gordonfamily3

Welcome! From my exp w/ insurance companies in general if your BMI is above 40 you don't have to have anything major wrong your BMI is enough to get you approved. If your BMI is 35- 40 then they are looking for sleep apena, diabetes, high BP something that is weight related. Sometime they will let the asthma go through because the weight loss can help. So hang in there and good luck!!!!!

ME!!!!! Except at the time I was 9 months out....it was super easy and nothing like the surgery. It's a pain but nothing to worry about. I am now almost 3 years out and I haven't had another problem. Good Luck!

UHC main plan is that if your BMI is over 40 you don't have to have anything wrong. They have started requiring the 5 yr weight history. I would see if try to get any documented weights you can, docs, ob's, weight watchers, anything. As for the 6 month diet UHC doesn't require it BUT companies can add it to their policy. So your husbands company wants the employees/spouses to do the 6 month diet then you are going to have to do it. Unless you have proof you have already done it and have documentation of it. My suggestion would be to call the insurance and ask them if they cover CPT 43770 (which is the lap-band) and then ask them for the policy. Good Luck!

Every surgeon has different pre-op procedures as each insurance company does. I have never seen an insurance company require the 3 month of Vitamins so that might be your docs requirements. Good luck as you start your journey.

I know Journey Lite is like the "middle man" if you will. They work w/ a surgeon and surgical center to do a special price for lap-bands. I have never heard anything bad about Journey lite themselves. Good Luck in your search!

Yes they do as long as you have coverage. Your doctor will have to make sure they have it pre-certed but you shouldn't have any problems. I have BCBS NC and have never had a problem. Good Luck!

Well I am very clumpsy when it comes to walking...although knock on wood it's been about 2 years since I had to be treated for fractured ankle. I can only feel your pain....my sister (who has never had a weight problem) and I can really step off a step wrong and break/fracture our ankles. We are soooo bad it's a running joke w/ our husbands. I know I didn't help you but know that I feel your pain. Have you seen a ortho doctor for help? Have you thought of wearing different shoes? Something w/ more support? (not sure what you wear) Good Luck!

If your doctors office is signed up w/ Allegran they have financing options through local banks in your area. Also Ethicon works w/ National City. Then there are medloanfiance.com, Reliance Financial. I think there is like surgeryloans.com and many others. Also if you own your home don't forget you can refiance or do a 2nd mortgage (home equity line/loan) Good Luck and you already have GREAT support.

Welcome - hope all goes well w/ the approval process. BCBS NC has a quick turn around time. Would love to have you join us March 8th for the lap-band support group. It's open to everyone......there is a thread w/ the details. Also in May there is going to be a big band confrence in Charlotte. May 2 - 4th....there is so much going on w/ the band community. Ok sorry...so welcome and can't wait to hear you have your approval.

Not from WV but my family is from there. Yes I admit it. haha... Really though welcome and hope you meet some other WV folks. My family is in Belington which is outside of Elkins. We have our family reunion there ever Sept. It's a beautiful place!!!

My exp w/ them I haven't had any problems. Quick turn around, friendly to work with. The one pt that I had sounded about like you and he was approved in 2 days. So good luck!!!! The High BP should be enough w/ your BMI of 39.

From my exp of working w/ Cigna about 2 - 3 weeks. Normally closer to the 2 week mark.

I do the insurance pre-cert for a local bariatric surgeon and from my exp w/ the companies I have worked with they do not consider that as a co-morbid condition. Sorry!!!!! There are so many things we could add to their list but they only are looking for a few select ones.

I personally can't tell you the difference I just know that I was always told to go for the whey protien over anything if possible. Now that is just what my nutritionist said but I never asked why. My favorite right now is the Matrix Cookies and Cream mix w/ mix and blend w/ some ice it's like a milk shake. LOVE it!!!!!

Most all insurance companies will cover revisions. Some use the same polices that you would have to meet for the orginal surgery some have a differnet set of polices. I have had exp w/ BCBS NC, Aetna and UHC covering revisions. Good Luck!

I am not familar with them but check out their web site and look for medical policies and then look for morbid obesity. Good Luck!!!!!

Sorry nope...as strick as insurnace companies are getting on WLS there are not any loop holes. Sorry!!!! Hang in there it will be over before you know it.

I have had dealings w/ Carefirst and so far I haven't had any problems now w/ that said each time I submitted anything the pt's BMI has been above 40. How long have you had your sleep apena? If they require a weight history then they will want your co-morbid conditions to last that long also. Also my exp w/ Carefirst is that they require a 6 month supervised diet. Good Luck!!!! Also you should feel free to contact your rep from your doctors office that does the insurance filing they should be able to help you also. :mad:

Well I am little ways from NYC but I wanted to say congrats on the date. You will be banded in no time!!!!!

Have you tried to google the different lap-band ports? I have personally seen both and there is no difference in the shape the low profile is just a little thiner not as tall if you will. :mad: Ask your band doc he should have them both there to show you. Or maybe email some one w/ allergan surely they would have a picture of the differnce.

I just found out today that Medicare requires a 6 month supervised diet, I am not sure if yours follows the CMS/Medicare guidlines or not but it kinda of stinks if you ask me. Most times you can pull their policies up on-line and look for Morbid Obesity. Good luck in your search.

So sorry to hear that....sometimes insurance companies will approve if you have some major co-morbidities that the doctor is going to treat by doing the surgery. I know in Charlotte, NC we have a doc that will do the band 15,900 and that includes the fills for the first year. Good luck in your search!!!!

Hey Joanne - The new bands are called Advance Platform. They have a small and a large. They are suppose to be better are preventing slippage. I know they have people in studies right now with them to get the data to support that. So we will see. You should be able to do a google search on it if you want to know more about it. :mad: Congrats on the new fill and you just might need a smidge more in a few weeks. Also Congrats on the 20pds lost!!!!

Those both sound good. Thanks for sharing!!!!

You look great!!!!! I am finally going to get my new do sometime this month. I like it and might have to take the picture to show my girl. Something simple is what I want and I really like it.