MizzouFan1

Hi guys, I was wondering if anyone has had any experience with Coventry of Kansas City? My husband is possibly getting a new job (we are waiting on the phone call any day now) with the largest Missouri University and they have Coventry which I am desperately hoping will cover lap band because our current health insurance excludes it. I was just curious if anyone knows the ins and outs. Even if the employer is different any information would be much appreciated...the suspense is killing me.

I am very willing to travel. I can't use my house so I am running into many road blocks. I have 3-4 grand in a flex spending account but I still need 5-6 grand for the Dr. Kishenbaum in Colorado. Thanks for the ideas and keep them coming!

thanks for the advice. Any ideas are welcome. The credit card is a no go, but maybe the house. Has anyone used a flex spending account?

Applied for lapband financing, hubby has great credit and was turned down twice. We just bought a house 2 months ago but his credit is decent. I am sooo discouraged anybody have any ideas? Can't use my credit because it is terrible. Thanks.:smile2:

Hi Guys, I was curious if it is possible for my hubby to take out a loan for my lapband surgery because my credit is not so good and I think even cosigning might not help. Any help would be much appreciated. Thanks!

hey nazzy, on the 6 month diet- did you have to actually lose weight or keep a food journal? I am excited but i wish I had already done this but we will see.

hi Nazzy, I had so many different answers and I finally called Michigan BCbS and not the number on my card and they gave me the same criteria that you have(I think). Psych eval, 6 month diet, BMI >40, letter of medical neccessity. What kind of info did they need for the 6 month diet. Do they accept weight watchers or previous attempts?

I called them myself. I am in KC and I called the number of the back of my BCBS card and that is what they told me.

Thats odd, because the criteria I need to qualify is different than that. They said I had to have 12 month failed weight loss attempt documented by PCP and psch eval, letter or medical nesseccity, and a BMI of at least 40. I wonder why there would be different requirements? Yeah I am in a hurry because I get kicked of my parent's insurance in FEB '09.

Hi guys, I was wondering if anyone out there has dealt with General Motors BCBS? I have had 12 months of weightloss (and regain) but nothing I would classify as clinically evaluated- what in the heck does that mean anyway:confused2:? I have PCOS and my(gyno) doctor tried Glucophage to get my insulin resistence under control and that didn't work- I wonder if they would consider that as 12 month documented weightloss attempt? Anyone that has any good advice- please please share. I am re-starting this journey - I tried back in summer of '07 and got discouraged by the requirements.:wink_smile: THANKS GUYS!

Andreerichards1- are the surgeries any sheaper in Canada?

Ally I take it you are from KC? I have been looking into Malley Surgical center and have a seminar this saturday! ( my second go-round I missed the last one because I got the meeting times mixed up- fingers crossed!!) Are you planning to self pay? Do you know anything about financing?

I figure whatever works. It really just depends on the person and their particular situation. I am well versed in politics and economics as I am a political science major at UMKC. I do believe Michale Moore is one-sided but it is factually based. Just because a person doesn't like what they are hearing or doesn't want to believe it does not make it any less true. The fact of the matter is- that this stuff does happen and is going on. It is a serious issue facing our country and I would say putting in such a crude and blatant way is the only way to get people to notice that there might actually be a problem. It is pretty evident just on this website alone, with all the serious hassels with the insurance companies. WE are paying them- if it was free I would understand. But, that is my soap box. I just want to get a damn lap band- lol. Don't mean to step on any toes.

Well my thought is- I have to do a 12month supervised diet regime with doctor, dietician, and excercise. Currently, my insurance doesn't pay for office calls. So by the end of 12 months I will have racked up close to 5,000 grand anyway and then what if I invest all that money and still didn't get approved because it isn't like they want to approve me. Obviously, they are making almost impossible to begin with. Then I will have wasted 5,000 when I could just put it towards my surgery. I wouldn't have to convinve some old ass that I "really" need it and that I have been struggling with this my whole life. I can do it when and how I want and I don't feel like I would be throwing it away, it is an ivestment. Think of all the money I will save from buying less food and cheaper clothes. Everybody knows fat people clothes cost like 3 times as much. LOL.

I think that is what I am going to do. About how much does the self-pay run? I know it varies from state to state but there must be some sort of average number?

Yeah- I might be selfpaying too because I don't want get the band and them pay for it and then later "find" something in my medical report and slap me with all the bills out of the blue. That would be a nightmare.

Anybody seen the Michael Moore movie SICKO?:omg: Man, I thought I have insurance issues. There is a man on there who accidentally sawed off the tips of his middle and ring finger. The hospital told him the middle finger would cost him $60,000 to get reattached and the ring finger $12,000. He couldn't afford both so he picked the ring finger. How messed uo is that? :faint:It really makes you think. If you haven't seen it you should. It might give you some insight into what the insurane companies really think about the lap-band surgeries. Even if you aren't a MM fan it is still a powerful film. Just thought I would share.

probably not going to be banded in august- but thought the name was really clever! Nice work.

Hey thanks! I appreciate it. So, today is better. I think I am gonna go through aetna through my work and do the 3 month pre-surgery diet thingie. I am just one of those instant gratification girls. How is everyone doing? Kugirl did you get a date? Tracy how is the losing going?

Today is just not my day. I missed the seminar because I could've swore it was at 7pm. I arrived 10 till only to find out I was an hour late and I wouldn't be able to go to another seminar until July 28th. UGH!!!!!!!!!!!! How frusturating. Anyway, KUgirl when is your surgery date? Or do you even have one yet?

so, along with my damn insurance issues- i missed the seminar because I could've sworn it was at 7pm and I arrived at 10 till and the nurse looked at me like I was crazy. I said I need to check in and she said the seminar started at 6pm. I have to wait until the 28th for another seminar and so I think I might go to a different seminar with a different doctor. Ugh! KUg

Has anyone delt with aetna insurance? Are there general requirements before a person can be approved? What about BCBS- anyone had any trouble with them?

:whoo:So, I am really discouraged by my insurance. BCBS is basically making it impossible to have this done. So i have to have 12months of supervised diet and a documentation of this failed attempt. I also have to provide documentation of behavior changes during this time and nutritionist and excersing documentation. I am confused as to why not just exclude coverage all together. that would make this a lot easier. Really bummed and not sure what to do.:think

NO worries KUGirl it will work out. You just have to ask yourself if waiting a year to possibly fix a lifelong struggle( at least for me) is worth it. The problem I am having is being able to actually document my weightloss efforts. I am in school until end of July and then start right back up again in late August. So, i am on a bit of a time crunch. Not that I want to hurry, I just like to be well prepared. And of couse I am anxious to start losing weight. The sooner the better.

Hey guys- nice to know there is some local KC peeps. I have my seminar with Dr. Malley this Thursday. I am a little nervouse because I don't know if I want to wait until Christmas to get it done. I have only certain times where I can be off work and school for long periods of time. My insurance requires me to have proof a dieting for at least a year - well I have been dieting since I was 15 and actually succeeded with WW and lost 50lbs but I have no actual proof. I am not sure what to do about that. Any good suggestions?