Annie

You're right Travel girl...I tend to always think the worst! I'll try to think positively about the ins approval! Thanks everyone for your posts!

Good luck! Keep me posted, as we have similar situations, and I'd like to hear how it goes for you! Anne

Great! You give me hope! I too have UHC, and was told by them that is what I need as well....at least on one of the 5 calls I've made to them....each time I've called I've gotten a slightly different answer. I also did WW and just got to the 25 wk mark, then no more entries....I wrote one in for the 26 week, just for good measure! LOL! Hope it's ok....I still did the program for a few more weeks, but i didn't pay for anymore of the meetings. Plus my doc can attest to my attempts as well, so I'm hoping I won't have problems getting approved....I have a BMI of 37, but HBP, and family history of diabetes, heart disease and cancer. I just started my pre-op testing today. As for 'fudgin'' the numbers, I'd say go for it, but I'd be nervous about doing it for too many weeks.....but who am I to call the kettle black...I did it with one week. My

Well, I DID IT! I had my appointment with my doc today and she approved of it! I was all worried for nothing. I was so nervous when I got there, I had a speech all planned, and I didn't have to sell it! LOL! She walked in the room after reading my chart, and said "so you're really going to do this?!" We had a really great talk about it, and I got my labs and EKG done....as I left, she said, just let me know what all you need from me, and I'll be happy to help. WOW! I'm so excited! Next step...insurance approval. I'm keeping my fingers crossed! WHOOHOO!!! I can't wait!

Thanks everyone for your input! You all have good points, and I appreciate the fact you took time to answer! It's nice to have everyone here to bounce things off of... My appointment is Thursday, I'll keep you posted!

Hey Jane, I too plan to have my WLS done at Barnes by Dr. Halpin or Dr. Eagon. I've just started the process, and am getting all of my pre-op appointments taken care of. Please let me know how you like them, and how your experience has gone/goes. How long did it take from your meeting with the surgeon, till you got a date? Thanks!! Good luck to you!!!

I have talked with her in the past, nothing too specific, just briefly touched on it, and judging from her reaction she seemed against it. I am hoping to have enough info for her, if she has questions, and hopefully she will sign off without much of an argument. Who knows, I could be wrong, perhaps she'll be ok with it. I just would like some good advice on how to get my point across to her if she seems unwilling.

Spectacularone, Well, I just spoke to the surgeons office, have my evaluation appointments set up for 24 Apr. Wish it was yesterday! LOL! I am really impatient, and I'm ready to do this now! Anyway, i told her of my concerns with all the different answers I have gotten from UHC, and she told me to call them back and ask to speak to a supervisor, that I should as them if there are any exclusions, and if I have to be on a supervised diet for any length of time before they approve it. Hopefully not, cause I don't want to have to wait 3-6-or 12 months to get this done. I'll keep you posted.

Spectatularone! I too have gotten a different answer each time I've called UHC....The first call seemed very promising, that's why I really started tp persue this. I've called them 3 more times, and each time I get a slightly different answer, each one sounding less likely it would happen. The last call, the lady was soooo rude, she actually said "I can't help you". She stated that it's all up to care coordination....that she couldn't tell me anything that could help this process along. I couldn't believe that she said it that way. Isn't their job to explain these types of things to us??? Hopefully my surgeons office will have better luck than me. Is your insurance plan for federal employees? I hear they are usually easier to get approved for some reason. Also, I'm hoping with my high blood pressure it will be enough. I have a strong family history of diabetes and heart disease also, so I hope that helps them deem it medically necessary.

Sharon, Your stats are similar to mine, I have yet to be banded, but just starting the process. What was your starting BMI? And were you a self pay or insurance?

Well, good luck to you! I'll say some prayers for ya! You'll have to keep me posted on how it goes. :mad:

Pamla, I wonder if that is normal, them taking that much time to review....

From what I gather from UHC, it's covered 100%, other than my normal co-pays. So I'm not worried about that part. I'd like to know if there are any others here with a lower BMI that had any troubles getting approved for the surgery by UHC? Those of you who got approved fairly easy, what are your weights/co-morbidities, etc? Cool Brz, I too worry that my PCP won't "approve" of the surgery, we've talked about it in the past, and she didn't seem to much of an advocate for that kind of thing...I am hoping to get this all approved without having to ask her...isn't that terrible, she's going to know eventually, but It's just another thing to make me feel like a failure ya know?? And changing docs isn't a choice for me. I know, it's not right....

I'm in the process of getting all my ducks in a row to have this surgery, so I've called UHC 4 times in the past 2 weeks, just to make sure I have everything I need to get this approved. I have UHC choice, a BMI of 37, and HBP. Each of the times I have called, I've got a slightly different answer. :mad: At first I felt positive about this, that I would qualify without any problems, but each time I talk to someone else there, it sounds more bleak...I meet the criteria, but I still worry that it won't go through....this waiting and wondering is awful! Can you tell I'm a little impatient?

I really appreciate it. I thought I'd done my homework, I've been looking into this for a long time. When I first inquired with the surgeons office, and my insurance, it seemed to be simple, but now as I'm digging a little deeper, I'm concerned that my insurance will deny me, after I've spent that non refundable fee.... Thanks again for all the advice, it's really helping me through this process.

If you don't mind me asking, what was your starting weight? I've started this process with Wash U Weight managment program, Dr. Eagon, but upon reviewing all of the paper work there is a $550 fee that is not refundable if your insurance denies you. I've called UHC and they say it is a covered benifit, however I am worried that they will still deny my surgery. My BMI is 37, but I am on meds for HBP, so I'm hoping it will all be alright, but $550 is alot of money to throw out the window if they choose not to approve it. I wonder if I should check into the New Start Program before going any farther... Thanks for your reply, and and all help is very much appreciated!

:help: I was looking into a surgeon named J. Christopher Eagon, in St. Louis MO. at Washington University Hospital. I have found a few items on line, and have seen some interviews he's done on the local news, but I'm looking to see if anyone has had any personal experiences with him. Thanks in advance for any and all help!

Thanks Sunshine! It's UHC, a federal employee plan, and 100% is covered. My BMI is only 37....gees, ONLY 37 is still huge...anyway, I'm concerned cause the only other comorbidity i have is HBP. I have a hx of depression, and my weights steadily gone up over the past 15 yrs, and a family history of diabetes and heart disease, so I'm hoping that's enough, and I don't have to jump through any hoops. I pray that it goes quick and smoothly.

Hello everyone. I'm new to the forum today. I've been lurking for sometime, and I decided today I would post. :success1: My story is like so many others here, I've tried so many things over the yrs to lose the weight, lost it, gained it back, only to repeat the cycle, and disapoint myself for not being able to control myself. I've been reading about Lapband surgery for quite some time, and I finally decided that I'm going to do it! Hopefully the insurance company agrees.:nervous It is a covered benefit as long as I meet the requirements, and according to them, and the surgeon I've picked out, I do. So I sent in my first packet of info to the surgeon, and I pray that this process goes smoothly and quickly!!! I get excited, and can't wait to get it done, especially after reading some of the posts here, it's very encouraging to read that I'm not alone, even though I feel like it sometimes. I can't wait to get the old me back. The one that isn't afraid to run into someone from their past, and not be recognized because of all the weight I've put on through the yrs. Well, thanks for listening. Good luck to you all...and me too!