us posted! fonldy, marg

Thank you so much Kathy for understanding. It was my co mobidity issue - not that I don't have any...as many as anyone carrying 90 extra pounds and strong genetic predisposition for obesity related illnesses! I am currently in the process of an appeal. It seems like Cigna is saying no now but after a few appeals they cave in and issue an approval...I'm hoping?

Anyone banded by Dr. Powers yet?

Cigna put up your dukes...wow haven't said that in decades

1. Why am I sad? Cigna turned me down after over a year of working on going through all the hoops while others get covered at the drop of a hat. 2. Why does not being covered by insurance make you sad? Because I feel like the universe doesn't think I deserve this...but boo hoo. maybe I just need to work on this more and make sure I'm ready for this lifestyle change and giving up of a very strong food addiction. Sad I really shouldn't go into debt at this time. Sad that I may die from being overweight and leaving my young daughter w/o a mum. Sad my sister died this way. 3. Why is death sad? Leaves people with a hole in their heart some time, not to mention big life disruption as well as a missing role, eg. missing parent, sister, grandma/pa. . 4. Who do you see passing soon? Ahh...hopefully not me, my daughter's only 11! 5. What can you do ? 1. Go to Mexico....though maybe too stressful to fly lately after a proceedure like this....2. Fight with Cigna more...fun. Get a equity loan and spread it out over 30- years. 6. What is stopping that from happening? I'll be lucky to get the loan and in 30 years I'll be 80 but husband could pay it off for me....Could get my neice to come w/me to Mex but always feel sick after being a plane lately.

Lucy sorry for your grief....it's like we are being penaltied for not being heavier! I was turned down with a 39 BMI.....I thought I was loosing my mind when I read your heading though...I thought I wrote it. My only son goes to UMASS and my only daughter attends Norwood School!

Dear VV: I'm almost twice your age and have a river of pain and tears behind me. You are so wise for your age, to be this much in touch with your feelings is amazing. Firstly I think you should not feel guilty for how you are feeling. Birth and or growing pains hurt and you are in the process of birthing a new you...hang in there, keep breathing, take soothing baths, get rest and trust that this too shall pass and you will be a strong wonderful adult who doesn't need food to stuff down the emotions any longer. Be strong ....it'll all be worth it!

Hey Jena: I think you hit the nail on the head as to why people have an issue with CIGNA As you stated :"Because the coverage said explicitly that it would not be covered, there was no getting around it. Period. End of story" I called Cigna numerous times before I went down this path and they are very secretive and sort of sneaky and won't be firm in their decisions. They never told me what I was told in the denial letter because they know if folks out there know exactely what to do to get covered they will. They cover some people who are under a 40 BMI while not covering others who do have a 40 BMI. (for a year) They are certainly not consistent at least the Point of Service covereage!

Well I was 7 pounds shy of being covered and I will never be able to be covered by Cigna any time soon. I feel I should post their letter to me dated March 31, 2008 After review of the information submitted by your provider and the terms of your benefit plan, we have determined the requested services are not covered for the following reason: Body mass index should be greater than 40 for at least one year and or BMI is between 35 and 39.9 for at least one year and the patient has one or more documented clinically significant co-mrbid conditions (1) that have failed to respond adequately to non -surgical treatment methods including appropriate and adequate medication; I think with Cigna the big 2 they will cover the Lap Band for are sleep Apnea and Type II Diabetes and or High blood pressure. But again they may only cover these if they don't respond to med or machines~ Also they threw in the middle of a long paragrah "Any claims associated with the denied request will not be considered for payment" period!

Hi Margo, I tried to post this to the group, but since I'm new, I'm not sure if I did it right, or if you'll see it, so I decided to email you. This is such important info for you (I feel:). I also have Cigna and was under a 40 BMI with some co-morbidities that I thought would qualify me. However, Cigna decided that since I was responding to my meds, I shouldn't qualify. However, thanks to a free-to-us advocacy service, that the manufacturer of the Lap Bands pays for, the attorneys there dealt directly with Cigna after I was denied and after another denial (expected), I was approved!! Cigna is a stinker, but these people are my new heroes! They've worked with them so much they are unbelievable!! Just go to ObesityLaw.com . The attorney that runs it has had a band and knows how we feel! His name is Walter Lindstrom. Kelley Brown Lindstrom is the one that I worked with. I didn't have to do a thing but send her all my info that the surgeon's office had submitted to Cigna. The whole process after my first denial took about 6 weeks. They are wonderful! I was approved on Tuesday of this last week, had my pre-op appt. on Wed. (they had a cancellation), and I'm scheduled on May 8th for the surgery! Let me know if you need the contact info for them. Maybe I'll figure out how to post on this site!! Good luck! ~Deb