kellyk

I am hoping someone here may be able to give me some guidance or answers. I had the lapband surgery in Mexico by Dr. Ortiz in May 2005. In October 2006, I moved from Michigan to Florida and became self-employed as of January 1, 2007. I applied for private health insurance (not employer-provided) in December 2006 with Aetna. I was declined coverage due to the lapband. I have also contacted Humana One here and have been advised that they automatically decline coverage for any applicant who has had the lapband procedure. This has absolutely nothing to do with the fact that I had the surgery in Mexico. It is the procedure itself that is causing me to be declined coverage. I have no health issues whatsoever and have lost over 70 pounds since the lapband. I am now at a healthy weight and have maintained it for 2 years. I am now sitting with no health coverage whatsoever and am being told that I will not ever be able to have it unless I become employed by a company that provides coverage as a benefit. Has anyone here run into this problem? I have to tell you, if I had known that having the lapband would cause me to be denied insurance coverage afterwards I would have NEVER had the procedure.

I had a phone conference with Dr. Ortiz about 2 weeks during which I asked that same question. He cannot answer whether there will be insurance coverage, but he told me that if the band had to be removed, he would not charge me any fee for his time to do it. I would still have to pay for the hospital. He said the hospital's fee is around $3,000. But at least he will waive his fee! May not be a perfect solution, but it is a compromise. I would really encourage you to ask his office to arrange a phone conference for you to speak to Dr. Oritz directly. He was very generous with his time and patient with all my questions. I was extremely impressed by his professionalism and obvious pride in his work. I am being banded by him on Wednesday. Leave tomorrow morning!

Lawyer and mediator. I do estate planning (wills, trusts, etc) and probate litigation (you know, when someone feels Mom loved their sister or brother more than them or can't understand why they were cut out of her will)

Thank you to everyone who has replied. Vinesqueen, thank you for the link to the prior thread -- the posts there were overall very encouraging. And Lasonyadj, thank you for the link to the thread on the other board. The posts there are very sobering and I kind of hate for Paula to see them, but she wanted to know! She will just have to keep in mind that the thread is on a board for all WLS and not just lapbands. Doing the countdown -- just 5 more days 'til surgery!!!

I told Paula that I was pretty sure the responses would be overwhelmingly in the positive -- no regrets. But didn't figure that response would be so small. I will chalk it up to the fact that it is obvious from this board that nearly everyone is happy with their band and grateful to have it. In fact, I told Paula that. But she still wanted me to ask. So keep the responses coming, please!

My friend, PaulaM and I are scheduled to have surgery with Dr. Ortiz on May 25th. Paula is on the road today but asked that I post this thread to ask if any of you regret having the band. I think Paula is 99% prepared to go forward with the surgery, but continues to have lingering worries/doubts. If any of you are uncomfortable with posting any regrets, please PM me and I will share with Paula when we speak later today. By the way, Paula is nearly a pack-a-day smoker and she is having to quit smoking for the surgery. This is extremely hard on her. Did any of you have to quit before surgery? How did you manage? Any tips? Did most of you go back to smoking after the surgery? Dr. Ortiz says that about 30% of his patients continue to abstain from smoking after being banded. We are wondering what all your experiences have been.

I have not had my surgery yet but I had my hair done yesterday and I was asking my hairdresser how I could avoid hair loss from the surgery. She suggested I take prenatal vitamins. She said that is very effective. I am going to try it and see. She said that she has a client who had by-pass about 6 months ago, was not taking any vitamin supplements and her hair really started thinning out. Once she started taking the prenatal vitamins, my hairdresser said it helped -- took about 6 weeks to notice any difference though.

Thanks, everyone, for your replies. I had a phone consult with Dr. Ortiz tonight and I feel very reassured about my decision to have him handle my surgery. He told me that he really insists that any follow up care be conducted by him because he wishes to make sure that I am a success. He said that if there were any subsequent complications with my band, he would see me and not charge me any doctor fee. He said that if I had to have the band removed, the hospital fee is about $3,000. If my port needed to be revised, the fee for the hospital is around $350. He did stress to me that the complication rate for this surgery is very low but not zero. I was extremely impressed by Dr. Ortiz. He seems extremely dedicated to his patients. He spent a little over 30 minuites on the phone with my friend and me and answered our many, many questions. He is very personable, has a good sense of humor, and seems to be very empathetic to his patients' situation. One week from today I will be in Mexico. I am excited and nervous although I am not nearly as nervous after speaking to Dr. Ortiz.

Hi, KarenB. I live in the mid-Michigan area. Work in Lansing. Glad to know that you are pleased enough with Dr. Ortiz to send your daughter to him. As for the fills, I always planned on paying for those out of my own pocket. Did you go back to Ortiz for your fills? I am planning on him doing at least my first fill.

Thank you, Hagerteresa for your reassurance. And Alexandra, I will call the insurance department or bureau tomorrow. Thanks for that tip! What you say makes sense to me but it seems like insurance issues never make sense to me. Sure is frustrating! Thanks again.

(I am cross-posting this in the Insurance Forum too. Wanting to maximize viewing by members because I am so perplexed and need to hear from others ASAP.) I am scheduled to have surgery with Dr. Ortiz on May 18. I made one more phone call to my insurance company (PHP of Mid-Michigan) to verify that follow up treatment would be covered. Unfortunately, my call only raised more questions and concerns for me. I had called some time ago and had been assured that any "complications" from the surgery would be covered. Today I was told that if I presented with vomiting or internal bleeding, as complications from the surgery, those would be covered. But, if I required any "follow-up" procedures dealing specifically with the band, including its removal, those procedures would "not likely" be covered. I think in order for me to go forward with the band in Mexico, I have to assume the worse case scenario -- no coverage for any follow-up procedures. I am just wondering how big a gamble I am taking if I go forward. Anyone with any insight? Those of you who were operated on in Mexico, have you had any subsequent insurance problems? Please let me hear of any. I was so determined to have this surgery but now I am thinking that I shouldn't if I will not have any insurance coverage. While I have drummed up the $9500 to have the band implanted, I don't have excess funds to deal with more surgeries in Mexico. Help! <!-- / message -->

I am scheduled to have surgery with Dr. Ortiz on May 18. I made one more phone call to my insurance company (PHP of Mid-Michigan) to verify that follow up treatment would be covered. Unfortunately, my call only raised more questions and concerns for me. I had called some time ago and had been assured that any "complications" from the surgery would be covered. Today I was told that if I presented with vomiting or internal bleeding, as complications from the surgery, those would be covered. But, if I required any "follow-up" procedures dealing specifically with the band, including its removal, those procedures would "not likely" be covered. I think in order for me to go forward with the band in Mexico, I have to assume the worse case scenario -- no coverage for any follow-up procedures. I am just wondering how big a gamble I am taking if I go forward. Anyone with any insight? Those of you who were operated on in Mexico, have you had any subsequent insurance problems? Please let me hear of any. I was so determined to have this surgery but now I am thinking that I shouldn't if I will not have any insurance coverage. While I have drummed up the $9500 to have the band implanted, I don't have excess funds to deal with more surgeries in Mexico. Help!

Actually, KarenB, my surgery is currently scheduled for May 18th. It was originally scheduled for the 26th. Sorry that I will not be seeing you after all! I called Sandy from Dr. Ortiz's office today to see if she thought I should bring someone with me. She told me that many, many people come by themselves. She said that it was totally up to me but that I should not feel it necessary to bring a family member or friend. Thanks live2canoe for the advice on packing lightly. I will plan on just bringing a rolling carry on bag so I am not having to lift and carry. I have developed a nasty sinus infection and went to the doctor today. He wrote me 3 prescriptions and I have started them this afternoon. I am determined to wipe this out before flying to Mexico. I don't want this to get in the way of my going. By the way, I broke the news of my surgery to my mother tonight over the telephone. I was very pleased by her support of my decision. I was super surprised that she knew about the lapband and was aware that Mexican doctors have more experience than US doctors so far. Wow, aren't mothers amazing? I am going ahead and booking my flight tonight. This is all now seeming very real to me. I know you have all heard this before, but I am so full of differnt emotions -- sometimes I feel so excited and thrilled and other times I feel scared and wonder what the hell have I signed up to do. But mostly I am excited. Thanks for all your support!