kat72

aneffie, thank you so much for your response; it has greatly encouraged me. The dietician that I have been seeing has just giveb me the ok to make an appt. to see the surgeon (9-22) since I told him that my insurance told me that the lap band is not covered. He does not want me wasting my time. Jack, thanks so much for your info. as well. BTW Pacificare does cover RNY as well as vertical banding. I don't want RNY and I don't even think that vertical banding is performed anymore, not that I would want that either. I suggested that they updates their info. They were not too thrilled about that. I'll ask the surgeon about his experiences (if any) with pacificare HMO patients as far as coverage for the band. Once again, thanks to both of you for the info.

Jack, I live in San Diego, Ca. I do not have my members benefit book, but I sure requested that it be mailed to me a few days ago, so hopefully, it will be here any day now. Thanx so much for the info., and I will definitely keep you posted.

Im just having hard time with all this "its a tool" "slow weightloss" stuff. Ok here is my honest true heartfelt real deal. I was unable to control myself when it came to eating before and this is a tool but so was everything else-if I could do it myself then I would have-this is not making much difference in my behavior Im a food addict period. alatina, I understand what you are going through (even though I do not have the band yet). I somewhat feel the same about myself, that maybe the band will not work for me or maybe it will work too slowly, because I have issues with food. However, I want you to know that one of the things that is helping me right now is OA meetings. I started attending them a few weeks ago, and so far, they have been a GREAT source of support and encouragement. So you might want to look into attending a meeting or two (if you never have) to get an idea of how the program works. If you become interested and need or want any further info., just let me know. Take care.

Jack, thanx so much for the info. you've provided. I've been told by the insurance co. as well as Don Mills that I could have the surgeon recommend that I have the lap band and it is possible that it could be covered, but who knows? At this point I have not been able to get any other info. from the ins. co. concerning the lap band. They only cover RNY and vertcal banding. I am so confused, because if I can't get the lap band, then I will not be able to have weight loss surgery, because I am not big on all of the risks that are involved with RNY. If you have access to anyone else that I can speak to in Pacificare, please let me know. Thanx!

Aunny, I also live in San Diego! I am with Scripps through Pacificare, and there are two surgeons there that perform the lap band. Their names are Matthew Brunson and Sunil Bhoyrul, and the # that you can reach them at is (858) 554-8984. The office is located in Torrey Pines. I hope this helps. Let me know if you need any other info.

Thanx so much, flower.

Audrey, way to go!!! You give me (and so many others) encouragement and strength

I just wanted to know if anyone with Pacificare (HMO) has had the lap band surgery approved through this insurance. I called them and was told that only the RNY and the vertical banding are covered. I was just wondering if anyone has been successful in having them cover the band even though they say they do not.

lizrd--- Are you inquiring as to whether or not insurance companies will COVER the switch from lap to gastric bypass if a person doesn't lose weight with the band? Hey, lizrd, I'd like to know the answer to that one myself-WOULD the insurance co. cover a gastric bypass if the band was unsuccessful? Or does it depend on each person's individual insurance and/or circumstances? Just a lil' curious.

Crystalstar, I was just curious...My insurance co. did the same thing-about a month ago I was told that RNY as well as the lap band were covered. Well, I called back a couple of days ago (just to make sure), and was told that only the RNY and the vertical band were covered. My question to you is: were the benefits just not updated at Kaiser? Because as far as I know vertical banding is no longer performed in the US? Also, were you denied coverage and had to do an appeal? Or did you just call the insurance group and ask them to send you something in writing as to ahy the lap band was not covered? I wish you the best in pursuing your goal of having lap band ssurgery.

Penni, you brought tears to my eyes (seriously). This reminded me of an interview that Kim Cattrall did (when Sex In The City was really BIG). I think that she was going through a difficult time with the man in her life, but her girlfriends had really been there for her. I'll never forget what she said: "Friends come and go, but girlfriends (and sisters) are forever". I cried then, and I'm cryin' now, because it's so true! Thanx for the reminder.

Good for you!!!

Mellie, not a problem at all! Don Mills can be reached at 1-800-624-4261 ext.4546. He is the nicest person!!! He'll be more than happy to help you out. He told me that inamed will actually write an appeal letter for you (up to 3, I believe). I wish you all the best in your endeavors to get the band.

Anwyn thanx so much for the info. and encouragement.

I just wanted to know if anyone with Pacificare (HMO) has had the lap band surgery approved through this insurance. I called them and was told that only the RNY and the vertical banding are covered. I was just wondering if anyone has been successful in having them cover the band even though they say they do not.

Are PBs an ongoing thing experienced by bandsters forever, or is it something that is experienced only with new bandsters?

Thanx so much for the encouragement. I spoke to Don Mills today, and he told me to keep going through with the process. I have not seen the surgeon yet (hopefully soon). Don Mills basically told me that it may be possible that I will be approved if the surgeon does a good job of explaining why the band would be best for me as far as health issues go. This frightens me, because at this time, the only health issues I have are anemia and PCOS. Other than that, the only thing that prevents me from having RNY is the fact that I want to have children in the future. To me this is a BIG issue, but the ins. co. may not agree. I'm afraid that they will deny coverage. Don explained that if I am not covered, I could simply call the office and inamed would be more than happy to write an appeal letter for me (up to 3 times) free of charge. So, I'm trying to be more positive about things, but it's difficult.

Thanx so much for the info. i2candoit. I called my insurance co. today and was able to get a little bit more info. from a different gal. She told me that my doctor can put in a request for me to have a specific type of weight loss surgery done if he feels that it would be of better for me, even if it is not approved through my insurance, and it is possible that it would be approved. While this is not a guarantee, at least it's better than being told that I will not be covered at all for the lap band.

I just called my insurance carrier (Pacificare HMO) and found out that they cover RNY and vertical banding, but NOT the lap band. I haven't heard much about the vertical band. Does anyone out there have any info. about this procedure? Isn't this the stomach stapling thing? I thought that was done away with. Why would my insurance cover that and not the lap band, which seems safer? I am so upset, all I can see right now is red! Just when I had decided that the RNY was not for me, now I find out that it may be all that I can have done since I am not financially able to pay for lap band surgery on my own. I just feel like crying.

I just called my insurance carrier (Pacificare HMO) and found out that they cover RNY and vertical banding, but NOT the lap band. I haven't heard much about the vertical band. Does anyone out there have any info. about this procedure? Isn't this the stomach stapling thing? I thought that was done away with. Why would my insurance cover that and not the lap band, which seems safer? I am so upset, all I can see right now is red! Just when I had decided that the RNY was not for me, now I find out that it may be all that I can have done since I am not financially able to pay for lap band surgery on my own. I just feel like crying.

Well, I guess I should have dropped by this spot to introduce myself when I first joined this site about a week or two ago, but I was not really paying attention. Well, I live in San Diego, Ca. and I am hoping to have surgery ASAP (before the hollidays). I've had visits with nutritionists, therapists, and I've attended a couple of support group meetings as well as an orientation. They don't really do much for me, because most of the people have had the RNY done, so the discussion is mainly about THAT surgery. But I have to attend at least 2 support group meetings before I can even be considered for weightloss surgery. I have been a bit hesitant about getting the band, because I fear that I will not be successful with this particular tool. However, since joining this site, I have been a bit more positive as well as encouraged, but still afraid. I go in to see the nutritionist as well as the dietician next week, and I will be seeing the psychologist again on 9-9-05, and I will go from there. The two choices I have been given as far as weightloss surgeons are through Scripps Green in La Jolla /Torrey Pines: Dr. Sunil Bhoyrul and Dr. Brunson. I wanted Dr. Alan Whittgrove at Scripps Memorial, but, unfortunately, they do not take my insurance. If anyone out there is familiar with either of these surgeons, PLEASE let me know. Thanx so much.

I'm not banded yet, but the fears and feelings that you are having are the same ones that I am having right now. I went back and forth with not knowing if I should get the band or have the RNY for the longest time, because I knew that I was guaranteed to lose weight with RNY, but I just was not so sure about the band. I still have my doubts, because I have just never been able to successfully lose and keep off weight. However, since joining this site, I have been encouraged a GREAT deal by everyone here. They have encouraged me to go with the band. My thoughts toward the band have been so much more positive, and I am really hoping that I have made the right choice and that the band will work for me. So, you are not alone. Like myself, I am sure that you will find all kinds of support and encouragement right here that will aid in your success. We have to believe that we CAN do it! I wish you all the best with your surgery.

I'm not banded yet (hopefully I will be soon), but I usually go for sugar free over fat free. It's a personal decision. I agree with all of the ladies, don't beat yourself up over eating a sugar free treat. Instead tell yourself that there was a time that you would have eaten the sugar AND the fat!!! And let yourself feel good about the fact that you are making smarter eating decisions and habits. Congratulate yourself, you've taken a huge step in managing your health and your weight. Good for you! I hope you have a great vacation.

Well...I went to see my therapist today, and he seems to think that I am swaying more towards the band. So, he encouraged me to go with my 'gut'. I guess he could tell that I favored the band by my conversation with him. He also told me that he could probably put in for me to have my surgery earlier than expected after I told him that I've decided that I definitely will be having WLS, but waiting 6 months seems to be taking forever! I haven't even gotten to 1 month yet. I am scared and nervous, but all of your comments have really encouraged me to go through with this. For the longest time I have been so depressed, allowing myself to believe that I am in some way taking 'the easy way out', feeling like all I have to do is try harder at diet and exercise (even though I have been working my ass off for the past 10 years or so). I need help, and there is nothing wrong with that. You all are a true encouragement. Thanx so much, and take care of yourselves. By the way, BURNSUN, I work with children with special needs for a living, and I love it! And I'm happy to know that you still have your hair and teeth

To everyone who replied to my post, you all have no idea what your info. has meant to me. I know a few people who have had RNY and they seem to be doing OK, but I have been a bit skeptical about having that particular procedure done, just because it really does seem like such a drastic measure in such a short period of time, and whenever I hear about the risks, I get really, really afraid. Of course, the people I know who have had RNY are all prety much against the band. Whenever I have told one of them that my Dr. believes that the band may be a better route for me to take instead of RNY, they each have something negative to say about it (ie I can't imagine having a foriegn object in my body for the rest of my life; You could get a bad infection from that; You have to constantly get it adjusted; You have to start from the beginning each time you get adjusted; It takes so long for you to lose weight,...). These comments (and then some) were extremely discouraging for me. It's so good to hear positive things about the band. I am definitely going to keep up with my research. Once again, thanx soooo much for ALL of the GREAT info., and I hope all of you continue to keep up with your good work!