Tamihott

I was just contacted by my surgreons office on Friday, regarding the requirements for Lapband surgery. I was prepared for lots of work ie..psych appt 6 month dr weight loss even a nutrionist and 5 year history of morbid obesity, but she seemed discouraged already. She told me that if you go below the 40 BMI during that 5 year period you are automatically excluded. I was shocked and got onto the bcbsil website and read the medical policies on the srugery. It did not say that you could not drop below 40 BMI. I read it as they just wanted to make sure you had weight issues for years not just a short period of time. She continued to state in 2 1/2 years she had gotten only one approval from this particular insurance co. I was getting discouraged, then later in the conversation she proceeded to tell me that honestly when most people find out about all the guidelines and the 6 mo diet they choose to go the self pay route. I think if it is worth doing you have to put some work into it, and that is what my insurance is for! I pay good money for it and think it is worth a shot to get all my stuff together and submit it. I was really just wondering if there were any experiences with this insurance and what was the outcome. Thanks for any advice you have. Tamara

I would wait and go to your free seminar and ask all your questions then! I did call my insurance company first and find out if WLS was a covered benefit, but all the other visits that they require I am sure I would have a co-insurance and or a copay. They require the notes from you pcp if you have already started your 6 month supervised weight loss, they have to "check it and make sure it has the correct info in it". Good luck and I hope you fair better than I did! Tamara

I went for the free Lapband info night last night at LVH in Allentown. I knew I was in trouble when I entered the room and there was 50 plus people there! This was only an 1 and half hour event. The surgeon spoke who I thought to be lacking of any personality and was very brief on his explanations on this surgery! There was not enough time to answer all the questions, but he ended on time abrubtly, only to turn the floor over to the WL center manager. Who was morbidly obese and was preaching to us! It was weird. The topper is the requirements of even being condsidered for the surgery is a 6 month bunch of dr visits etc. I already have begun my 6 month of medically surpervised wl visits with my own pcp. They make you see their psychologists, there Bariatrician there nutrionist and there internist all the while billing and taking copays from you. Then they requre a 450. program fee due up front. They don't even call your insurance company to do a benefit verification! They ask you the layperson to get that info. So basically if you call your insurance company and you get the info wrong and you join the program and finish you very well may not even qualify. So you are out 450 and no surgery. They do not even promote losing much weight if any before surgery! I was very disappointed with this set up. I want a group focused on my well being and health and not soo much on my money! Many of us left very upset. Thanks for listening Tamara

Thanks! Good luck to you guys!

I just went for my first visit to get info and meet with the surgeon yesterday! The doctor is Dr Brian Boe. The hospital is Barix in Langhorne pa. Is very personable and informative. I was just wondering if anyone has had surgery there or by him, and what were your experiences? Thanks for any input.

I have an appt at Barix in Langhorne on the 23rd of this month. I am gland to know the experience was good!